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)*
  • Insulin glargine – LantusMD (Sanofi Aventis)
  • Insulin lispro – HumalogMD (Lilly)
  • Glatiramer – CopaxoneMD (Teva Innovation)
  • Insulin Aspart – NovoRapidMD (NovoNordisk)

*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?

Here are a few possible reasons:

  • You may receive your personalized letter soon.
  • You may not be impacted by the transition with regard to your prescription drug use, medical condition or any other exception.
When did the Régime public d’assurance médicaments du Québec (RAMQ) initiative come into effect?

It went into effect in April 2022. Since April 13, eligible individuals under the RAMQ who use a reference biologic drug must transition to a biosimilar equivalent under the supervision of their physician, except in the event of a medical exception. This change applies only if the biologic drug to one or more corresponding biosimilar equivalents on RAMQ’s List of Medications.

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?

Regardless of the province, if your coverage includes coordination with a public plan, SSQ Insurance will respect the exceptions determined or authorized by the provincial plans.

Otherwise, individuals in the following situation are subject to exceptions with regard to the mandatory transition:

  • Pregnant women, they must however transition to biosimilar drugs during the 12 months following delivery.
  • Pediatric patients must make the transition to biosimilar drugs during the 12 months following their 18th birthday.
  • Patients with chronic illnesses who have experienced prior therapeutic failures while being treated with a least 2 other biologic drugs for the same illness.
  • Patients treated with Humalog insulin administered with an insulin pump do not have to transition to the biosimilar equivalent, Admelog.

To request an exception, please send us this completed form.

Have many Canadian provinces implemented a similar transition?

Yes. Five provinces have implemented the transition so far.

  • British Columbia (2019)
  • Alberta (2020)
  • New Brunswick (2021)
  • Quebec (2022)
  • Nova Scotia (2022)
Can you provide the contact information for the patient support programs for various biosimilar drugs?
Adalimumab

AmgevitaMD (adalimumab)

www.amgevita.ca/en
Telephone: 1-877-936-2735
Email: [email protected]
Fax: 1-833-423-0252

HadlimaMD and Hadlima PushTouchMD (adalimumab)

Telephone: 1-866-556-5663
Email: [email protected]
Fax: 1-866-240-4076

HulioMD (adalimumab)

www.hulio.ca
Telephone: 1-844-485-4677
Email: [email protected]
Fax: 1-844-554-8546

HyrimozMD (adalimumab)

Telephone: 1-888-449-7673
Email: [email protected]
Fax: 1-844-449-7673

IdacioMD (adalimumab)

www.kabicare.ca/
Telephone: 1-888-304-2034
Email: [email protected]
Fax: 1-888-304-2014

SimlandiMD (adalimumab)

www.jampcare-support.ca/en/simland.html
Telephone: 1-855-310-5102
Email: [email protected]
Fax: 1-888-331-3432

Étanercept

BrenzysMD (etanercept)

Telephone: 1-866-556-5663
Email: [email protected]
Fax: 1-866-240-4076

ErelziMD (etanercept)

Telephone: 1-844-279-7673
Email: [email protected]
Fax: 1-866-872-5771

Filgrastim

NivestymMD (filgrastim) and NyvepriaMD (pegfilgrastim)

Services offered

Including, 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.

Infliximab

AvsolaMD (infliximab)

www.avsola.ca/en
Telephone: 1-877-936-2735
Email: [email protected]
Fax: 1-833-423-0252

RenflexisMD (infliximab)

Telephone: 1-866-556-5663
Email: [email protected]
Fax: 1-866-240-4076

InflectraMD (infliximab)

Telephone: 1-855-935-FLEX (3539)
Email: [email protected]
Fax: 1-833-958-FLEX (3539)

Pegfilgrastim

FulphilaMD (pegfilgrastim)

www.BiosimilarsCanadaPSP.com
Telephone: 1-833-847-4323
Email: [email protected]
Fax: 1-833-794-2382

ZiextenzoMD (pegfilgrastim)

Telephone: 1-833-726-3690
Email: [email protected]
Fax: 1-833-726-3698

NivestymMD (filgrastim) and NyvepriaMD (pegfilgrastim)

Services offered

Including, 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

Rituximab

RuxienceMD (rituximab)

Patients transitioning from Rituxan to Ruxience do not have to change their infusion clinic location, since both manufacturers use the infusion clinic network provided by Innomar.

RiximyoMD (rituximab)

Telephone: 1-888-449-7673
Email: [email protected]
Fax: 1-844-449-7673

TruximaMD (rituximab)

Telephone: 1-877-714-2469
Email: [email protected]
Fax: 1-833-981-2254