Ontario Begins Biosimilar Switching Policy

Over 2 years after a cabinet vote to establish a biosimilar switching policy, the Ontario government is putting one in place, making it the seventh province and eighth jurisdiction in Canada to do so.

Ontario, Canada’s public health plan announced that it will finally establish a biosimilar switching policy. The measure comes after the province’s cabinet voted to implement a measure in 2020.

The province joins sixth others (Saskatchewan, British Columbia, Quebec, Alberta, New Brunswick, Nova Scotia) and 1 jurisdiction (Northwest Territories). Saskatchewan announced its biosimilar switching policy in October 2022.

The Ontario Drug Benefit (ODB) is the largest drug plan in Canada, accounting for about 40% of public drug spending in the country. Ontario is the province that is home to the nation’s capital (Ottowa) and its most populated city (Toronto). The measure also comes after Biosimilars Canada, a national association representing the biosimilar industry in Canada, held a press conference to pressure Premier Doug Ford’s administration to implement a biosimilar switching policy in October 2022.

Sylvia Jones, Ontario’s Health Minister, confirmed that the transition to biosimilars will enable Ontario to invest more money in new drug treatments and continue to grow its roster of publicly funded medications.

“Biosimilars Canada and its member companies congratulate Minister Jones and the Government of Ontario for moving ahead with a biosimilars switching policy, and remain committed to working with the government, specialists, and other stakeholders to ensure the smooth transition to biosimilars for Ontarians,” commented Jim Keon, president of Biosimilars Canada, in a statement praising the decision.

Under the program, patients who are either beginning or currently taking certain reference biologics will be switched to a biosimilar instead. For now, the program will primarily focus on reference biologics to treat chronic conditions, such as arthritis, diabetes, inflammatory bowel disease, and psoriasis. The transition period will begin March 31, 2023, and end December 29, 2023, during which providers will inform, educate, and facilitate their patients on medication changes.

Patients who are being administered Copaxone, Enbrel (etanercept), Humalog (insulin lispro), Humira (adalimumab), Lantus (insulin glargine), NovoRapid (insulin aspart), Remicade (infliximab), and Rituxan (rituximab) will be required to transition to a biosimilar or pay out-of-pocket for the reference product.

The Ontario government said that exemptions to the program will be considered for patients in “certain clinical circumstances on a case-by-case basis in consultation with their health care provider.”

Kelsey Cheyne, executive director, Canadian Digestive Health Foundation (CDHF), commented in Ontario’s statement saying, “Both biologics and biosimilars have gone through rigorous standards for authorization by Health Canada, to which both have been found safe and effective for use in [IBD]. CDHF knows having to change any kind of medication can be very stressful. While we believe in patient-physician choice, we acknowledge political policy decisions and our organization is committed to providing clear and unbiased information on biosimilars.”

Cheryl Koehn, founder and president of the Arthritis Consumer Experts, continued, saying that she hopes that the success from other Canadian provinces will make patients feel confident about the safety of switching to biosimilars and the government’s commitment to reinvesting the savings into the health care system, especially at a time when resourced to maintain and improve patient care are urgently needed.

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