Information for insureds impacted by the transition to biosimilar drugs

Please read the FAQ section below if you were mailed a letter indicating that you must transition to a biosimilar drug. The deadline to make the change is indicated in the letter.

If you do not find the answer to your question in this FAQ, contact our customer service at 1-877-651-8080.

What is a biosimilar drug?

A biosimilar drug is highly similar to a biologic drug that was already authorized for sale. Health Canada authorizes biosimilars for sale using the same rigorous regulatory standards for quality, efficacy and safety as for all other biologic drugs. A biosimilar drug may enter the market once patents and data protection of the reference biologic drug are expired.

Reminder of definitions:

  • Biologic drugs: Drugs that come from living organisms such as animals, bacteria or yeast.
  • Biosimilar drugs: Highly similar copy of biologic drug.
  • Reference biologic drugs: Drugs of biologic origin to which the biosimilar drug is compared.
Which prescription drugs are impacted by SSQ Insurance’s mandatory transition?

All biologic drugs for which at least one biosimilar equivalent is available on the Canadian market are likely to be impacted by this transition.

However, this mandatory transition will comply with approved Health Canada indications and with the Basic Prescription Drug Insurance Plan for insureds in Quebec and, at all times, by promoting coordination with public provincial plans, when applicable.

The list of targeted biologic drugs is subject to change and will evolve as new biosimilar drugs enter the Canadian market:

  • Adalimumab - HumiraMD (AbbVie)
  • Bevacizumab - AvastinMD (Roche)*
  • Etanercept - EnbrelMD (Amgen)
  • Filgrastim – NeupogenMD (Amgen)
  • Infliximab – RemicadeMD (Janssen)
  • Pegfilgrastim – NeulastaMD (Amgen)
  • Rituximab – RituxanMD (Roche)
  • Trastuzumab - HerceptinMD (Roche)*
  • Insuline glargine – LantusMD (Sanofi Aventis)
  • Insuline lispro – HumalogMD (Lilly)
  • Glatiramer – CopaxoneMD (Teva Innovation)

*These drugs are considered as hospital-use only drugs by SSQ Insurance and are only covered under exceptional circumstances.

I take a biologic drug but have not received a letter in the mail. Why?

You may not have received your personalized letter yet. The letters are sent over a period of several weeks.

It is also possible that you are not impacted by the transition with regard to your prescription drug, medical condition or any other exception. Only insured impacted by the transition will receive a letter.

When will Quebec’s Public Prescription Drug Insurance Plan’s (RAMQ) initiative go into effect?

The RAMQ initiative goes into effect on April 13, 2022. Eligible individuals under the RAMQ who use a reference biologic drug for which one or more biosimilar drugs are registered on the RAMQ’s List of Medications must transition to the biosimilar equivalents by April 12, 2022, under the supervision of their physician, except in the event of a medical exception.

Are biosimilar drugs as effective as biologic drugs?

Yes. In order for a biosimilar drug to be approved by Health Canada, manufacturers must demonstrate the quality of the drug and conduct comparative studies to demonstrate highly similar structure, function, efficacy and safety to a previously authorized reference biologic drug.

Is it safe to transition from a biologic drug to its biosimilar equivalent?

Yes. Many clinical studies conducted with a number of patients demonstrated that biosimilar drugs are just as effective and safe as their biologic equivalents.

Biosimilar drugs work the same way as their reference biological drugs. A patient may transition from a biologic drug to a biosimilar drug or even start treatment with a biosimilar drug. There are no clinically meaningful differences in efficacy and safety between the treatments.

What steps do I need to follow if I must transition to a biosimilar drug?

If you receive a letter from SSQ Insurance regarding the transition to biosimilars policy, you must do the following:

  1. Schedule an appointment or contact your physician as soon as possible.
  2. During your appointment, discuss the transition process with your physician. He or she will be able to answer your questions and register you for a support program for patients of the biosimilar manufacturer, if any.
  3. If your situation qualifies as an exception under our transition policy, your physician can fill out an exception drug form and send it to SSQ.

Make sure you have a new prescription for the biosimilar equivalent before the transition period ends. This will ensure your reimbursements are not interrupted.

If you are insured under the Régime public d’assurance médicaments du Québec (RAMQ) Prescription Drug Insurance Plan, there is no action to take. Healthcare professionals who treat patients impacted by this change will contact you in due course.

The deadline passed and I still don’t have a new prescription for the biosimilar equivalent. What should I do?

Once the deadline is passed, we will no longer reimburse you for the reference biologic drug. You must contact your medical team or pharmacist to continue being reimbursed without interruption.

Under certain exceptional situations, we agree to evaluate the possibility of granting a short extension period to complete your transition. These requests will be assessed on a case-by-case basis.

