B.C. Introduces Long-Awaited Biosimilars Switching Policy

Province’s Move Could Have Implications Across the Country

British Columbia’s Minister of Health, Adrian Dix, announced a series of policy changes yesterday designed to reduce the cost of biologic drugs and expand access to new medicines. These goals will be accomplished through the “Biosimilars Initiative,” a policy framework unveiled Monday morning that will transition most of the 20,000+ patients in B.C. currently receiving an originator biologic medicine to one of its biosimilars.

The Key Details

  • BC will begin switching patients immediately and should be finished in 6-8 months. Patients with diabetes, rheumatoid arthritis, psoriatic arthritis, plaque psoriasis and ankylosing spondylitis will have six months “to work with their health-care team to transition their prescription from the [originator] biologic to the biosimilar drug by November 25, 2019.” Patients suffering from gastroenterology diseases like Crohn’s and ulcerative colitis will begin their transition period this summer.
  • BC expects to garner ~$100M in savings over the next 3 years. The B.C. announcement notes that the province is planning for $96.9M in saving over the first 3 years of the Initiative, savings that “will be redirected to support additional drug listings and patient coverage.”
  • B.C. is already announcing new and expanded drug listings as a result of the ensuing savings from greater use of biosimilars. B.C. announced its decision to list the diabetes drug JARDIANCE and the psoriatic arthritis drug TALTZ on its provincial formulary – while broadening coverage for a number of additional arthritis drugs.
  • Exceptions will be available on a case-by-case basis. B.C has assembled physician-lead advisory committees which will review requests for exceptions, and who are likely to grandfather a small number of patients in unique circumstances. However, B.C. Pharmacare clearly intends that the majority of patients will complete their transition before the end of the year.

What This Means

We see 3 key takeaways from B.C.’s move:

  1. A Determination to Fix a Broken Market. The province’s move comes as uptake of biosimilars across the country has stalled, leaving Canada lagging virtually every country in Europe when it comes to biosimilar uptake. Minister Dix made a point to call out countries where the biosimilar market share for infliximab is greater than 80% – including Norway (98%), the United Kingdom (90%) and Scotland (85%).
  2. A Willingness to Push the Pharma Policy Envelope. B.C. has historically been the province most willing to embrace wide-ranging policy reforms aimed at reducing prices. Yesterday’s decision is very much in keeping with that tradition.
  3. A Commitment to pan-Canadian Leadership. Although B.C. also has no problem moving first, or on their own, we believe a number of other Canadian provinces are closely watching B.C.’s move – and now that the Biosimilars Initiative has been rolled out – we will be carefully monitoring who is most interested in the “How To” guide Dix & Co. are furiously writing.

The Bottom Line

The decision by the Government of British Columbia to implement a biosimilars switching policy is one of the most significant pharmaceutical policy reform announcements in the past decade. If B.C. can successfully navigate the next 6 months of patient transitions, and recoup the ensuing savings, the province will have laid out a path to accelerated cost savings that every other Canadian province will be hard-pressed not to follow.