Alberta, Canada, Begins Mandating Switches From Originator to Biosimilar Humira

Alberta, Canada has expanded its biosimilar switching program to include Humira (adalimumab) for all the originator indications except pediatric juvenile idiopathic arthritis, according to Alberta Blue Cross.

Under the expansion, all patients over the age of 18 covered by an Alberta government sponsored health plan who would like to maintain coverage for their adalimumab therapy will be required to switch from Humira to 1 of 5 federally approved biosimilar versions.

The initiative grants a 1-year transition period, during which patients will have from May 1, 2021 until May 1, 2022 to switch to a biosimilar adalimumab. About 3300 patients are expected to be impacted.

The 5 biosimilars that patients are eligible to switch to include Amgevita, Hadlima, Hulio, Hyrimoz, and Idacio. Amgen launched Amgevita in Canada in early May 2021.

Adalimumab products are used to treat several inflammatory conditions, including rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, ankylosing spondylitis, Crohn disease, ulcerative colitis, hidradenitis suppurativa, plaque psoriasis, and psoriatic arthritis.

Humira is the second most sold biologic drug in Canada, amassing CN$974 million (US $793 million) in sales during 2020, according to a statement released by Biosimilars Canada, a national association comprised of biosimilar companies and biosimilar advocates.

“Biosimilars Canada congratulates the Province of Alberta and Health Minister Tyler Shandro for continuing to expand the use of biosimilars in the province to manage costs, ensure the sustainability of the drug program and fund innovative new therapies,” said Jim Keon, President of Biosimilars Canada.

Additionally, Alberta has spent more than CN $238 million (US $193 million) on biologic medications during the 2018 to 2019 fiscal year, and the costs are rising 13.9% annually, according to Alberta Health.

The province is anticipated to save between $227 million and $380 million (US $184 million to US $309 million) over 4 years once their Biosimilars Initiative is fully implemented. The savings generated from the switches will be reinvested into the health system.

Alberta launched its Biosimilars Initiative in December 2019 and has so far succeeded in switching 16% of patients from using certain reference biologics to approved biosimilar versions, including 30% of infliximab (Remicade) users.

When fully implemented, the initiative will have discontinued coverage of originators Remicade, Enbrel (etanercept), Lantus (insulin glargine), Neulasta (pegfilgrastim), Neupogen (filgrastim), Copaxone (glatiramer), Rituxan (rituximab),and Stelara (ustekinumab) in addition to Humira.

The news comes after New Brunswick, Canada announced in April 2021 that it would begin implementing its own biosimilars switching policy. The initiative will mandate patients to switch to biosimilar versions of Humira, Enbrel, Remicade, Lantus, Humalog (insulin lispro), Rituxan, and Copaxone, according to New Brunswick Canada.

“As domestic and international experience has shown, the full benefits of biosimilars cannot be realized unless drug plans adopt policies that support their expanded use, as [British Columbia] and Alberta public drug plans did with the implementation of successful biosimilar switching policies in 2019 and as New Brunswick announced last month,” said Biosimilars Canada.