The Northwest Territories (NWT) has become the fifth jurisdiction in Canada to implement a biosimilars switching policy. The policy begins from 21 December 2021 and includes 10 biologicals.
             
            
                                    
                                
Canada is leading the way in biosimilar policy, with several provinces initiating switching policies to increase biosimilar use, including British Columbia [1], Alberta [2], Ontario [3], and Quebec [4].
NWT, a territory with a population of around 45,000 people, has now become the fifth Canadian jurisdiction – and the first territorial government – to announce a biosimilars switching policy.
From 21 December 2021, NWT residents will have a six-month period to switch from originator biologicals to a biosimilar version. After this time (20 June 2022), coverage under the Extended Health Benefit and Métis Health Benefit Program will be prioritized to biosimilar drugs only, unless an Exception Request is approved for medical reasons.
The programme includes 10 biologicals for a range of health conditions including arthritis, diabetes and inflammatory bowel disease, see Table 1.
| Table 1: List of originator biologicals their biosimilar versions included under the NWT biosimilar switching policy | 
| Active ingredient | Originator biological | Biosimilar | Indications | 
| Adalimumab | Humira® | Amgevita® Hadlima®
 Hulio®
 Hyrimoz®
 Idacio®
 | Ankylosing spondylitis Crohn’s disease
 Hidradenitis suppurativa
 Plaque psoriasis
 Polyarticular juvenile idiopathic arthritis
 Psoriatic arthritis
 Rheumatoid arthritis
 Ulcerative colitis
 Non-infectious uveitis
 | 
| Enoxaparin | Lovenox® | Inclunox® Noromby®
 Redesca®
 | Thromboembolic disorders | 
| Etanercept | Enbrel® | Brenzys® Erelzi®
 | Ankylosing spondylitis Plaque psoriasis
 Psoriatic arthritis
 Polyarticular juvenile idiopathic arthritis
 Rheumatoid arthritis
 | 
| Infliximab | Remicade® | Inflectra® Renflexis®
 Avsola®
 | Ankylosing spondylitis Plaque psoriasis
 Psoriatic arthritis
 Rheumatoid arthritis
 Crohn’s disease
 Ulcerative colitis
 | 
| Insulin glargine | Lantus® | Basaglar® | Diabetes | 
| Insulin lispro | Humalog® | Admelog® | Diabetes | 
| Insulin aspart | NovoRapid® | Trurapi® | Diabetes | 
| Filgrastim | Neupogen® | Grastofil® Nivestym®
 | Neutropenia | 
| Pegfilgrastim | Neulasta® | Lapelga® Fulphila®
 Nyvepria®
 Ziextenzo®
 | Neutropenia | 
| Rituximab | Rituxan® | Truxima® Riximyo®
 Ruxience®
 Riabni®
 | Rheumatoid arthritis Vasculitis
 Autoimmune diseases
 | 
| Glatiramer | Copaxone® | Glatect® | Multiple sclerosis | 
 
The NWT Government hopes the initiative will optimize the use of public resources and reduce spending. Supplementary health benefit programme spending on biological drugs in the Territories increased by 17.6% between 2020 and 2021, reaching CA$2.8 million.
Jim Keon, President of Biosimilars Canada – the association representing biosimilars manufacturers in the country – congratulated the NWT Government on implementing a switching policy. He said: ‘Biosimilars Canada and its member companies look forward to working with the Government of the Northwest Territories to ensure the successful implementation of its biosimilars switching policy’.
Adding: ‘It is time for all provincial and territorial governments to follow the lead of the Northwest Territories and four provinces in bringing the benefits of biosimilar switching programs to their patients, healthcare providers and taxpayers’.
Related articles
British Columbia expands biosimilar switching programme to include insulin
Canadian provinces expand their use of biosimilars
British Columbia adds adalimumab to biosimilar switching programme
  
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 2022 Feb 4]. Available from: www.gabionline.net/policies-legislation/Canada-s-British-Columbia-to-switch-patients-to-biosimilars 
2. GaBI Online - Generics and Biosimilars Initiative. Alberta Biosimilars Initiative: switching policy updates in Canada [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Feb 4]. Available from: www.gabionline.net/biosimilars/general/Alberta-Biosimilars-Initiative-switching-policy-updates-in-Canada 
3. GaBI Online - Generics and Biosimilars Initiative. Ontario becomes third Canadian province to switch patients to biosimilars [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Feb 4]. Available from: www.gabionline.net/biosimilars/general/Ontario-becomes-third-Canadian-province-to-switch-patients-to-biosimilars 
4. GaBI Online - Generics and Biosimilars Initiative. Quebec announces biosimilar switching policy [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2022 Feb 4]. Available from: www.gabionline.net/biosimilars/general/Quebec-announces-biosimilar-switching-policy
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                            Source: The Government of Northwest Territories
                        
                     
                             
                            
                
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