Page 8 - Nov-Dec 2019 - Reporter

Insurance UPDATE

recent

developments in

pharmaceutical

Provided by
benefit coverage
morneau shepell

everal new developments in 2019 point British Columbia biosimilar transition program
Stowards greater government intervention to British Columbia’s provincial PharmaCare
manage drug prices, as well as the cost of public program has announced a biosimilar transition
drug plans. These changes may result in better program. This program is the first of its kind for
sustainability for private drug plans; and point to a Canadian public drug plan. This program will
the need for private plan sponsors to pro-actively transition individuals taking certain high-cost
manage their drug plans. biologic medications to lower-cost biosimilar
medications. This program is significant in the
Federal drug pricing regulations Canadian marketplace, where most private
Revised federal drug pricing regulations were insurance carriers and public plans do not
published on August 21, 2019 and currently support biosimilar transitions and the
"As the new will become effective on July 1, 2020. utilization of biosimilars is much lower than in
regulations would These revisions are expected to lower other countries. British Columbia expects to save
the costs of new patented drugs approximately $96.6 million over the first three
only apply to new entering the market by allowing the years of this initiative.
patented drugs, Patented Medicine Prices Review Several insurers have indicated that they will
Board to set prices based on how well align their coverage with the provincial plan for
we do not expect the drug works compared to other BC plan members. Since managing the spiralling
private plans to available therapies; and by revising cost of biologic drugs is one of the highest priority
the reference countries used to guide challenges for many private drug plans, increased
see a significant how drugs are priced. The changes usage of biosimilars would improve the financial
reduction in are facing a recent constitutional stability of private drug plans.
challenge by several pharmaceutical
current costs in companies. PharmaCare report released in June 2019
As the new regulations would As discussed in the July 2019 News & Views,
the foreseeable only apply to new patented drugs, the final report of the Advisory Council on the
future." we do not expect private plans to Implementation of National PharmaCare was
see a significant reduction in current released in June 2019, calling for a universal
costs in the foreseeable future. single-payer drug plan for all Canadians phased
Instead, these changes will contribute to long- in between 2022 and 2027. If implemented as
term sustainability of private plans as well as proposed, there would be a significant impact to
government programs by managing new drug the employer-sponsored drug plan landscape.
costs. National PharmaCare was anticipated to be a
Insurance Update continued on page 18...

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