A Patient-Focused Transition to Biosimilars in Ontario

Endorsed in:

May, 2023

Paper Type:

Position Paper

Authors:

Matthew T Lawrence (Western University)

Background:

In December 2022, the Government of Ontario announced that the current Ontario Health Insurance Plan (OHIP) will no longer cover specific biologic medications, only biosimilar medications, beginning on December 29th 2023. 1 The class of biologic medications are defined as being derived from a living source, such as cells or living organisms. This is compared to conventional small molecule drugs, which are created chemically. Common examples of biologics include growth hormones and insulin. One specific subset of biologic medications, also called biotherapeutics or biopharmaceuticals, are vastly complex molecules created to treat a number of autoimmune diseases including cancer, diabetes, blood disorders, rheumatoid/psoriatic arthritis, Crohn’s disease and ulcerative colitis, among others. 2,3 From hereon, “biologics” and “biologic medications” will refer to the latter examples. Due to their high cost, biologic medications are commonly being removed from provincial public formularies. These changes are forced upon patients and leave them with a reduced number of treatment modalities. The following position paper advocates for a patient-focused transition to lower-cost biologic medications, balancing patient-autonomy, and responsible healthcare spending.

Recommendations:

That the Government of Ontario alter their current policy before December 29th , 2023, to ensure that no patient currently prescribed a biologic medication, and is clinically stable, is forced to transition to a biosimilar.
That the Government of Ontario keep original biologic medications on the Ontario Drug Benefit formulary for second-line treatment after a patient has exhausted their biosimilar options.
That the Government of Ontario invest portion of the cost-savings from the switch from biologics to biosimilars into a) supplemented treatment for the affected populations (Diabetes, IBD, MS and RA) and b) a post-switch surveillance program.
That the OMSA explores student-led initiatives for equitable and universal pharmacare, beginning with advocating against forced biosimilar switching in Canada.