By Brent Delveaux
With pressure mounting on the Canadian health care system and insurance companies struggling to manage costs, everyone is looking for new ways to decrease spending. One consideration is to explore the possibility of switching to biosimilar drugs.
The Evolution of a Drug
New drugs and treatments go through an extensive process before finally becoming available to patients.
- A biologic drug is created through significant investment, research and technology, making many of them very expensive to use.
- A generic is the brand name’s bioequivalent, which means it contains identical medicinal ingredients. It costs less because the company that makes the generic doesn’t have to cover the research investment of the brand name. The patient can opt to choose the generic when he or she picks up the prescription at the pharmacy.
- A biosimilar is a drug made to mirror a brand name. Because it is from living organisms rather than static chemicals, a biosimilar is very similar – but not identical – to the brand name. An approved biosimilar has been proven to have the same effects and benefits as the original name brand, and can therefore be an effective alternative.
New Legislation
Recently, British Columbia adopted new legislation to encourage the use of certain biosimilars. By November 26, 2019, PharmaCare will cover only the biosimilar drugs –and not the biologic.
The targeted name biologic drugs – Enbrel, Remicade and Lantus – are costly drugs that give new life to patients with diseases such as arthritis, diabetes or Crohn’s disease.
Health care providers have hesitated to prescribe biosimilars for a number of reasons. First, someone living with a debilitating disease is understandably hesitant to stop an effective treatment. Second, although biosimilars are approved by Health Canada and proven to safely and effectively treat the symptoms or the disease, there is always a risk. Biosimilars are not considered bioequivalent to their biologic brand. If they do not react exactly the same way for each patient, they may not be interchangeable.
However, like a generic, a biosimilar is more cost effective than a name brand. But unlike a generic, a health care provider must actually prescribe the biosimilar rather than the brand name. This procedural requirement has made the uptake and adoption to biosimilars slow.
Furthermore, biosimilar usage has grown much more quickly in Europe where interchanging the biologic with the biosimilar is more widely accepted.
We are also starting to see some insurance companies react to the BC Pharmacare change by making similar biosimilar contractual changes to their drug programs.
Change can be hard, but biosimilar drugs can be an option, proven to help patients in need effectively – but without the hefty price tag. Part of facing the reality of rising health care costs means making responsible choices to protect the entire system.
Hub International’s team of brokers are constantly in touch with new trends and developments in healthcare and employee benefits, ensuring that our clients can access the information needed to make informed decisions.