Changes to Ontario’s policy on the use of biosimilars in its public drug plan could result in savings for private benefits plans if they choose to follow the provincial model, says Theresa Tran, a principal in group benefits at Eckler Ltd.
Starting March 31, Ontario Drug Benefit recipients who are on an originator biologic will begin to transition to a Health Canada-approved biosimilar version. Ontario is the seventh province or territory to announce a biosimilars switching policy, after Northwest Territories, British Columbia, Alberta, Saskatchewan, Quebec, New Brunswick and Nova Scotia.
Read: Quebec biosimilars policy could cut drug costs for plan sponsors: expert
Where insurers integrate provincial biosimilars strategies into their group benefits plans, plan sponsors and members can benefit from cost savings, says Tran, noting one insurer reported more than $20 million in cost avoidance after nearly all of its B.C.-based plan sponsors transitioned to the provincial policy.
“The cost avoidance would encompass those patients taking a biologic transitioning to a biosimilar, plus new patients being prescribed a biosimilar rather than the originator biologic.”
As more benefits plan sponsors look to adopt these policies, it will be key for the health-care industry to provide awareness and education about biosimilars, says Tran. “Educating patients, physicians and other health professionals about biosimilars, their safety and efficacy and how they fit into the provincial policies can be challenging. If that’s been achieved, plan sponsors will experience less of an impact from integrating biosimilars into their plans.”
Read: Head to head: Should private drug plans require biosimilar non-medical switching?