On March 31, 2023, the Province of Ontario started its expansion of the use of biosimilar drug treatments for Ontarians. Ontario Drug Benefit (OBD) recipients who are on an originator biologic will begin to transition to a Health Canada-approved biosimilar version of the drug. The transition period will be from March 31, 2023 to December 29, 2023.
Originator Biologics vs. Biosimilars
Biologics are medicines made from substances found in living things instead of synthetically manufactured drugs. Biologics are used to treat a variety of diseases, such as immune system disorders and diabetes.
A biosimilar biologic drug is a highly similar but generally less expensive version of an originator biologic drug. They are not exactly the same as the originator biologics but undergo rigorous testing to ensure they are as safe and effective as the originator biologic drugs. Biosimilar drugs are akin to the generic version of a manufactured drug.
Why the Change?
Biosimilars cost anywhere from 25 to 50% less than the originator biologics, and despite their safe use and efficacy (as determined by Health Canada), Canada only has a use rate of 8%. In comparison, other jurisdictions have a 50-95% use rate, with European countries like Hungry, Greece, and Germany leading the way. Ontario is not the first province, with biosimilars being available in British Columbia, Alberta, New Brunswick, Quebec, Nova Scotia, Saskatchewan, and the Northwest Territories. More recently, Newfoundland and Labrador, and the Yukon also announced the implementation of biosimilar switching policies.
Expanding the use of biosimilar drugs will allow patients to receive the same treatment but save the government significant expense. The Ontario government plans to use those savings to “fund more new drug therapies, bring innovation to the health care system and continue its work to deliver better, connected patient care.”
Key Information for Health Care Providers
Health Canada recommends that the transition from an originator biologic to a biosimilar start with discussions by the prescriber with the patient. For this reason, the Ministry of Health has introduced aBiosimilar Support Fee to recognize the efforts required to contact and support patients through the transition to a biosimilar. In cases where the transition fails, a physician may need to assist a patient with the process of applying for a medically necessary exemption.
Pharmacists will not be able to adapt prescriptions to biosimilars. However, pharmacists may need to educate Ontario Drug Benefit recipients when they fill their new prescription for a biosimilar.
TheMinistry of Health has indicated that treatment-experienced, stable patients using an originator biologic for some time may need more support in the transition to treatment-naïve patients. The Ministry of Health has identified critical information that healthcare providers should know and relay to patients, including that biosimilars:
NOTE: Our blog post is not intended to be legal advice. Please contact us to see if we may be able to assist you.
To learn more about Wise Health Law and our services, please contact us!