Transition to biosimilars: Ontario follows suit
Like most other Canadian provinces1, Ontario announced last December that it was expanding the use of biosimilar drugs2.
As a result, Ontarians covered by the public program for certain biologic drugs will be required to transition to their biosimilar version by the end of 2023.
Following this announcement, iA Financial Group continues to roll out its biosimilar transition program in Ontario. In fact, we will now be deploying it in all Canadian provinces.
As a result, all plan members treated with a targeted biologic drug who have not yet made the transition to the biosimilar version will receive a communication from iA Financial Group.
Reimbursement policies for reference biologics
We will modulate reimbursement for reference biologics according to your plan parameters.
Widely used in drug plans, the lowest price policy3 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.
|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 the member is encouraged to switch to a biosimilar.
|Managed list (for example, list corresponding to the provincial list)
|Only listed biosimilars will be reimbursed.
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 British Columbia, Alberta, Northwest Territories, Saskatchewan, Quebec, New Brunswick, Nova Scotia.
2 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 that has been shown to be similar to a reference biologic drug.
3 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.