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Vials of Remicade at the Mount Sinai Hospital in Toronto.

Chris Donovan/The Globe and Mail

The Quebec government will not appeal a court decision forcing it to restore full public coverage of Remicade, an expensive medication for rheumatoid arthritis and inflammatory bowel diseases that most other provinces have stopped funding for new patients in a bid to save money.

A spokeswoman for Quebec’s Ministry of Health and Social Services told The Globe and Mail by e-mail Thursday that the government does not intend to challenge the Quebec Court of Appeal ruling, which was handed down last month.

Quebec’s highest court found that the government violated procedural fairness when it failed to give Janssen, the unit of Johnson & Johnson that makes Remicade, formal prior notice and a chance to respond before the government stopped paying for Remicade for patients who had previously not taken the infused medication.

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The three-judge panel did not weigh in on the wisdom of Quebec’s decision to halt Remicade funding for new patients.

Like every other province except Prince Edward Island, Quebec stopped covering Remicade for new patients as part of its efforts to promote biosimilars, which are cheaper, near-copies of off-patent biologic drugs that could help to keep prescription-drug spending under control.

Biologics are complex, large-molecule drugs manufactured from living cells.

Remicade, Canada’s top-selling drug by revenue, was the first blockbuster biologic in Canada to face competition from biosimilar versions of infliximab, the molecule that is sold under the brand-name Remicade.

Two infliximab biosimilars available in Canada sell for about half the sticker price of Remicade, although the real price of Remicade is likely lower because of confidential discount arrangements in some provinces.

However, biosimilars have made barely a dent in the Canadian infliximab market, which is still dominated by Remicade.

A Globe investigation last year found Janssen used a suite of tactics to exploit cracks in Canada’s system for paying for prescription drugs to keep Remicade on top, including taking the Quebec government to court over its decision to delist Remicade for new patients.

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In 2017, seven of 10 provinces, including Quebec, say they spent more on Remicade than on any other prescription drug. Quebec reported spending about $120-million on Remicade that year.

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