CADTH Symposium 2019: Enhancing Access to Oncology Biosimilars in Canada Sang Mi Lee Senior Pharmacist, pCPA Office
Disclosure: I have no actual or potential conflict of interest in relation to this topic or presentation.
Biosimilars in Canada are Still Relatively ‘Early’ 14 biosimilars have been approved by Health Canada, the EMA and/or the FDA Canada Updated Total: 6 + 3 (in 2018) = 9 Source: http://www.pmprb-cepmb.gc.ca; Meds Entry Watch 2017 Report (Released Feb 20, 2019)
Biosimilar Uptake in Canada Remains Low Source: http://www.pmprb-cepmb.gc.ca; Meds Entry Watch 2017 Report (Released Feb 20, 2019)
Biosimilar – pCPA Policy Principles / Directions pCPA Pricing Principles (April 2016): Commitment to a pan-Canadian pCPA negotiation process Decisions informed by evidence Foster competitive biologics market , supporting long term cost reductions & sustainability Lower transparent pricing Pursuit of optimal value from all industry stakeholders
Biosimilar – pCPA Policy Principles / Directions pCPA Biologics Policy Directions & pCPA Negotiations (Sept 2018): The pCPA is committed to a unified, pan-Canadian process 1) Biologic drugs will be considered on an individual basis, in their market 2) context Negotiation for biosimilar drugs will begin in parallel with the HTA process 3) Offers for biologic drugs considered after biosimilar 4) Offers for biologics will not be considered if seek to restrict / exclude 5) biosimilars Offers for biologic/new biosimilar only considered with transparent list price 6) reductions Tiered listings for biologic drug products may be implemented 7) Switching of patients from a reference to a biosimilar may be implemented 8)
Top 5 Best Sellers in 2017 1. Adalimumab (Humira by Abbvie) - $18B 2. Lenalidomide ( Revlimid by Celgene) - $8B and growing 3. Etanercept (Enbrel by Amgen/Pfizer) - $7.5B 4. Rituximab (Rituxan by Roche) - $7.5B 5. Trastuzumab (Herceptin by Roche) - $7B Source: Keith Speight from the Motley Fool 18/12/2017
Pan-Canadian Oncology Biosimilars Initiative • pCPA is implementing a pan-Canadian biosimilar strategy with the goal of ensuring appropriate and cost-effective use of biologics • Cancer Care Ontario (CCO) and the pCPA have partnered to develop and implement a pan-Canadian oncology-specific biosimilars strategy. WHY? • Implementation of oncology biosimilars across cancer agencies and hospitals will be different compared to our experience with implementing non-oncology biosimilars. Unlike the biosimilars negotiated thus far by the pCPA, oncology biosimilars will be used exclusively in the hospital environment and must be integrated into specific regimens and protocols.
Pan-Canadian Oncology Biosimilars Summit (November 16, 2018, Toronto) o Aim: Consultation and engagement event to discuss the challenges and opportunities of introducing therapeutic oncology biosimilars in Canada o Approach: open, collaborative, consultative, and action- oriented o Stakeholders: patients, patient advocacy organizations, clinicians, agencies, health system administrators and government officials
Summit Key Learnings Stakeholder Engagement Clinical Operations Ongoing stakeholder Implementation issues at the engagement is critical hospital level and appropriate systems to maintain pharmacovigilance Education & Information Sharing Reinvestment Monitoring Comprehensive education Savings should be Real-world data should needed (e.g., to help reinvested to help assess utilization, safety clinicians discuss fund new and and effectiveness of biosimilars with patients) innovative cancer oncology biosimilars therapies
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