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INSIGHTS: Oncology Biosimilars

This week, the Canadian Institute for Health Information (CIHI) released its report on Prescribed Drug Spending in Canada, 2018.  Among the data and insights contained in this report, CIHI pointed out that uptake of biosimilars in Canada has been modest, accounting for only 2.4% of claims and 1.4% of spending in the limited areas where they are available – primarily rheumatology and gastroenterology.

This discussion began changing in April 2018 when Health Canada approved a biosimilar of bevacizumab – Canada’s first oncology therapeutic biosimilar.  As more and more cancer patients are treated with biologic medicines – and there are more and more oncology biosimilars poised to enter the market here – Canada’s oncology treatment landscape is headed for massive change.

Looking to better understand how best to optimize the potential of this coming wave of oncology biosimilars, Santis recently conducted 40 interviews with policymakers, oncologists, hospital pharmacists and patient group leaders across the country.  This project was conducted with the financial support of Amgen Canada, but its findings and conclusions are our own.

Those conversations – and the insights, challenges and opportunities they generated – led us to 5 key recommendations:

  1. ACT NOW.
    We heard a palpable excitement about the impact that oncology therapeutic biosimilars will have on the budgets of ministries of health, cancer agencies and hospitals.  However, there was an explicit understanding that the clock was ticking on preparations for these drugs.  As a result, stakeholders need to move quickly – and together – to leverage the period of time before the anticipated wave of oncology therapeutic biosimilars arrive in the Canadian market.
    From Health Canada and pCODR to CAPCA and pCPA, there are multiple pan-Canadian and federal organizations with important roles to play in catalyzing a robust, sustainable market for oncology therapeutic biosimilars.  Against this backdrop, provincial payers and policymakers should focus on working with – and through – these pan-Canadian and federal organizations to simultaneously accelerate multiple provincial markets.
    With the introduction of oncology therapeutic biosimilars, many clinicians and patient groups would benefit from a new suite of education and awareness materials. This campaign should centre around three distinct goals: (1) building confidence in the biosimilars development process; (2) highlighting the robustness of Health Canada’s regulatory approvals process; and (3) sharing the growing body of real world evidence of biosimilar safety and efficacy across Europe and in other jurisdictions.
    For many of the clinicians and patient groups we spoke with, support for biosimilars is directly linked to the ability and willingness of payers to redirect the ensuing savings to accelerating or expanding access to new oncology treatments. Payers and policymakers need to work with their respective Ministries of Health and Finance to find a way to channel the savings from oncology therapeutic biosimilars into new or expanded listings of innovative cancer medicines.
    Rather than imposing a single, top-down “one size fits all” solution, payers should design provincial implementation processes and protocols in close consultation with the leading cancer centres in each jurisdiction.

The arrival of oncology therapeutic biosimilars will have significant implications for patients, physicians, pharmacists and payers.  They have the ability to not only ease the strain on over-burdened cancer drug systems, but also offer faster and expanded access to more patients.  As our research showed, optimizing the use of these drugs will only be possible through collective and collaborative effort that unites hospitals, payers and policymakers and – most importantly – clinicians and patients.

For more information on this research – and to download a copy of the White Paper and accompanying summary – please visit: