The New Brunswick government is following the lead of other jurisdictions and expanding its use of biosimilar drugs to improve the sustainability of public drug plans, Health Minister Dorothy Shephard announced Wednesday.
Biosimilars are "highly similar," but less expensive versions of originator biologic drugs that are produced once the patent on the first versions expire, according to a news release.
About 3,000 patients with diseases such as arthritis, diabetes, inflammatory bowel disease and psoriasis, who are currently taking originator biologics, have until Nov. 30 to switch to a biosimilar.
After that, the plans will no longer provide coverage for the originator biologics. Only those whose physicians determine they are "medically unable" to switch to a biosimilar may request "exceptional coverage."
The move is expected to save more than $10 million once fully implemented and the savings are expected to increase as more biosimilars become available.
"Biosimilars have been proven to work just as safely and effectively as biologic drugs," said Shephard.
And the savings will be reinvested to support coverage of new therapies and improve patient access to more medications, she said.
Biosimilars are just as safe and effective as the originator versions. - Mark MacMillan, gastroenterologist
British Columbia and Alberta have implemented similar policies over the past two years, safely switching tens of thousands of patients in each province to biosimilars, according to the news release.
In Europe, some countries have had more than 15 years of experience with biosimilars.
Dr. Mark MacMillan, a gastroenterologist at the Dr. Everett Chalmers Regional Hospital and assistant clinical professor at Dalhousie University and Memorial University, thinks the switch "makes sense."
"Biosimilars are just as safe and effective as the originator versions, as demonstrated by the experiences in British Columbia, Alberta and Europe," he's quoted as saying in the government release.
Biologics are drugs made in, taken from or partly-made from living cells through a complex manufacturing process.
Like generic drugs, biosimilars become available after the patent on the originator biologic drug expires.
A generic drug is a chemically manufactured drug that is "an exact copy of the original drug," according to the Arthritis Society's website. "This is possible because the active ingredients in common medications are easy to duplicate," it states, citing as an example acetaminophen in a drug store brand of pain reliever being exactly the same as the acetaminophen found in the brand name product.
"In contrast, biosimilars are highly similar but not identical to the original biologic. This is because of their large size and complicated structure, and the specialized biological steps needed to make them."
Support of stakeholders
The Department of Health consulted with a number of stakeholders about making the switch and received support from prescribers and patient groups, such as Arthritis Consumer Experts, Arthritis Research Canada, Arthritis Society and the Canadian Digestive Health Foundation, according to the release.
"The transition to a biosimilar can take place safely under the right conditions, improve access to treatment while also providing savings that can be reinvested into expanded health care," Jone Mitchell, executive director of the Atlantic Region Arthritis Society, is quoted as saying.
"The Arthritis Society's priority is to ensure that people living with arthritis have access to the life-changing treatments and information they need. We are supportive of the New Brunswick government's biosimilars initiative announced today and look forward to working with them to ensure that this transition is seamless for patients and puts their needs and experiences front and centre."
Biologics cost nearly $64M in 2019-20
Biologic drugs make up some of the province's largest drug expenditures, and their costs are growing, Department of Health figures show.
In 2019-20, government spending on biologic drugs grew by 19 per cent to $63.8 million. In the same year, biologic drugs accounted for 29.4 per cent of drug costs but only represented 1.5 per cent of the total number of prescriptions paid.
The province's plans provide subsidized drug coverage for about 135,000 people. In 2019-20, the province invested about $220 million in these drug plans.