Do I need to fill out another prior authorization drug form?

If your situation is impacted by the transition to biosimilars, you do not need to fill out a new form. The letter you received contains your next prior authorization renewal date.

Are there any exceptions to the transition measures to biosimilars?

In all provinces, if you benefit from coverage that includes coordination with the public plan, SSQ Insurance will respect the exceptions determined or authorized by the various provincial plans.

Otherwise, individuals in the following situations do not have to make the mandatory transition:

  • Pregnant women are excluded from the initial transition, but must make the transition to biosimilar drugs during the 12 months following delivery.
  • Pediatric patients are excluded from the initial transition, but must make the transition to biosimilar drugs during the 12 months following their 18th birthday.
  • Patients who have experienced two or more therapeutic failures with biologic drugs used to treat the same chronic illness will not need to transition.

A transition exception form can be completed and submitted to our prior authorization program.

Have other Canadian provinces implemented a similar transition?

Yes, British Columbia and Alberta implemented a policy to transition to biosimilars in 2019 and 2020, respectively. In New Brunswick, patients who use certain biologic drugs will also have to transition to a biosimilar equivalent, between April 21 and November 30, 2021, to maintain their coverage under the New Brunswick Drug Plan.

Also, in Quebec, RAMQ patients who take reference biologic drugs will have to transition, unless there is a medical exception, to a biosimilar equivalent by April 12, 2022, under the supervision of their attending physician or pharmacist.

Can you provide the contact information for the patient support programs for various biosimilar drugs?
Adalimumab

AmgevitaMD (adalilumab)

www.amgevita.ca/en
Telephone: 1-877-936-2735
Email: info@oneenliven.ca
Fax: 1-833-423-0252

HulioMD (adalimumab)

www.hulio.ca
Telephone: 1-844-485-4677
Email: hulio@assistprogram.com
Fax: 1-844-554-8546

IdacioMD (adalimumab)

Kabicare.ca/
Telephone: 1-888-304-2034
Email: info@kabicare.ca
Fax: 1-888-304-2014

HadlimaMD and Hadlima PushTouchMD

Telephone: 1-866-556-5663
Email: info@harmonybyorganon.ca
Fax: 1-866-240-4076

HyrimozMD (adalimumab)

Telephone: 1-888-449-7673
Email: xpose@sandozprogramsupport.ca
Fax: 1-844-449-7673

Étanercept

BrenzysMD (etanercept)

Telephone: 1-866-556-5663
Email: info@harmonybyorganon.ca
Fax: 1-866-240-4076

ErelziMD (etanercept)

Telephone: 1-844-279-7673
Email: erelzi@xposeprogram.ca
Fax: 1-866-872-5771

Filgrastim

NivestymMD (filgrastim) and NyvepriaMD (pegfilgrastim)

Services offered

In particular, but not limited to: Providing education about injections and support for patients or their caregivers who are uncomfortable or need assistance with the injection. This service is offered by a network of Innomar clinics.

https://www.innomar-strategies.com/clinic-and-pharmacy-finder

Glatiramère

GlatectMD (glatiramer)

https://glatect.com/en/

Infliximab

AvsolaMD (infliximab)

www.avsola.ca/en
Telephone: 1-877-936-2735
Email: info@oneenliven.ca
Fax: 1-833-423-0252

RenflexisMD (Infliximab)

Telephone: 1-866-556-5663
Email: info@harmonybyorganon.ca
Fax: 1-866-240-4076

InflectraMD (Infliximab)

Telephone: 1-855-935-FLEX (3539)
Email: inflectra@pfizerflex.com
Fax: 1-833-958-FLEX (3539)

Pegfilgrastim

FulphilaMD (pegfilgrastim)

www.BiosimilarsCanadaPSP.com
Telephone: 1-833-847-4323
Email: BiosimilarsCanada@innomar-strategies.com
Fax: 1-833-794-2382

ZiextenzoMD (pegfilgrastim)

Telephone: 1-833-726-3690
Email: Biocare@programsupport.ca
Fax: 1-833-726-3698

Rituximab

RiximyoMD (rituximab)

Telephone: 1-888-449-7673
Email: xpose@sandozprogramsupport.ca
Fax: 1-844-449-7673

TruximaMD (rituximab)

Telephone: 1-877-714-2469
Email: tss.info@truximacanada.com
Fax: 1-833-981-2254

RuxienceMD (rituximab)
Patients transitioning from Rituxan to Ruxience don’t have to change their infusion clinic location, since both networks use the infusion clinic network provided by Innomar.
https://www.innomar-strategies.com/clinic-and-pharmacy-finder