Switch to biosimilar drugs may save N.S. millions of dollars

The provincial government is changing the way it purchases one class of drugs to save the Nova Scotia Pharmacare program millions of dollars per year. 

"We spend, right now, over $44 million a year on biologics. And by moving forward with the switch to the biosimilars, we're expected to save about $13 million a year," said Natalie Borden, senior executive director of client service and contract administration with the Department of Health and Wellness. 

Drugs known as biologics contain complex molecules derived from living sources such as yeast cells. They can be used to treat conditions from Crohn's disease to diabetes and arthritis.

But biologics are expensive when they first come to market.

And Mina Tadrous, a professor of pharmacy and drug safety expert at the University of Toronto, said the growth in biologics is stretching provincial health budgets due to a "very steep price tag."

"More and more of these biologics are taking up a larger piece of the pie," Tadrous said. "It's important to think of solutions that don't hurt patients, but at the same time maintain access, but reduce costs." 

The rise of biosimilars

The solution is to switch to drugs called biosimilars.

When the patents for popular biologics expire, smaller companies create biosimilars by figuring out new ways to produce the drugs.

According to Borden, this can lower costs by up to 60 per cent.

Tadrous said Denmark was the first country to commit to buying biosimilars as a cost-saving measure.

He said British Columbia was the first Canadian province to try it in 2018, and found no negative effect on patients. Tadrous said other provinces were "waiting for other folks to jump in the pool" with biosimilars. 

"Once you started seeing other provinces do it, and they had seamless experiences, and there were no adverse signals both in safety and efficacy, I think it gave confidence," he said. 

Arthritis Society support

The executive director of the Arthritis Society in Atlantic Canada thinks switching to biosimilars is a good idea.

Jone Mitchell said the Nova Scotia government listened to the society's recommendations, adopting a year-long transition period and an appeal process to allow practitioners to advocate for alternative drugs.

"We were really, really pleased to see it. We've worked with a few of the provinces, British Columbia, Alberta, Quebec and New Brunswick, that have already implemented their biosimilar policy," she said. 

The Department of Health and Wellness said roughly 4,000 Pharmacare patients are already using biosimilar drugs. 

Another 5,000 patients will make the switch in the coming year.

Borden said all savings will stay within the Pharmacare program.

"The money that we'll save will really allow us to fund more drugs and to expand the benefits in the services of the Pharmacare program," Borden said.