Biosimilars FAQ for Patients

Biologic drugs are made using living organisms (e.g., yeast or animal cells) rather than being synthetically manufactured and are used to treat patients with serious chronic conditions.

When patents on biologics expire, other manufacturers may produce biosimilar drugs using a similar process and living organisms. Due to their complex structure, biosimilars are not identical to biologics but are highly similar and are tested to ensure no differences in health outcomes and safety.

Because biologic drugs are manufactured using living organisms with some inherent variability, there are also similar, very small differences between one batch of an originator drug and another. These differences, like those with a recognized biosimilar, are not clinically meaningful and every batch is tested to ensure safety and efficacy.

Although biologics help treat patients with serious diseases including some autoimmune diseases, they are complex drugs and can be very expensive and time consuming to develop. The biologic drugs being switched (Enbrel®, Remicade®, and Lantus®) represent some of the largest drug expenditures in B.C.

Since biosimilars are developed based on previous biologic work and require far less research and development, they are less expensive to produce, don’t compromise efficacy and safety, and offer major cost savings that can be reinvested into our healthcare system. A healthy and competitive drug market can support more manufacturers to produce new and affordable drugs.

Health Canada is responsible for ensuring the safety, efficacy, and quality of all new drugs including biologics and biosimilars. For a biosimilar drug to be approved in Canada, Health Canada must find no meaningful differences in safety and effectiveness compared to the biologic originator. The biosimilars involved in PharmaCare’s Biosimilars Initiative have been approved by Health Canada and are already in widespread use.

If you are covered by PharmaCare and you take Enbrel®, Remicade®, or Lantus® for the indications shown in the table below, you must switch to the biosimilar version of your medication before the end of the transition period (May 27 to November 25, 2019) to avoid any disruption to your coverage.

Drug Originator Biosimilar Indications Affected
insulin glargine Lantus ® Basaglar ™ Diabetes (Type 1 and 2)
etanercept Enbrel ® Brenzys ®

Ankylosing spondylitis

Rheumatoid arthritis
Erelzi ™

Ankylosing spondylitis

Psoriatic arthritis*

Rheumatoid arthritis
infliximab Remicade ®

Inflectra ®

Renflexis ®

Ankylosing spondylitis

Plaque psoriasis

Psoriatic arthritis

Rheumatoid arthritis

*Of the two etanercept biosimilars, only Erelzi is currently indicated for psoriatic arthritis.

If you take a biologic for a gastrointestinal condition like Crohn’s disease or ulcerative colitis, you may be affected by a subsequent phase of the Biosimilars Initiative. Talk to your gastroenterologist for more information.

Though a biosimilar is not identical to a biologic, there are no meaningful differences between them. The safety, efficacy, and similar health outcomes of biosimilars is evidenced by a large body of clinical study. 

Ask your prescriber about your biosimilar options.

The nocebo effect occurs when a patient’s negative expectations affect the treatment outcomes. A patient’s mindset can impact their symptoms and their sense of wellbeing. Factors that can contribute to experiencing the nocebo effect are: mental health issues, language barriers, use of online media as an information source, interactions with healthcare professionals and settings, etc.

To combat against a possible nocebo effect, you can:

  • Acknowledge the nocebo effect
  • Seek out more information on biosimilars (see Resources for Patients)
  • Speak to your pharmacist or doctor about the switch and discuss your biosimilar options
  • Stay informed about the switch process
  • Keep a neutral or positive outlook

There may be medical reasons why some patients cannot switch to a biosimilar. Your prescriber can help you determine if it is medically necessary to remain on an originator drug. They can submit a Special Authority request to ask PharmaCare to consider continued coverage of the originator drug.

As part of the biosimilar switch, you may have to go to a new infusion centre to receive your infliximab infusion. The patient support program for the biosimilar will help coordinate this change.

Many European nations have required that patients taking biologics under publicly funded coverage plans switch to biosimilars. These patients have been tracked and followed in many studies. The clinical trials and registry data findings are regularly reported at the European League Against Rheumatism (EULAR) and American College of Rheumatology (ACR) annual scientific meetings. There are now more than 75 research studies in rheumatology, gastroenterology, dermatology and other diseases, which collectively show no meaningful clinical differences between biosimilars and their biologic originators.

These studies also found that efficacy loss associated with switching to biosimilars was the same as is expected for patients who remain on the originator drug.

The Ministry of Health will be carefully monitoring drug usage, patient outcomes, and feedback from patients and healthcare practitioners both during and after the Biosimilars Initiative.

To minimize the impact of the Biosimilars Initiative, biosimilar manufacturers are providing patient support programs (PSP) and services, and access to infusion centres similar to that of the originator drug (see below). Your prescriber can initiate the enrolment process into a PSP for you, if applicable.


The Inflectra Patient Assistance Program provides support services and coordination with private payers and infusion centres for patients taking Inflectra®.

Phone 1 844 466-6627
Fax 1 844 295-0219
Hours Monday-Friday, 5AM to 5PM PST

B.C. Inflectra Navigators

Marlena Giordano
District Manager, B.C. and Ontario

Kelly Blumeschein
Inflectra Navigator, Kelowna and Kamloops

Rekha Singh
Inflectra Navigator, Vancouver and Lower Mainland

Jennifer Bayntun
Inflectra Navigator, Vancouver

Jennifer Paronen
Inflectra Navigator, Vancouver Island

Tel. 1 416 452-3464

Tel. 1 250 300-1313

Tel. 1 604 347-8815

Tel. 1 604 340-3795

Tel. 1 250 418-5549

Renflexis and Brenzys

The Merck Harmony® Patient Support Program provides support services, including coordination with private payers (for patients taking Renflexis or Brenzys) and infusion centres, for patients taking Renflexis. To enroll a patient, contact the Merck Harmony central number, and you will be directed to an assigned coordinator.

Phone 1 866 556-5663
Fax 1 866 240-4076
Hours Mon-Fri, 8AM to 8PM PST, Sat-Sun 12PM to 5PM PST

B.C. Patient Support Program Managers

Rose Wilbee

Baloo Dosanjh

Tel. 1 604 999-1164

Tel. 1 604 999-1173

B.C. Merck Harmony Coordinators

Bobbie Uppal

Kirk Chen

Beth-Anne Holbrook

Meghan Keenan

Tel. 1 289 295-0709

Tel. 1 289 295-0710

Tel. 1 289 295-0711

Tel. 1 289 295-0702


The Erelzi XPOSE® program provides support services, including self-injection training, for patients taking Erelzi™. Both the prescriber and patient must complete and sign an enrolment form to enroll in the program.

Phone 1 844 279-7673
Fax 1 866 872-5771
Hours Monday-Friday, 5AM to 5PM PST


Please talk to your insurer. PharmaCare does not maintain information on private insurance policies for biologics or any other prescription medications.