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Opposition party in Alberta, Canada fights biosimilar switching policy Posted 03/04/2020

The opposition New Democratic Party (NDP) in Alberta, Canada has urged the province not to force patients to switch to biosimilars, citing concerns about patient safety.

After the province of British Columbia decided to stop the coverage of some originator biologicals and instead switch patients to biosimilars in May 2019 [1], Alberta followed suit [2].

The office of Alberta’s Health Minister Tyler Shandro announced in December 2019 that 26,000 patients receiving provincially funded biologicals would be switched to biosimilars by 1 July 2020.

The decision applies to seven biosimilars (Brenzys, Erelzi, Glatect, Grastofil, Inflectra, Lapelga and Renflexis) which are used to treat conditions including rheumatoid arthritis, diabetes, inflammatory bowel disease and low white blood cell count.

The move was motivated by cost, with the province’s spending on biologicals increasing from around CA$20 million per year to more than CA$200 million per year in the past decade. Biologicals represent almost 20% of the government’s total spending on drugs, despite meeting the needs of less than 2% of patients. The province hopes to save up to CA$380 million over the next four years by switching patients to biosimilars.

NDP Opposition leader David Shepherd however says this could cause complications or setbacks for patients. He agrees the government should introduce patients to biosimilars; but said the government should not make the change mandatory.

‘It’s important to introduce biosimilars (to new patients)’, he said. ‘I recognize that there are indeed costs that we need to reckon with, and I think it’s reasonable for government to move forward. My disagreement is with the manner in which it is moving forward … chaotic, rushed, not thought through, not considering long-term potential consequences.’

Concerns have been shared by patients and the charity Crohn’s and Colitis Canada, which says the switch could lead to adverse reactions in some patients. Further concerns have been raised by an academic team from the University of Calgary in Alberta [3], who argued that the quality of evidence on switching is low.

However, Health Minister Shandro said keeping patients on biologicals is unnecessary, adding: ‘There is no scientific evidence that switching to biosimilars puts patients at added risk; there is overwhelming evidence that biosimilars are clinically equivalent to biologics.’

The switching programme does not apply to privately paying’ patients, pregnant women or children. Patients are also able to apply for medical exemption if supported by a physician review board.

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Law and ethics of switching to biosimilars in Canada

References
1. GaBI Online - Generics and Biosimilars Initiative. Canada’s British Columbia to switch patients to biosimilars [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2020 Apr 3]. Available from: www.gabionline.net/Policies-Legislation/Canada-s-British-Columbia-to-switch-patients-to-biosimilars
2. GaBI Online - Generics and Biosimilars Initiative. Concerns raised as Canada’s Alberta plans to switch patients to biosimilars [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2020 Apr 3]. Available from: www.gabionline.net/Policies-Legislation/Concerns-raised-as-Canada-s-Alberta-plans-to-switch-patients-to-biosimilars
3. GaBI Online - Generics and Biosimilars Initiative. Arguments against Alberta’s plans to switch patients to biosimilars www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2020 Apr 3]. Available from: www.gabionline.net/Biosimilars/Research/Arguments-against-Alberta-s-plans-to-switch-patients-to-biosimilars

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