Page 8 - Jan-Feb-2025 - REPORTER

INSURANCE UPDATE

USING BIOSIMILARS TO

REDUCE DRUG COSTS

HUB INTERNATIONAL LIMITED

n the association industry, attracting and retaining top talent is along with its evidence-based decision. The insurer also decreased its
Ioften a critical challenge, especially in a competitive market where premium rates to boost the uptake of the policy.
employees have numerous options. To stand out as an employer of “We’ve been working with our plan sponsors to maximize
choice, offering comprehensive employee benefits as part of the total biosimilar value. Not only were we giving them peace of mind, but we
compensation package is more than a strategy, it’s a necessity. were also considering the [sustainability] of their drug plan. We had a
These benefits not only enhance the value of compensation but long-term mindset; obviously one of the reasons we did this is because
also demonstrate a commitment to employee well-being, fostering it’s going to stimulate competition, and when it does . . . it’s going to be
loyalty and long-term engagement. One innovative approach a bit more affordable for everyone.”
associations can adopt to manage costs while maintaining robust Also speaking during the session, Ross Wallace, secretary of the
benefits is the inclusion of biosimilars in their health plans. By opting Canadian Biosimilars Forum, noted while biosimilars are biologics, the
for biosimilars - highly effective, FDA-approved alternatives - instead most significant difference is price: biosimilars in Canada tend to have
of name-brand pharmaceuticals, associations can significantly list prices of roughly 30 per cent to 50 per cent that of the originator
reduce drug costs without compromising quality or care, ensuring biologic.
that resources are used effectively to deliver maximum value to both Under Desjardins’ policy, when a new biosimilar comes to market,
employees and the organization. the insurer sends personalized communications to all plan members
Despite the safety and efficacy of biosimilars — and the potential taking the reference biologic. The communication sets out clear
cost savings they offer — uptake among private payers has been definitions for relevant terms like reference biologic, biosimilar and
low historically and is only starting to gain steam, said Neda Nasseri, transition and includes a Health Canada poster on biosimilars. Since
pharmacist and private payer product director at Desjardins Insurance, 2019, the insurer has sent out roughly 10,000 letters to plan members.
during Benefits Canada’s 2023 Face to Face Drug Plan Management Plan members are given six months to make the switch, and they
Forum in December. receive a reminder roughly three months before the deadline. To help
The insurer first developed a policy to promote biosimilar use them along, Desjardins applies their existing prior authorization for the
back in 2016: when a plan member submitted a claim for a biologic, reference biologic to the biosimilar. “Offering personalized support is
if there was at least one biosimilar on the market, only the biosimilar really the best way to make it easier for them to switch,” said Nasseri.
would be covered. In 2019, it began implementing biosimilar switching The insurer follows the same exception criteria as the provinces,
for existing patients, following in the footsteps of British Columbia, including allowing reference biologics for pediatric use, during
Saskatchewan, and Quebec. pregnancy and for people who have failed prior therapies. Just six
To date, the insurer has 94 per cent biosimilar penetration in those per cent of plan members have used the exception. She noted that not
three provinces and 40 per cent in Ontario and the rest of Canada, only is biosimilar switching a “low-hanging fruit” for cost-savings, but
where the switching policy went into effect on January 1, 2024. It has association plan members can also get faster access to treatment for
made the switch from 12 reference biologics to their corresponding some biosimilars.
biosimilars, resulting in savings of between 15 per cent and 50 per To learn more about employee benefits and the value-add programs
cent. In Quebec alone, Desjardins said it has saved $10 million. offered through the LBMAO program visit lbmao.on.ca, Affinity Partners
Nasseri noted it isn’t always easy for employers to make a decision and click on Morneau Shepell.
that impacts employees’ health, but Desjardins’ plan sponsors went

8 LBMAO Reporter - January-February 2025 www.lbmao.on.ca