British Columbia’s biosimilars policy a turning point for private plans

B.C.’s Biosimilars Initiative has had a profound impact on private drug plans. By the end of 2020, biosimilars’ share of costs among biologic reference drugs had more than quadrupled to 69% for private plans. This is a significant increase from 15% in May 2019 when the government first announced its program, according to TELUS Health claims data for private drug plans. This suggests sizable savings, given that biosimilars are priced 20% to 50% lower than the reference biologic.

“Even though it is a policy that applies only to public plan claims, it appears that private plans are following suit,” said Shawn O’Brien, Principal, Data Enablement and HBM Product, TELUS Health, while presenting the Data Trends and National Benchmarks Retrospective 2020 report during day one of the TELUS Health annual conference on April 20.

B.C.’s pharmacare program likely motivated private drug plans to adopt its own switching policy, to avoid having to take on the full cost of a reference biologic for patients who turn to their private plan for coverage.

Changes in prescribing behaviour is another important factor behind biosimilars’ growing share of the private claims for biologics. “The public initiative in B.C. has influenced physician prescribing habits for all patients, and we can likely expect the same result in other provinces as other public payers implement switching policies,” noted O’Brien in a separate interview with the TELUS Health Benefits Hub.

Interestingly, a ripple effect already appears to have begun in the rest of Canada, as biosimilars’ share of eligible costs in private drug plans increased to 11% by the end of 2019 (from 8% in May) and 13% by the end of 2020, reported O’Brien at the conference.

Private plans can expect the uptake of biosimilars to accelerate across Canada for two reasons:

1. The implementation of switching policies in other provinces. Alberta’s Biosimilar Initiative, affecting six reference biologic drugs so far (compared to the initial four in B.C.), went into effect in January 2021. Similarly, New Brunswick recently announced their switching policies affecting six reference biologic drugs, with a transition period between April 21, 2021-November 30, 2021. While Saskatchewan announced its switching policy for Enbrel, effective March 1, 2021. Ontario had announced a switching policy in March 2020; however, the implementation has been delayed due to the COVID-19 pandemic.
2. Up to six biosimilars may launch in Canada this year, after a two-year drought for private drug plans. This includes the first biosimilar options for the reference biologic, Humira, which ranks second on TELUS Health’s list of top drugs by eligible cost. The top drug is Remicade, a biologic with three biosimilar options, all of which are included in the switching programs in B.C. and Alberta. More details on the biosimilars for Humira can be found in TELUS Health’s The Drug Pipeline: What private plans can expect in 2021.