Recognizing that the evidence shows that biosimilars are just as safe and effective as their originator biologic counterparts, the British Columbia government announced on May 27, 2019, that BC PharmaCare is requiring that patients taking three biologic drugs – Enbrel®, Remicade®, and Lantus® – transition to biosimilars. The British Columbia health ministry’s goal is to improve the sustainability of the PharmaCare program and reduce costs – the shift to biosimilars is expected to save $96M over the first three years – as well as use the savings to add other new and/or expensive drugs to the PharmaCare formulary.
A two-phased transition…
Phase one will occur between May 27 and November 25. During this period:
- Rheumatology patients will transition from Enbrel to the biosimilar Brenzys® or Erelzi™
- Dermatology and rheumatology patients will transition from Remicade to the biosimilar Inflectra® or Renflexis®
- Endocrinology patients will transition from Lantus to the biosimilar Basaglar™
Patients have until November 25, 2019, to consult with their physicians to change their prescriptions to the applicable biosimilar. After that, PharmaCare will no longer provide coverage for these originator biologics for the affected indications, except in exceptional situations.
What does this mean for GSC plan members in British Columbia?
By November 25, 2019, all GSC plan members in British Columbia taking originator drugs for the listed conditions will be transitioned to the corresponding biosimilar in accordance with GSC’s provincial coordination policies. To ensure GSC is aligned with the provincial coverage, GSC is adapting our Biosimilar Transition Program for all plan members who are residents of British Columbia and are covered under the PharmaCare program.
GSC will be issuing letters to affected plan members in August advising them to discuss a transition to the biosimilar with their physicians before the November 25 deadline. If the drug is a BC Special Authority medication, the plan member will simply need a new prescription from their physician – they do not need to reapply for Special Authority. In addition, if PharmaCare grants an exception to allow someone to remain on the originator, GSC will follow suit, and pay for the originator as well. At this time, the focus of our program in British Columbia will be limited to individuals coordinating with PharmaCare.
This is what the Biosimilar Transition Program will look like in British Columbia:
What does this mean for your drug plan?
GSC’s adapted Biosimilar Transition Program will become standard for all plan members in British Columbia coordinating with PharmaCare effective November 26, 2019. We would urge that you also implement the optional GSC Biosimilar Transition Program in the other provinces and territories, which several GSC clients have done to good effect over the past two years.
Questions?
Don’t hesitate to speak to your account team about British Columbia’s biosimilar transition and its impact on GSC’s Biosimilar Transition Program and your plan.
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