Pangaea Express: Green Shield Canada's New Biosimilar Policy

March 9, 2018

Green Shield Canada is ramping up their biosimilar policy with the announcement of their new biosimilar transition program to move patients from their originator biologic to the biosimilar. Back in 2016 they listed biosimilars as their preferred product under their formularies, but only required coverage of the biosimilar for new starts. Those already taking an originator biologic were grandfathered in. Well, this is now changing.

The program will initially focus on medications, Remicade and Enbrel for the conditions of rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. Members who are currently taking one of these drugs will receive a letter asking them to discuss with their physician whether they choose to move to the biosimilar and receive full coverage or to continue with their originator biologic and pay the difference in price. This new biosimilar transition program will be implemented as a pilot project for some plan sponsors in the first half of 2018 with plans to roll it out to more broadly by the end of the year. As well, more drugs will be added in the future.

Interesting that Green Shield is using the word "transitioning" and not "switching". It denotes a softer, subtler message that doesn't imply changing one's medication but just adjusting it slightly! Also noteworthy is the fact that the insurer is engaging the patient directly and putting the onus in them to discuss with their doctor.

For more information, please contact Marla Weingarten at mweingarten@pangaea-consultants.com.