A Biosimilar is a biologic that comes to market after the originator drug.
A Biosimilar is a Health Canada-approved medicine that has the same positive health outcomes for patients as the originator, but at a significantly lower cost. A biologic originator is the first one of its kind into the market and is initially manufactured by a single pharmaceutical company that holds a patent for the drug for a specified number of years. At the end of the originator’s patent life, other companies are allowed to produce their own version of the drug which enters the marketplace as a biosimilar. Unlike conventional generic drug products, which can be interchanged at the pharmacy, a biosimilar is treated like a new drug due to the complicated development and manufacturing process. This means a new prescription from the prescriber is required.
What is the Biosimilar New Start Program?
The New Start program lists biosimilars as preferred products under all formularies. Under this standard program, for all patients newly starting biologic therapy, the benefit plan covers only biosimilars (if one exists) and allows originator products only in exceptional circumstances.
What is the Biosimilar Transition Program?
This highly effective program helps plan members currently taking one of the impacted originator biologic drugs to transition to the corresponding biosimilar product. This program applies in all provinces and territories excluding Quebec.
Here’s how the optional Biosimilar Transition Program works:
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Plan members eligible for the transition are identified.
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A letter is sent to each impacted plan member advising them that a biosimilar is now available for their originator biologic drug and reimbursement is changing within 90 days.
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The plan member is given the choice of remaining on the originator product or transitioning to the biosimilar medication. For plan members who choose to remain on the originator biologic drug, the plan will reimburse the cost of the biosimilar, and the plan member will be responsible for the difference in cost.
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The plan member is provided with a contact number for a patient-support nurse who will assist them with the transition process and reach out to their physician should they choose that option.