A nine-month transition period will start on 31 March 2023 and patients taking a number of biological drug products will be required to consult their healthcare providers regarding their transition plan. Exceptions will be considered on a case-by-case basis. The named originator products that patients are to be switched from are: Copaxone®, Enbrel®, Humalog®, Humira®, Lantus®, NovoRapid®, Remicade®, and Rituxan®. The policy was first approved in 2020 [1].

Ontario joins British Columbia (BC) [2], Quebec [3], New Brunswick [4], Nova Scotia [5], the Northwest Territories [6] and Saskatchewan [7] in introducing biosimilars mandatory switching policies. These policies have been introduced in a bid to drive down healthcare costs across Canada wherein patients are switched from expensive originator products to lower-cost approved biosimilar versions of the drug. BC was first to introduce such a policy in May 2019 [1].

Sylvia Jones, Deputy Premier and Minister of Health noted, ‘Patients will continue receiving the same high-quality treatment, while allowing the government to fund more new drug therapies, bring innovation to the healthcare system and continue its work to deliver better, connected patient care’.

Despite the financial benefits of switching policies, some organizations, such as Crohn’s and Colitis Canada, Gastrointestinal Society, Diabetes Canada and the Institute for Optimizing Health Outcomes, have previously voiced concerns about non-medical switching of stable patients [1, 8].

‘While the Ontario announcement justifies the policy by citing 15 years of successful use of biosimilars in Europe, it is important to note that in nearly every European country physicians retain free choice between multiple reimbursed products and forced substitution is rare. A 2017 survey of 403 Canadian physicians revealed that Canadian physicians are generally opposed to forced substitution,’ according to Alliance for Safe Biologic Medicines.

Related articles
Low levels of biosimilar uptake in Canada

Law and ethics of switching to biosimilars in Canada

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

References
1. 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 2023 Jan 20]. Available from:
www.gabionline.net/biosimilars/general/Ontario-becomes-third-Canadian-province-to-switch-patients-to-biosimilars
2. 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 2023 Jan 20]. Available from:
www.gabionline.net/policies-legislation/Canada-s-British-Columbia-to-switch-patients-to-biosimilars
3. GaBI Online - Generics and Biosimilars Initiative. Quebec announces biosimilar switching policy [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2023 Jan 20]. Available from:
www.gabionline.net/biosimilars/general/quebec-announces-biosimilar-switching-policy
4. GaBI Online - Generics and Biosimilars Initiative. Canadian provinces expand their use of biosimilars [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2023 Jan 20]. Available from: www.gabionline.net/biosimilars/general/canadian-provinces-expand-their-use-of-biosimilars
5. GaBI Online - Generics and Biosimilars Initiative. Nova Scotia, Canada implements biosimilar switching policy [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2023 Jan 20]. Available from:
www.gabionline.net/biosimilars/general/nova-scotia-canada-implements-biosimilar-switching-policy
6. GaBI Online - Generics and Biosimilars Initiative. Northwest territories Canada announces biosimilars switching policy [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2023 Jan 20]. Available from: 
www.gabionline.net/biosimilars/general/northwest-territories-canada-announces-biosimilars-switching-policy
7. GaBI Online - Generics and Biosimilars Initiative. Canada’s Saskatchewan province introduces biosimilars switching policy [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2023 Jan 20]. Available from: 
www.gabionline.net/biosimilars/general/canada-s-saskatchewan-province-introduces-biosimilars-switching-policy
8. GaBI Online - Generics and Biosimilars Initiative. Concerns raised as Canada’s Alberta plans to switch patients to biosimilars [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2023 Jan 20]. Available from: www.gabionline.net/policies-legislation/Concerns-raised-as-Canada-s-Alberta-plans-to-switch-patients-to-biosimilars

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