Canada's BC will be first province to switch patients to biosimilars

Credit: REUTERS/Robert Galbraith

TORONTO, May 27 (Reuters) - The Canadian province of British Columbia said on Monday that its public drug plan will switch as many as 20,400 patients from three branded biologic drugs to cheap near-copies called biosimilars, saving an estimated C$96.6 million ($71.9 million)over three years.

The new policy from the province's PharmaCare program targets Janssen's JNJ.N Remicade and Amgen's AMGN.O Enbrel which treat arthritis, among other conditions, and Sanofi's SASY.PA long-acting insulin Lantus. It is the first of its kind in a Canadian public plan and could pave the way for similar programs across the country.

Biologic drugs are large molecules made using biological processes, and they tend to be expensive. Biosimilars work in the same way as biologics, making them appealing to governments grappling with how to pay for high-priced drugs. Unlike generics, however, biosimilars are not identical versions of the drug they are copying.

"Biosimilars are a necessary step to ensure PharmaCare provides existing coverage for more people and funds new drugs well into the future," said the British Columbia government in a statement.

In Canada, pharmacists cannot swap biosimilars in for their predecessors once patents expire, the way they can with generics. Doctors must specifically prescribe the biosimilar, and they have been slow to do that. European countries have been quicker to adopt the drugs.

Sanofi Canada said it was disappointed and regretted that BC "did not take the opportunity to find an alternative solution to preserve this treatment option." Janssen and Amgen did not immediately respond to requests for comment.

Canadian law says provincial governments must cover medically necessary care by doctors, including treatment in hospital, but prescription drugs are paid for through a patchwork of public and employer-based insurance plans.

While every province offers some drug coverage, it is often limited to the elderly or people with low incomes or exceedingly high drug costs. BC's system is unusual because it covers most residents, with deductibles based on income.

BC said patients with some types of arthritis, diabetes and plaque psoriasis would have until Nov. 25, 2019 to switch to a biosimilar. After that, original biologic drugs would only be covered for those indications under exceptional circumstances.

At the same time, BC announced that it would begin covering two newer biologic drugs: Boehringer Ingelheim and Eli Lilly's LLY.N Jardiance, a diabetes drug, and Eli Lilly's Taltz, which treats psoriatic arthritis.

The United States has also been slow to adopt biosimilars. Regulators have lagged Europe in approving the drugs, and a complex system of rebates offered to insurers by drugmakers has created barriers to use.

($1 = 1.3440 Canadian dollars)

(Reporting by Allison Martell, Editing by Rosalba O'Brien)

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