Ontario to swap original brand-name drugs with cheaper ‘biosimilar’ drugs for seniors, people on social assistance

Ontario is moving more seniors and people on social assistance from original brand-name drugs for conditions like inflammatory bowel disease to cheaper “biosimilar” drugs despite concerns the switch could throw some patients off track.

Health Minister Sylvia Jones announced the change for Ontario Drug Benefit plan recipients Tuesday, saying biosimilars are “safe and effective” alternatives that will create financial room for the province to fund “more new drug therapies.”

Her office would not say how much money is being saved.

The transition will begin March 31 with patients required to be on biosimilar drugs by the end of 2023. Drug plan recipients on the medications involved have chronic health conditions such as rheumatoid arthritis and diabetes.

“Exemptions will be considered for patients in certain clinical circumstances on a case-by-case basis in consultation with their health-care provider,” the government said in a statement.

Several other provinces have already made the switch to biosimilars, which are copies of the original drugs — but not identical. They undergo a “robust and rigorous approval process” by Health Canada, the statement added.

Representing people with inflammatory bowel disease, Crohn’s and Colitis Canada has been fighting the switch for years, arguing the differences between original drugs and biosimilars can cause “adverse effects” in patients who have previously been stable.

“This decision is concerning for Ontarians living with inflammatory bowel disease (IBD) and (our organization) commits to working with the government in order to minimize adverse effects on Ontarians with IBD in every way possible,” the organization said in a statement Tuesday.

It called the change a “non-medical switch” of medications and pledged to work with the government “to identify high-risk groups that should be exempted or delayed from being included.”

Thousands of patients who take the brand-name drugs Humira, Remicade, Copaxone, Enbrel, Humalog, Lantus, NovoRapid and Rituxan will be switched to biologics under the Ontario Drug Benefit, the largest public drug plan in the country. It covers about 5,000 medications.

“Patients are encouraged to discuss a transition plan with their health-care provider,” the Ministry of Health said.

Since 2019, British Columbia, Alberta, Saskatchewan, Quebec, Nova Scotia and the Northwest Territories have made the change to biologics, which are made with living organisms rather than being synthetically manufactured.

“Biosimilars are biologic drugs that enter the market after the patents or data protection rights for the original biologic expire, having similar effectiveness, safety and quality,” the ministry statement said.

The switch to biosimilars will “encourage companies to bring more cost-saving medicines to market,” said Jim Keon, president of Biosimilars Canada, a national association representing manufacturers.

Original biologic drugs can cost $10,000 to $25,000 more per patient per year, straining the budgets of public drug plans, Keon added.

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