On 23 March 2022, the Government of British Columbia announced PharmaCare coverage for three new enoxaparin biosimilars.

Enoxaparin is an anticoagulant (blood thinner) used to treat and prevent blood clots including deep vein thrombosis and pulmonary embolisms. It is given by injection and can also be used in the case of heart attack.

The originator drug, Lovenox, is manufactured by Sanofi-Aventis and is a limited coverage drug in British Columbia. It is used for: preventing venous thromboembolism (VTE); as a bridge to oral blood thinners; and as a replacement to oral blood thinners when they fail in treating non-cancer related VTEs.

As of 22 March 2022, PharmaCare approvals for enoxaparin will be for eligible biosimilars only, and Lovenox will no longer be covered for new approvals. The new enoxaparin biosimilars included in the coverage are: Redesca (Valeo Pharma) [1], Noromby (Juno Pharmaceuticals), and Inclunox (Sandoz) [2].

Patients with a current prescription for Lovenox however will not need to switch, as enoxaparin is usually used for less than six months, so existing patients will be able to continue with the originator treatment until the end of their prescription.

The change will also affect patients receiving treatment for cancer-associated thrombosis. It means cancer patients will now be able to access enoxaparin, as well as the blood thinners dalteparin and tinzaparin, without having to first trial warfarin.

Adrian Dix, Minister of Health for British Columbia, commented on the news saying: ‘Our government’s biosimilars program continues to help people in B.C. save money by accessing more treatment options that are less expensive than the originator drug and are just as effective. The new biosimilars we are announcing will be of great assistance to those who develop blood clots, which can be deadly’.

British Columbia’s biosimilar switching policy has been in place since 2019 [3] and has recently been expanded to include insulin [4] and adalimumab [5].

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Biosimilars of enoxaparin sodium

References
1. GaBI Online - Generics and Biosimilars Initiative. Canada approves heparin biosimilars Redesca and Redesca HP [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Apr 15]. Available from: www.gabionline.net/biosimilars/news/Canada-approves-heparin-biosimilars-Redesca-and-Redesca-HP
2. GaBI Online - Generics and Biosimilars Initiative. Canada approves enoxaparin biosimilars Inclunox and Noromby [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Apr 15]. Available from: www.gabionline.net/biosimilars/news/Canada-approves-enoxaparin-biosimilars-Inclunox-and-Noromby
3. GaBI Online - Generics and Biosimilars Initiative. Canada’s British Columbia to switch patients to biosimilars [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Apr 15]. Available from: www.gabionline.net/policies-legislation/Canada-s-British-Columbia-to-switch-patients-to-biosimilars
4. GaBI Online - Generics and Biosimilars Initiative. British Columbia expands biosimilar switching programme to include insulin [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Apr 15]. Available from: www.gabionline.net/biosimilars/general/british-columbia-expands-biosimilar-switching-programme-to-include-insulin
5. GaBI Online - Generics and Biosimilars Initiative. British Columbia expands biosimilar switching programme to include insulin [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Apr 15]. Available from: www.gabionline.net/biosimilars/general/british-columbia-expands-biosimilar-switching-programme-to-include-insulin

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