P.E.I.'s move to biosimilar drugs will save money — but is there a cost?

Some of the biosimilar versions that P.E.I. is beginning to use, including two different versions of insulin at the left.  (Laura Meader/CBC - image credit)
Some of the biosimilar versions that P.E.I. is beginning to use, including two different versions of insulin at the left. (Laura Meader/CBC - image credit)

Some advocacy groups are wondering what the P.E.I. government's change to a cheaper variety of medications over the next year will mean for patients covered by provincial prescription plans.

The drugs are known as biosimilars, and they are said to be very much like the original brand-name biologic drugs they will replace in the province's pharmacare coverage.

Researchers are creating biosimilar forms as the patents on the original brand-name drugs expire, much like generic versions of drugs will eventually replace the well-known originals.

"As defined by Health Canada, biologic drugs come from living organisms or from their cells," the province said in a recent news release about the change. "Examples of biologic drugs include insulin, growth hormones and antibodies. Biologic drugs are generally larger and more complex in composition than chemically produced pharmaceutical drugs."

P.E.I. is among a number of Canadian provinces moving to the cheaper biosimilar forms, with Island health managers hoping to save about $1.5 million a year.

"Biosimilars are less expensive than the original, but they are reviewed by Health Canada to ensure they work in the same way as the reference biologic drugs and are equally effective," the provincial news release said.

Kilby Rinco of Health P.E.I. says biosimilar drugs have been used around the world for 10 or 20 years and have proven to be as safe as the original biologic versions.
Kilby Rinco of Health P.E.I. says biosimilar drugs have been used around the world for 10 or 20 years and have proven to be as safe as the original biologic versions.

Kilby Rinco of Health P.E.I. says biosimilar drugs have been used around the world for 10 or 20 years and have proven to be as safe as the original biologic versions. (Shane Hennessey/CBC)

Kilby Rinco is the director of pharmacy services for Health P.E.I.

"Worldwide, biosimilars have been used in other countries with very highly effective health systems for many, many years — 10, 20 years," she said in an interview. "These are very effective and very safe."

As the changeover occurs, she said pregnant patients will not have to switch from what they have been using, but exemptions are probably unlikely for other patients.

The first biosimilars to be prescribed in P.E.I. will treat a variety of conditions, including diabetes, arthritis and Crohn's disease.

Patrick Tohill, the advocacy and government affairs director with Crohn's and Colitis Canada, told CBC News that the group has some concerns about the switch.

Crohn's and Colitis Canada is worried that some patients who have struggled to find an appropriate medication will experience flare-ups because of the change to biosimilars, says advocacy and government affairs director Patrick Tohill.
Crohn's and Colitis Canada is worried that some patients who have struggled to find an appropriate medication will experience flare-ups because of the change to biosimilars, says advocacy and government affairs director Patrick Tohill.

Crohn's and Colitis Canada is worried that some patients who have struggled to find an appropriate medication will experience flare-ups because of the change to biosimilars, says advocacy and government affairs director Patrick Tohill. (Laura Meader/CBC)

He said some high-risk patients have struggled for years to find the right medication, and they fear being compelled to change medications could lead to flare ups.

"We would hope that we could create some exemptions for the small number of patients who might have the worst impacts — negative impacts — as a result of the switch," he said.

The group points out that the change might not save governments money if patients end up needing more health care as a result of such complications.

A close-up look at Basaglar, a biosimilar type of long-acting injectable insulin.
A close-up look at Basaglar, a biosimilar type of long-acting injectable insulin.

A close-up look at Basaglar, a biosimilar type of long-acting injectable insulin. (Laura Meader/CBC)

The senior manager for policy at Diabetes Canada wishes patients had more choice about the switch, but Laura Hoffe agrees that biosimilar insulins are safe and effective.

"For the majority of people, I think it's a welcome change," she said.

"They won't really recognize that they will be on a different form of insulin. It will not impact the quality of care or the effectiveness of their insulin treatment."

But Health P.E.I. said the agency has done its homework, and the change will free up money to go into other services.

"We have all of the safety data; we know that the switch has not affected or impacted most patients when they do switch," Rinco said, adding: "I understand that it's very challenging for people to change. It's very anxiety-inducing."