While the impact of biologics on patients has proven successful, it’s counterbalanced by an equally significant fiscal impact, delegates heard at the 2018 Halifax Benefits Summit in September.
“The impact of biologics on patients is incredible,” said Ned Pojskic, leader of pharmacy and health provider relations at Green Shield Canada. However, he added, the industry has to understand what’s happening to the sustainability of drug plans.
Canada is a heavy user of biologics, second only to the United States, he said, noting 8.3 per cent of prescription drugs were biologics in 2013 and that rose to 21.2 per cent last year. “Two out of every three drugs today are in a high-cost category. . . . Current innovation is outpacing our ability to pay,” said Pojskic.
Biosimilars may offer some relief. “They are similar but not identical to the originator. They produce the exact same level of therapeutic quality,” he said.
The increased use of biologics and biosimilars has led to increased market competition, which has resulted in greater access and lower medication prices. “New drugs must price themselves against the biosimilar, not the originator. Biosimilars are driving this,” said Pojskic. He pointed to Remicade, an anti-TNF inhibitor and the No. 1 prescribed drug in Canada, as an example of how the current landscape is being transformed. The biosimilar version of the drug costs up to 50 per cent less.
In some countries, this difference has compelled governments to regulate the use of biosimilars over biologics. While adoption of biosimilars is at 2.1 per cent in Canada, these figures are much higher in Finland (93.1 per cent), Norway (97.7 per cent) and Poland (100 per cent), for example. The estimated potential savings if biosimilars were used in Canada range from 13 per cent to 43 per cent, which equates to $800 million at the upper end, said Pojskic.
On-the-ground experience and financial savings are serving to rapidly change positions around the use of biosimilars, he said, though he noted the primary concern is patient outcomes. “Patients need to be responsibility transitioned and provided with the necessary support.”
Help may be at hand, at least on the other side of the Atlantic. “Europe has had this experience [with biosimilars] for over a decade now and we are not drawing on that experience,” said Pojskic.
The discussion over the use of biologics versus biosimilars is likely to become more heated – and more challenging, he added. “Oncology will be the biggest area going forward. That conversation will be even more difficult.”
Read more coverage from the 2018 Halifax Benefits Summit