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Alberta to change drug coverage for 26,000 patients, expects to save up to $380M

Patients being treated with biologics on government-sponsored drug plans must switch to biosimilars

The Alberta government is changing its drug coverage for more than 26,000 patients, including those with diabetes, rheumatoid arthritis and Crohn’s disease.

Health Minister Tyler Shandro says over the next six months, patients on government-sponsored drug plans being treated with biologics must switch to biosimilars.

He notes biosimilars are up to half the cost, while being deemed just as effective by Health Canada.

Shandro says Alberta is following the lead of B.C. and Manitoba in making the switch and expects to save up to $380 million over the next four years, with more savings after that as more similar drugs come on the market.

Ontario is also consulting on biosimilars.

RELATED: B.C. Pharmacare expanding use of ‘biosimilar’ drugs to save money

Biologics are complex drugs derived from living cells, while biosimilars mimic the original drugs but are based on expired patents and can be delivered at less cost.

Critics, including Crohn’s and Colitis Canada, have questioned the move, saying the switch could lead to adverse reactions in some patients.

The change does not affect patients on private drug plans or those paying out of pocket, and will not apply to pregnant women or children.

The plan is to have everyone switched over by next July.

Shandro told a news conference Thursday that patients can apply for medical exemptions to prevent a switch, which could be granted pending a review by a team of physicians.

He said spending on biologics has been soaring over the past five years, growing on average at 16 per cent a year in Alberta, reaching $238 million in 2018-19.

“These high-cost drugs represent 19 per cent of Alberta’s total spending on drugs, despite being provided to fewer than two per cent of patients,” Shandro said.

“We understand that this is a change for patients and a change for health professionals, and change is not always easy.

“But this is the right thing to do. We’re continuing to provide Albertans with a safe, effective treatment at much lower cost.”

It’s one of several changes announced by Shandro for a health system that the United Conservative government says is delivering substandard results given its higher input costs compared to other provinces.

Earlier this week, Shandro announced Alberta will begin relying more on private clinics to deliver routine publicly funded operations, such as hip and knee replacements, in order to allow hospitals to handle more complex procedures and reduce wait times.

The province has also warned nurses and health-care support staff that layoffs could be coming as early as the spring, and has passed legislation allowing it to tie billing privileges for new doctors to rural areas where service is lacking.

Alberta is spending $20.6 billion this year on health.

That is a one-per-cent increase from the previous budget and represents 43 per cent of total government operational spending, but critics note it doesn’t keep pace with the rate of population growth plus inflation.

The Canadian Press

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