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Ontario is introducing a new policy requiring cheaper versions of pricey biologic drugs to be offered to most patients who need them, The Globe and Mail has learned.

The policy, which was approved by cabinet last Wednesday, will save money and better ensure the long-term sustainability of the province’s drug plan, according to a government official. The Globe is not naming the official because they were not authorized to speak publicly about the decision.

Similar mandatory switching policies have already been adopted in several other provinces, including British Columbia and Alberta.

Biologic drugs are made from living organisms and are used to treat an array of conditions, including rheumatoid arthritis, inflammatory bowel disease and some forms of cancer. While they are vital treatments, the medications are expensive and make up a significant chunk of drug spending in Canada.

Medical industry advocates urge Ontario to offer cheaper versions of prescription medications

According to a report from the Patented Medicine Prices Review Board, sales of biologic medicines in Canada rose to $10-billion in 2020 from $3.3-billion in 2011. The report notes that Canada spends more on biologics than most other industrialized countries, representing 34 per cent of pharmaceutical sales in 2020.

Biosimilars are nearly identical versions of biologic drugs that are typically offered at a much lower cost. For instance, Biosimilars Canada, an advocacy group representing the biosimilars industry, has stated that mandatory switching to their products would save the province about $150-million a year in drug costs.

As a result of the high cost, there’s been an increasing push toward mandatory switching, which requires clinicians to prescribe biosimilar medications to most patients. Biosimilars Canada has been lobbying Ontario to follow the lead of other provinces and adopt such a plan.

But mandatory switching is not without controversy. The biologics industry advocates against such policies, saying patients and care providers should be able to choose the appropriate medication, regardless of cost.

On its website, the Alliance for Safe Biologic Medicines, a U.S. group consisting of biotechnology companies, patients and physicians, says that forced switching may result in unexpected or harmful outcomes for patients.

Ontario approved a mandatory switching in 2020, but it was sidetracked as a result of the pandemic.

Under the new policy, there will be a nine-month transition period that is set to start March 31. That will allow patients time to have discussions with their care providers about what the changes mean, as well as their options. Certain patients will be exempt from mandatory switching, such as those who are pregnant and people with certain types of cancer, the government official said.

The province will be reaching out to various stakeholders this week to discuss the new plan and its implications.

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