Green Shield Canada (GSC), a not-for-profit health benefits company that offers employee group health benefits that supplement government-sponsored provincial health plans, has announced a new program to switch patients to biosimilar therapies.
Green Shield Canada (GSC), a not-for-profit health benefits company that offers employee group health benefits that supplement government-sponsored provincial health plans, has announced a new program to switch patients to biosimilar therapies.
Beginning in 2016, GSC began to prefer available biosimilars and follow-ons (which it then referred to as “subsequent-entry biologics”) on its formulary, and required patients initiating treatment to use these preferred products. GSC’s next effort is to implement a “biosimilar transition program” in which patients already receiving originator biologics will switch to biosimilars.
“The evidence has rapidly accumulated over the last [2] years, and it is all pointing in the same direction: patients can safely transition from an originator biologic to a biosimilar product with no loss of clinical benefit and no compromise in safety,” said the payer in a statement.
The program will initially apply to a select group of plans for patients with rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis who are currently receiving branded etanercept (Enbrel) and infliximab (Remicade). As more biosimilars and more indications are approved, and as evidence on the feasibility of switching accumulates, the plan will increase the number of drugs and indications eligible for the transition program.
To help ensure a successful switch, the GSC says that it will use a “strong support system” that includes a dedicated team of care-coordinator nurses to help guide patients through the process, and news of the switch will be communicated to patients via a letter that outlines their options. First, patients may choose to undertake the switch after having discussed it with their provider. Second, they may choose to continue on their current treatment and pay the difference in costs between the biosimilar and the reference starting 60 days after the date of the letter. No claims for originator biologics will be denied; all claims will be paid based on the price of the biosimilar.
GSC has long been vocal in its calls for private payers in Canada to make greater use of biosimilars for the purpose of cost containment. In a statement in September 2017, the payer said that, though it has just 7% market share in Canada, due to its policy of beginning new starts on biosimilars, it generated 37% of claims for biosimilar infliximab (Inflectra) in the private market.
The payer has called on fellow companies to stop “signing up for the easy deals” in contracts with reference product sponsors to secure formulary placement. “We’re hoping to see more of our friends in the industry join us to support building a viable biosimilar market in Canada through forward-looking strategies. We did it for generics last decade, so we can do it again.”
Exploring the Biosimilar Horizon: Julie Reed's Predictions for 2024
February 18th 2024On this episode of Not So Different, Julie Reed, executive director of the Biosimilars Forum, returns to discuss her predictions for the biosimilar industry for 2024 and beyond as well as the impact that the Forum's 4 new members will have on the organization's mission.
The 6 Key Policy Factors to Ensure Biosimilar Market Sustainability
April 16th 2024Magnus Bodin, senior director and head of international access and policy at Biogen, presented warning signs for unsustainable biosimilar markets as well as key factors needed to create effective policies and future-proof biosimilar markets globally.
A New Chapter: How 2023 Will Shape the US Biosimilar Space for 2024 and Beyond
December 31st 2023On this episode of Not So Different, Cencora's Brian Biehn and Corey Ford take a look back at major policy and regulatory advancements in 2023 and how these changes will alter the space going forward.
Global Biosimilar Market Projected to Reach $1.3 Trillion by 2032
April 11th 2024The global biosimilar market is projected to surge from $25.1 billion in 2022 to approximately $1.3 trillion by 2032, with a compound annual growth rate of 17.6%, driven mainly by the increasing prevalence of cancer and the cost-effectiveness of biosimilars, as outlined in a report by Towards Healthcare.
Biosimilars Council: PBM Rebate Schemes Cost Americans, Payers $6 Billion
April 10th 2024A report from the Biosimilars Council evaluating IQVIA data found that rebate schemes orchestrated by pharmacy benefit managers (PBMs) are costing US patients and payers billions of dollars by suppressing biosimilar adoption.