British Columbia (BC) was the first Canadian province to stop coverage of originator biologicals and switch patients to biosimilars for certain indications in November 2019 [1]. This policy has resulted in significant benefits from its biosimilars initiative, achieving substantial cost savings that have been reinvested into BC PharmaCare for enhanced drug coverage.

Over five years, the province saved CAN$732 million by transitioning patients from high-cost biologics to affordable biosimilars. In 2023‒2024 alone, savings exceeded CAN$226 million, redirected to expand access to various medications and medical devices.

Improvements in coverage include:

• Continuous and flash glucose monitors
• Improved access to inhalers for chronic obstructive pulmonary disease
• Addition of dapagliflozin for type 2 diabetes and heart failure
• Expanded coverage for Trikafta to treat cystic fibrosis
• ADHD medications for patients over 19 years old

Health Canada regulates biosimilars, ensuring over a decade of proven safety and efficacy. Studies since the 2019 launch of BC’s Biosimilars Initiative show that patients transitioning to biosimilars experience health outcomes comparable to those on reference biologicals. The initiative's report confirms biosimilars' cost-effectiveness without compromising patient care. Monitoring metrics such as physician visits, emergency room visits, hospitalizations, and medication use indicate similar health outcomes for patients switching to biosimilars.

BC PharmaCare's pioneering effort in 2019 inspired 11 other Canadian jurisdictions to adopt similar initiatives, with over 40,000 individuals in BC making the switch by 2024. As of 13 June 2024, BC PharmaCare covers 33 biosimilars, including:

1. Infliximab (Inflectra, Renflexis, Avsola: for various inflammatory conditions
2. Filgrastim (Grastofil, Nypozi, Nivestym): for neutropenia
3. Etanercept (Brenzys, Erelzi): for arthritis and psoriasis
4. Insulin glargine (Basaglar, Semglee): for diabetes
5. Rituximab (Ruxience, Truxima, Riximyo): for autoimmune diseases
6. Adalimumab (Abrilada, Amgevita, Hadlima, Hulio, Hyrimoz, Idacio, Simlandi, Yuflyma): for inflammatory conditions
7. Insulin lispro (Admelog): for diabetes
8. Insulin aspart (Trurapi, Kirsty): for diabetes
9. Enoxaparin (Elonox, Elonox HP, Inclunox, Inclunox HP, Noromby, Noromby HP, Redesca, Redesca HP): for thromboembolism
10. Ustekinumab (Jamteki): for arthritis and psoriasis

This strategic move towards biosimilars has resulted in considerable cost savings, ensuring the sustainability and enhancement of BC’s public drug coverage system 

Related articles
Insurer perspective on increasing biosimilar uptake in Canada

Canada calls for support to national pharmacare and generics industry

British Columbia releases latest data on biosimilar switches

Reference
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 2024 Jun 19]. Available from: www.gabionline.net/policies-legislation/Canada-s-British-Columbia-to-switch-patients-to-biosimilars

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