In May 2019, the Canadian province of British Columbia introduced a policy of switching rheumatology patients to biosimilars [1]. Soon after, the province of Alberta also announced that it was considering plans to stop coverage of originator biologicals and switch patients to biosimilars for certain indications. The new policy, when introduced, would apply to the approximately 30,000 patients in Alberta living with inflammatory bowel disease (IBD) [2].

However, concerns were raised in Alberta about the safety of such a policy to switch patients stable on their current treatment and in fact Canadian gastroenterologist associations do not recommend non-medical switching for such patients [3].

The deadline for patients in Alberta to switch to biosimilars was the 1 July 2020. However, the province has now said that the deadline for patients taking a biological to switch to a biosimilar has been changed from 1 July 2020 to 15 January 2021.

Under Alberta’s government sponsored drug plan, biologicals cost more than CA$238 million in 2018‒19 fiscal year; and are going up an average 16.2% per year. The originator biologicals Remicade (infliximab), Humira (adalimumab) and Enbrel (etanercept) are three of the top four drivers of drug spending in Alberta.

The province believes that switching to biosimilars will save between CA$227 million and CA$380 million over the next four years once fully implemented. These savings, according to the province, ‘can be invested into other healthcare services for Albertans’.

The switch will affect not only patients using Enbrel, Humira and Remicade, but also patients using Lantus (insulin glargine) for diabetes and Neulasta (pegfilgrastim) for neutropenia [an abnormally low concentration of neutrophils (a type of white blood cell) in the blood]. In addition, the province also intends to switch patients using Copaxone (glatiramer), which is a non-biological complex drug, for multiple sclerosis.

Related articles
British Columbia releases latest data on biosimilar switches

Opposition party in Alberta, Canada fights biosimilar switching policy

Ontario becomes third Canadian province to switch patients to biosimilars

References
1. GaBI Online - Generics and Biosimilars Initiative. Law and ethics of switching to biosimilars in Canada [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2020 Apr 24]. Available from: www.gabionline.net/Biosimilars/Research/Law-and-ethics-of-switching-to-biosimilars-in-Canada
2. 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 2020 Apr 24]. Available from: www.gabionline.net/Policies-Legislation/Concerns-raised-as-Canada-s-Alberta-plans-to-switch-patients-to-biosimilars
3. GaBI Online - Generics and Biosimilars Initiative. Canadian gastroenterologists issue biosimilar position statement [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2020 Apr 24]. Available from: www.gabionline.net/Biosimilars/General/Canadian-gastroenterologists-issue-biosimilar-position-statement

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