Pacific Blue Cross plan update
The Government of British Columbia and BC PharmaCare have announced the expansion of the use of biosimilars to create new opportunities for new drug listings. Coverage for the original biologic (originator) drugs Remicade, Enbrel, and Lantus, will be discontinued for affected patients, and coverage will instead be provided for their biosimilar. New drug listings will include Jardiance and Taltz.
Physicians have been informed that as of November 26, 2019, BC Pharmacare will no longer be covering originator drugs and they should transition patients to biosimilars. Physicians were asked to book an appointment with their patients to discuss the details.
The Rising Cost of Biologics
Across Canada, biologic drugs are a major contributor to healthcare costs increasing at an unsustainable rate. In 2017, Canada spent over $1.1 billion on Remicade alone – more than any other drug. With new drugs (including new biologics and innovative therapies) entering the market frequently, the cost pressures for Canada’s drug plans will only continue to increase.A solution to this challenge is already available: biosimilar version of originator drugs offer significant cost savings. Biosimilars offer significant cost savings to the health care system, which allows for improved access to drug therapies for more people who need them. Biosimilars also contribute to a healthy and competitive drug market in Canada, supporting diversification of drug products and manufacturers, as well as driving both demand and capacity for newer, better drugs.
How effective are Biosimilars?
Biosimilar drugs are designed to be as safe and effective as the originator drug, and to treat the same conditions. To be approved in Canada, a biosimilar must be proven to have the same chemical structure, be equally as safe, and have the same therapeutic effect as the originator. Studies must show that patients taking the biosimilar have the same outcomes as those taking the originator drug. If a Doctor feels that a transition is not medically appropriate, a special authority request for continued coverage of the originator drug can be submitted to BC Pharmacare. Requests will be reviewed on a case by case basis. Pacific Blue Cross will honour the results of the review.
For more information about biosimilars, including a list of frequently asked questions, please visit www.gov.bc.ca/biosimilars
The BC Government is also providing a patient support program available at no cost to Members to offer support through their switch to biosimilars. They can also visit pac.bluecross.ca or
call 1-877-722-2583 to speak with a local health benefits expert about their coverage.
People and Culture team
