Changes to coverage of Humira in BCBC Pharmacare recently announced it is adding Humira to the list of drugs included in its ongoing initiative to switch patients to biosimilar versions of high-cost biologics. Patients taking Humira for most conditions will be required to switch to a biosimilar version of the drug by Oct. 7, 2021 to maintain coverage under the public plan.
Biologics are drugs that are engineered using living organisms like yeast and bacteria. The first version of a biologic developed is also known as the “originator” biologic. Biosimilars are also biologics. They are highly similar to the originator biologic drugs they are based on, and Health Canada considers them to be equally safe and effective for approved conditions.
How we are responding to protect our clients
To help prevent this change from resulting in additional costs for our clients’ drug plans, while still providing plan members with access to safe and effective medications, we will no longer cover Humira for plan members in BC. Effective Oct. 7, 2021, claimants currently taking Humira will be required to switch to a biosimilar version of the drug to maintain coverage under their Equitable Life plan.
We will be communicating this change to plan administrators later this week. And we will be communicating with affected claimants in early August to allow ample time to change their prescription and avoid any interruptions in their treatment or their coverage.
If you have any questions about this change, please contact your Group Account Executive or myFlex Sales Manager.