Biosimilars: rollout of the transition campaign for plan members
As announced last August, we are pleased to inform you that our transition campaign for group insurance plan members who use reference biologics is underway. At this time, this campaign is only targeted at provinces where a biosimilars transition policy is in place:
|― British Columbia||― Quebec|
|― Alberta||― New Brunswick|
Over the next few weeks, all plan members residing in the above-mentioned provinces and treated with a biologic drug for which a biosimilar1 drug is available will receive a communication from iA Financial Group.
This personalized communication will inform them about biosimilar drugs and the benefits of switching to them. It will also include specific details regarding reimbursement of their biologic drug, based on the parameters of their group insurance plan.
Reimbursement policies for reference biologics
Reimbursement for reference biologics will be modulated according to your plan parameters.
Widely used in drug plans, the lowest price policy2 will be applied to reference biologics when it is included in the plan parameters. In these cases, a plan member who wishes to continue treatment with the reference biologic, rather than switching to the biosimilar, will be able to do so. However, the reimbursement of the biologic will be limited to the price of the lowest priced corresponding biosimilar.
Examples according to plan parameters
|Parameters||Personalized communications||Impact on reimbursement of the biologic drug|
|Lowest price policy included||✓||Reimbursement of the reference biologic will be limited to the price of the lowest priced corresponding biosimilar.|
|Lowest price policy not included||✓||No impact on reimbursement, but member is encouraged to switch to a biosimilar.|
|Managed list (for example: list corresponding to the provincial list)||✓||Only listed biosimilars will be reimbursed.|
The application of the lowest price policy for reference biologics will take place by province on the following dates:
|― Quebec: April 13, 2022|
|― British Columbia, Alberta and New Brunswick: 6 months after the communication is sent to the plan member (by mail)|
With the increased availability of several biosimilar drugs in recent months and the implementation of policies promoting the use of biosimilars in several provinces, it was appropriate to implement such an initiative to demystify and optimize the use of biosimilar drugs among plan members.
In addition to being less expensive than reference biologics, biosimilar drugs offer additional options to plan members and therefore facilitate access to certain treatments. Furthermore, biosimilar drugs are comparable to biologics and there are no clinically significant differences in efficacy and safety between the two.
In terms of drug management, this campaign is part of our vision to support the sustainability of drug plans while ensuring plan members’ physical and mental health through continuing access to an excellent drug plan.
If you have any questions, please contact your advisor or your iA Financial Group Account Executive.
1 A biosimilar drug is a drug that has been authorized for market by Health Canada after the patent of the reference biologic drug (the brand name product) has expired, and has been shown to be similar to a reference biologic drug.
2 The lowest price policy is the one used to limit reimbursement of brand-name drugs to the cost of the lowest priced generic drug (commonly referred to as "generic substitution"). Although biosimilar drugs are not generic drugs, the same policy will apply.