In a bid to drive down healthcare costs, biosimilars switching policies have been adopted 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, stopping coverage of originator biologicals and switching patients to biosimilars for certain indications [1].

As biological drugs are relatively expensive products, they contribute significantly to rising drug plan expenditures throughout Canada. For example, in Saskatchewan in 2018, just over 35% of the drug expenditure was made on biologicals, despite these accounting for only just over 3% of total drug claims. 

The biosimilars initiative in Saskatchewan by the Ministry of Health will include 10 medications for treatment of conditions including arthritis, diabetes, inflammatory bowel disease, and psoriasis, that are covered by the Saskatchewan Drug Plan, along with additional products as biosimilars become available. An estimated 24,000 existing patients already receiving an original biological drug are expected to transition to a biosimilar version by 30 April 2023. Exemptions will be considered for those who cannot use a biosimilar for a medical reason and prescribers will be able to submit a request and supply clinical rationale for review on a case-by-case basis. All patients starting on a biological drug will only be offered the listed biosimilar(s).

The Saskatchewan transition to biosimilars is expected to be complete by 1 May 2023 and the Ministry of Health estimates that following this, the province could see annual savings of approximately CA$20 million. 

Paul Merriman, health minister of Saskatchewan, noted, ‘This initiative will ensure access to high-quality, essential medications for Saskatchewan residents remains sustainable into the future…. The savings will be reinvested into the Saskatchewan Drug Plan to support patient access to public drug coverage and new drug benefits’.

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 [3, 4, 7]. Specifically, they called for a slower more considered approach to switching, as it was reported that patients were fearful due to a lack of information, lack of consultation, lack of education and a lack of research on what happens when being switched.

Related articles
Biosimilar infliximab uptake in Canada

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. Nova Scotia, Canada implements biosimilar switching policy [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Nov 4]. Available from: www.gabionline.net/biosimilars/general/nova-scotia-canada-implements-biosimilar-switching-policy
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 Nov 4]. Available from: www.gabionline.net/Biosimilars/General/British-Columbia-adds-adalimumab-to-biosimilar-switching-programme
3. 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 Nov 4]. Available from: www.gabionline.net/biosimilars/general/Ontario-becomes-third-Canadian-province-to-switch-patients-to-biosimilars
4. GaBI Online - Generics and Biosimilars Initiative. Concerns over Canada’s New Brunswick transition to biosimilars[www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Nov 4]. Available from:  www.gabionline.net/biosimilars/general/concerns-over-canada-s-new-brunswick-transition-to-biosimilars
5. GaBI Online - Generics and Biosimilars Initiative. Quebec announces biosimilar switching policy [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Nov 4]. Available from: www.gabionline.net/biosimilars/general/quebec-announces-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 2022 Nov 4]. Available from:  www.gabionline.net/biosimilars/general/northwest-territories-canada-announces-biosimilars-switching-policy
7. 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 2022 Nov 4]. Available from:  www.gabionline.net/policies-legislation/Concerns-raised-as-Canada-s-Alberta-plans-to-switch-patients-to-biosimilars

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