Should government have a say in what drugs are prescribed to patients? André Picard
2019-12-17 from theglobeandmail.com
In Norway, 98 per cent of patients with conditions such as rheumatoid arthritis, Crohn’s disease or ulcerative colitis are treated with infliximab, a biosimilar.
In Canada, only 8 per cent of patients with those same conditions receive a biosimilar; the vast majority get an expensive originator biologic, sold under the brand name Remicade. Why?
The short version is that Norway pays far more attention to getting value for money for its public drug spending than Canada. They also don’t fall for the marketing bumpf about brand-name biologics somehow being magically better than biosimilars. Research has shown, time and time again, that they are “highly similar.”
With biologics now accounting for more than 23 per cent of public drug spending – $3.4-billion of $14.5-billion paid by public drug plans last year – governments are finally starting to wake up to this issue.
Both B.C. and Alberta have announced that they will switch patients on government-sponsored programs from biologics to biosimilars. What the other provinces are waiting for to act is not clear. Likely just run-of-the-mill, money-wasting inertia.
Needless to say, pharmaceutical companies are pushing back. Remicade alone has sales in excess of $1-billion a year for Janssen Inc. in Canada.
In response to Alberta’s announcement, one company offered the province a price cut equivalent to $100-million, which provincial Health Minister Tyler Shandro rejected, saying switching to biosimilars would save more money. He also said a deal would undermine the pan-Canadian Pharmaceutical Alliance, the group that negotiates drug prices on behalf of federal, provincial and territorial governments.
The list price of infliximab biosimilars is about 45 per cent cheaper than Remicade’s list price, but we don’t actually know what negotiated price provinces are paying for originator drugs.
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