Answer Questions for Patients Switching to a Biosimilar

More questions will come up about biosimilars...now that BC will require patients to switch to biosimilars to save healthcare dollars.

Biosimilars are biologics that are highly SIMILAR to the original, or "reference," biologic...but cost up to 50% less.

For example, patients in BC may be switched from Lantus to Basaglar (insulin glargine)...Enbrel to Brenzys or Erelzi (etanercept)...or Remicade to Inflectra or Renflexis (infliximab).

Expect more provinces to follow suit.

Help identify other patients who may benefit from a switch to a biosimilar...and be ready to answer common questions.

Are biosimilars safe and effective? Biosimilars have no meaningful differences in safety or efficacy compared to the reference.

Health Canada doesn't require clinical studies to confirm the same efficacy outcomes for all approved indications...it's based on extrapolation from studies with the reference biologic.

And so far, worldwide studies following patients who switch to biosimilars show no clinical differences from the reference biologic.

Can you substitute a biosimilar for a reference biologic? Biosimilars are NOT generics...and therefore not automatically interchangeable with the reference biologic. Biologics are made from living organisms and contain more complex molecules than most drugs.

Refer patients to their prescriber to discuss the switch and get a new Rx. And point out that enrollment in a new patient assistance program is usually needed for the biosimilar.

What are other biosimilar dispensing considerations? Expect biosimilars to be dosed and administered the same as the reference.

But watch for differences in storage requirements. For example, Inflectra or Renflexis must be kept in the fridge...but Remicade can be kept at room temp for up to 6 months.

Also keep an eye out for different product strengths...to avoid mix-ups. For example, Enbrel comes in a 50 mg prefilled syringe, but Erelzi comes in both 25 mg and 50 mg prefilled syringes.

For more answers to common questions, see our chart, FAQs About Biosimilars.

Key References

  • www2.gov.bc.ca/assets/gov/health/health-drug-coverage/pharmacare/biosimpharmguide.pdf (07-24-19)
  • www.canada.ca/en/health-canada/services/drugs-health-products/biologics-radiopharmaceuticals
    -genetic-therapies/applications-submissions/guidance-documents/fact-sheet-biosimilars.html (07-24-19)
Pharmacist's Letter Canada. August 2019, No. 350813



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