In 2019, British Columbia was the first province in Canada to initiate a biosimilar switching policy, stopping coverage of the originator biologicals etanercept (Enbrel) and infliximab (Remicade) and switching patients to biosimilar versions [1]. Since that time, the province has expanded the initiative to include other biologicals, including adalimumab (Humira) [2].

Recently, the Ministry of Health in British Columbia announced that it would be expanding its biosimilar switching programme to include rapid-acting insulins used in the treatment of diabetes. An estimated 497,000 people in British Columbia (almost 10% of the population) have diabetes, which has a direct cost to the province of CA$546 million each year.

From 30 November 2021, patients receiving originator insulin lispro (Humalog, Eli Lilly) and insulin aspart (NovoRapid, Novo Nordisk) in British Columbia will have six months to transition to biosimilar versions.

These will be Sanofi’s Admelog (insulin lispro) and Trurapi (insulin aspart). From 30 May 2022, PharmaCare (British Columbia's publicly funded programme for prescription drugs) will no longer cover the originator products.

The expansion is estimated to affect around 30,000 patients. Exceptions can be made in cases where a physician determines a patient is medically unable to switch to a biosimilar. Such requests will be reviewed by PharmaCare’s Special Authority branch on a case-by-case basis.

Minister of Health for British Columbia Adrian Dix said: ‘In British Columbia, we examine evidence thoroughly and have already seen great successes with our biosimilars initiative with patients transitioning safely to biosimilar drugs. Thanks to this initiative, we are able to save more money that can be reinvested in our PharmaCare program, which means expanded drug coverage for people’.

2020 data on the switching programme showed that 28% of patients with inflammatory bowel disease in British Columbia had already switched to a biosimilar version of their medication [3]. Several other Canadian provinces have also initiated biosimilar switching policies, including Alberta [4], Ontario [5] and, most recently, Quebec [6].

Related articles
Canadian provinces expand their use of biosimilars

Cost savings from the use of biosimilars in Canada

Praise for Canada’s BC after it adopts biosimilar transitioning policy

References
1. 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 Jan 14]. Available from: www.gabionline.net/policies-legislation/Canada-s-British-Columbia-to-switch-patients-to-biosimilars
2. GaBI Online - Generics and Biosimilars Initiative. British Columbia adds adalimumab to biosimilar switching programme [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Jan 14]. Available from: www.gabionline.net/biosimilars/general/british-columbia-adds-adalimumab-to-biosimilar-switching-programme
3. GaBI Online - Generics and Biosimilars Initiative. British Columbia releases latest data on biosimilar switches [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Jan 14]. Available from: www.gabionline.net/biosimilars/general/British-Columbia-releases-latest-data-on-biosimilar-switches
4. GaBI Online - Generics and Biosimilars Initiative. Alberta Biosimilars Initiative: switching policy updates in Canada [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Jan 14]. Available from: www.gabionline.net/biosimilars/general/Alberta-Biosimilars-Initiative-switching-policy-updates-in-Canada
5. GaBI Online - Generics and Biosimilars Initiative. Ontario becomes third Canadian province to switch patients to biosimilars [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Jan 14]. Available from: www.gabionline.net/biosimilars/general/Ontario-becomes-third-Canadian-province-to-switch-patients-to-biosimilars
6. GaBI Online - Generics and Biosimilars Initiative. Quebec announces biosimilar switching policy [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Jan 14]. Available from: www.gabionline.net/biosimilars/general/quebec-announces-biosimilar-switching-policy

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