Government switch policies are integral to promoting innovation in therapeutics and MS treatment program sustainability.
There’s no cure for multiple sclerosis (MS), but there’s been much progress in developing innovative treatments — including biologic therapies — which are designed to target specific molecules involved in the disease.
Used to treat many diseases, biologics are made from animal or plant cells, instead of a chemical process. Biologic therapies can offer an advantage because their mechanisms of action are more targeted to the factors that cause a disease and its symptoms.
Biologics, however, can be expensive to develop and for patients. And while provincial and employer-sponsored benefit plans want to expand their coverage to include new medicines, they need to manage costs. Biosimilars provide a way to help manage health payer budgets.
A biosimilar is a non-biologic complex molecule that’s similar to a biologic already developed. There are Health Canada standards and regulations to ensure treatment safety and efficacy. In Canada, there are many people taking biologic medicines that have expired patents — allowing manufacturers to produce biosimilars to replace them. Jurisdictions including Nova Scotia, British Columbia, New Brunswick, Alberta, Quebec, and the Northwest Territories have implemented switching policies, which allow for the original biologics to be automatically substituted with biosimilars.
Biosimilars are an important way to ensure the sustainability of treatment programs.
“Biosimilars are an important way to ensure the sustainability of treatment programs,” says Dr. Virginia Devonshire, Director of the University of British Columbia MS and NMO Clinic and its Clinical Trials group and an associate clinical professor at the University of British Columbia. “They allow us to increase the funding where we really need it and not necessarily spend money where we don’t have to spend money.”
As science evolves, MS management has also evolved. In Canada, there are two trends to treat MS: escalation therapy and an induction strategy. In escalation therapy, a patient starts on medications that have a good balance between effectiveness and a relatively low risk of adverse events or complications and moves to more powerful treatments — which may have more side effects — as needed.
With induction therapy, a patient starts with stronger therapies, which may have more side effects and risks, followed by less powerful treatments to keep their immune response in check.
“It’s hard to know what a patient’s disease trajectory will be. So, with induction therapy, we put patients on higher efficacy treatments to hopefully prevent or slow the accumulation of disease and gain that control early,” says Dr. Devonshire. “In another patient, maybe they’ve had the disease longer and it’s not as aggressive. Escalation therapy uses a treatment that has a longer track record and fewer risks or side effects.”
“With most treatments, we’re confident in saying this is going to be as safe and effective as the treatment you’ve been taking. With some, you may get different side effects, but most of these transitions go very well,” continues Dr. Devonshire. “If there are concerns, I would tell patients to talk to their health-care provider and they’ll work to find a solution, perhaps switching to a different biosimilar or switching back to the original treatment.”
Dr. Devonshire encourages patients to talk to their health-care provider to learn about their treatment options.
This article was made possible with support from a leading research-based pharmaceutical company.