PEI Biosimilar Initiative

Some drugs are made using living organisms or their cells. These drugs are called biologics. The first version of a biologic drug to be produced is called the originator or reference biologic.

Biosimilars are highly similar versions of originator biologic drugs. They are produced when the patent expires on the originator biologic drug. Biosimilars are less expensive drugs that are reviewed by Health Canada to ensure they work in the same way as the originator biologic drugs and are equally effective.

Through the PEI Biosimilar Initiative, coverage under PEI Pharmacare for certain biologic drugs will be replaced with coverage for biosimilar drugs.

If you are covered for any of the following originator drugs through PEI Pharmacare, you will need to switch to a biosimilar version before the end of the switching period for that drug to keep your coverage.

Drug	Originator brand name (switch from)	Biosimilar brand name (switch to)	Reimbursed conditions may include	End of switching period
Insulin aspart	NovoRapid®	Kirsty® Trurapi®	Diabetes	June 30, 2024
Insulin glargine	Lantus®	Basaglar® Semglee®	Diabetes	June 30, 2024
Insulin lispro	Humalog®	Admelog®	Diabetes	June 30, 2024
Adalimumab	Humira®	Abrilada® Amgevita® Hadlima® Hulio® Hyrimoz® Idacio® Simlandi™ Yuflyma™	Ankylosing spondylitis Crohn's disease Hidradenitis suppurativa Juvenile idiopathic arthritis Plaque psoriasis Psoriatic arthritis Rheumatoid arthritis Ulcerative colitis Uveitis	September 30, 2024
Etanercept	Enbrel®	Brenzys® Erelzi® Rymti®	Ankylosing spondylitis Juvenile idiopathic arthritis Plaque psoriasis Psoriatic arthritis Rheumatoid arthritis	September 30, 2024
Glatiramer acetate (a non-biologic complex drug)	Copaxone®	Glatect™	Multiple sclerosis	September 30, 2024
Infliximab	Remicade®	Avsola® Inflectra® Renflexis®	Ankylosing spondylitis Crohn’s disease Plaque psoriasis Psoriatic arthritis Rheumatoid arthritis Ulcerative colitis	September 30, 2024
Rituximab	Rituxan®	Riabni™ Riximyo® Ruxience™ Truxima™	Rheumatoid Arthritis Granulomatosis with polyangiitis (GPA) Microscopic polyangiitis (MPA)	September 30, 2024
Ustekinumab	Stelara^®	Jamteki^TM Wezlana^TM	Plaque psoriasis	August 31, 2025

As new biosimilars become available, the Biosimilar Initiative will also apply to other originator biologics listed on the PEI Pharmacare formulary.

How to switch

To give you time to see your health care provider, the originator drugs and the biosimilar versions listed above will be covered until the end of the switching periods.

Once a switching period has ended, PEI Pharmacare will no longer cover the originator drugs listed above without an approved exemption.

If you use NovoRapid, Lantus or Humalog insulin:

The switching period has ended (June 30, 2024). Unless you have been approved for an exemption (e.g. insulin pump compatibility), you will no longer have coverage for NovoRapid, Lantus or Humalog insulin.

If you use Copaxone, Enbrel, Humira, Remicade or Rituxan:

For Copaxone, Enbrel, Humira, Remicade or Rituxan – You will need to switch to a biosimilar before September 30, 2024.
For Stelara – You will need to switch to a biosimilar before August 31, 2025

Your prescriber can help you switch to a biosimilar. They can also answer questions and, if needed, help you enroll in a biosimilar patient support program.

If your special authorization approval needs to be renewed during the switching period, you will need to be switched to a biosimilar at that time.

If you don't have an appointment with your prescriber before you special authorization needs to be renewed:

You or a healthcare provider must complete:

On this form, you will need to provide the name of the originator biologic you are taking, the name of your prescriber and the date of your appointment with your prescriber.

If your appointment is scheduled before September 30, 2024, the special authorization coverage for your originator biologic may be extended for 1 month following your appointment date.

Frequently Asked Questions

Is a biosimilar the same as a generic?

No. A generic drug is a simpler molecule and can copy exactly the original brand name medication.

Biologic drugs are made from live cells and are more complex than traditional drugs. Biosimilar drugs are highly similar to their originator biologic but not an exact copy.

Each batch of a biologic drug can have minor variations from the first biologic that was made. These minor changes can happen with each batch of an originator biologic and with the biosimilar copies, but do not change the effect or safety of the drug.

The biosimilar will work in the same way as the originator biologic.

Are biosimilars safe and effective compared to the originator biologic drug?

Yes, before a biosimilar drug is approved by Health Canada, the manufacturer must show that there are no meaningful differences in safety and effectiveness compared to the originator version. Patients and health care providers can have confidence that biosimilars are effective and safe.

What is the nocebo effect and how can I prevent it?

A person’s mindset can impact their symptoms and their sense of well-being. When a person’s negative expectations affect the treatment outcomes, this is called the nocebo effect. (When their positive expectations affect treatment outcomes, this is called the placebo effect.)

To prevent a nocebo effect, you can:

recognize the possibility of the nocebo effect
seek out more information on biosimilars (see Biosimilar Resources for Patients)
speak to your doctor, nurse or pharmacist about the switch and discuss your options
stay informed about the switch process
keep a neutral or positive outlook

If I’m pregnant, can I delay my switch to a biosimilar until after delivery?

Yes. You or a healthcare provider can complete the online biosimilar switching exemption form or the paper biosimilar switching exemption form where you will need to provide your due date. You will need to switch to using a biosimilar within three months after delivery.

If my insulin pump is not yet shown to be compatible with a biosimilar version of the insulin I use in my pump, can I still get coverage for the originator?

Yes. You or healthcare provider can complete the online biosimilar switching exemption form or the paper biosimilar switching exemption form. You will need to provide the name of the originator insulin you are taking and the make and model of your insulin pump. You will need to switch to using a biosimilar once there is information available to confirm the compatibility of a biosimilar version of your insulin with your pump.

What if I have private coverage?

If you do not rely on PEI Pharmacare drug programs for coverage of your originator biologic, the Biosimilars Initiative will not directly affect you. However, as some private insurance plans have also been implementing biosimilar switch policies, you may wish to contact your private insurer for more information.