Advocates warn move to biosimilar drugs under new N.B. plan could affect patients

Click to play video: 'As N.B. expands biosimilar drug coverage, Crohn’s and Colitis Canada asks for delay' As N.B. expands biosimilar drug coverage, Crohn’s and Colitis Canada asks for delay
Crohn's and Colitis Canada is asking the New Brunswick government to delay – and rethink – a proposed switch to cheaper drug coverage for patients living with inflammatory bowel disease (IBD). The province says the move can be made safely and effectively for about 3,000 patients with arthritis, IBD, and psoriasis. And while Crohn's and Colitis Canada admits the risk is low, it says caution is needed. Callum Smith reports. – Nov 11, 2021

New Brunswicker Joleen DeGrace, 43, was diagnosed with Crohn’s Disease in 2004.

The inflammatory illness causes her immune system to attack her bowel.

Being off on medical leave for the past three years, she says it’s had a major impact on her life.

“Especially when I’m in a flare-up or not feeling well. I have missed appointments, I’ve missed work, I’m in the hospital quite a bit of times,” DeGrace tells Global News. “If I’m in a flare-up, I’m there two-to-three weeks at a time, it affects how I’ve eaten over the years, it affects how I plan my day-to-day living.”

The New Brunswick government’s deadline to cover originator biologic drugs is looming, but she says the move might not work well for everyone.

Read more: B.C. government becomes first Canadian jurisdiction to shift to cheaper biosimilar drugs

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DeGrace takes Stelara, a newer biologic that doesn’t have a biosimilar available so she won’t be directly impacted, says she’s had to shuffle through several biologics to find what works.

“I’ve been on all the biologics over the years,” she says. “I’m on pretty much the last one that’s available at the moment for me.”

As announced back in April, the New Brunswick Drug plan will cover biosimilars and no longer cover the more-expensive biologics as of Nov. 30.

“Increasing the use of biosimilars is expected to save over $10 million once fully implemented and the savings will increase as more biosimilars become available,” Health Minister Dorothy Shephard said in a news release in April.

“Biosimilars have been proven to work just as safely and effectively as biologic drugs. Savings from increasing their utilization will be reinvested to support coverage of new therapies and improve patient access to more medications.”

According to the province, biologic drug spending “makes up some of [New Brunswick’s] largest drug expenditures.”
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It says the cost grew by 19 per cent in 2019-2020, up to $63.8-million.

Read more: ‘Every month is a scramble’: B.C family pleads for coverage of son’s $8K drug bill

The Department of Health said it consulted with physicians and there are about 3,000 people covered under the province’s drug plan living with diseases such as inflammatory arthritis, inflammatory bowel disease, diabetes and psoriasis that will need to make the switch.

But Crohn’s and Colitis Canada is asking the government to delay the move until after the pandemic and cautions it could be a difficult transition for some.

While acknowledging it’s a “low risk” move, Dr. Eric Benchimol, the organization’s chair of the scientific and medical advisory council, says one in 11 patients switching from biologics to biosimilars “will experience more symptoms.”

“I think what’s not being accounted for in that number of savings of millions of dollars, is firstly obviously stress on the patient,” he says, “but that strain and that anxiety that the patient feels is also resulting in more health-care visits and potentially more emergency room visits and hospitalizations.”

He worries about potentially sending immunosuppressed patients to an already-overwhelmed health-care system.

Read more: Opposition NDP urges Alberta government not to switch drugs for some patients

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“I think it is important that we are able to continue to fund our public health-care system,” he says. “These drugs are very expensive and these drugs are costing a lot of money to each and every province.”

“Patients and health-care providers can have confidence that biosimilars are effective and safe for each of their authorized indications,” a statement from Health Canada’s website says.

“No differences are expected in efficacy and safety following a change in routine use between a biosimilar and its reference biologic drug in an authorized indication.”

But Benchimol says that “there are some patients where it’s not a good idea to switch, that it’s not worth rocking the boat” altogether.

The province says exceptional coverage may be requested for those deemed medically unable to switch.

Alberta and B.C. have made similar moves.

Patients starting a drug under Nova Scotia Pharmacare plans would only be approved for biosimilar versions, but a spokesperson says patients can remain with the innovator brand if already prescribed.

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