Pangaea Express: Alberta Next Up with a Biosimilars Initiative
Alberta just announced their Biosimilar Initiative that will take effect July 1, 2020. This initiative stretches beyond that of B.C. to include all the following reference biologic drugs: ENBREL, REMICADE, LANTUS, NEUPOGEN, NEULASTA, and COPAXONE (a non-biologic complex drug). All patients over the age of 18 years must switch to a biosimilar. With respect to REMICADE, this includes all the various indications (Ankylosing Spondylitis, Plaque Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Crohn's Disease, Ulcerative Colitis). Alberta’s initiative to mandate switching to a biosimilar will affect approximately 26,000 patients and is expected to save the province between $227 million and $380 million over the next 4 years.
This was not a surprise as rumblings about Alberta taking the biosimilars plunge had been circulating for a few months. Interesting that they include COPAXONE in their initiative.
Many gastroenterologists and patient groups are not happy with the required switch to biosimilars for GI conditions. This past November 2019, the Association of Gastroenterology and Crohn’s Colitis Canada issued a joint position statement on biosimilars for the treatment of inflammatory bowel disease, “We recommend against nonmedical switching from originator infliximab to biosimilar in patients who have stable IBD and are doing well on the original product. This is a weak recommendation based on very low-quality evidence but data suggest that switching in this setting leads to an increased risk of worsening of disease, dose escalation and/or switching to an alternative therapy.”(1)