Image Credit: Remicade

By David Charbonneau

EYEVIEW

CHARBONNEAU: Big Pharma threatens patients over biosimilars

Nov 28, 2019 | 1:55 PM

PATIENTS WHO ARE PRESCRIBED the drug Remicade have received letters from the manufacturer warning them about the switch to a cheaper version.

British Columbia has already decided to switch to a cheaper class of drugs called biosimilars. Ontario and Alberta are looking at following B.C.’s lead. Patients in all three provinces have received letters from Janssen Inc.

Janssen Inc, a unit of Johnson & Johnson, is the maker of Canada’s most lucrative drug, Remicade. The biosimilar would be about one-half the cost. In a letter to Albertans dated October 29, 2019, patients are urged to contact provincial politicians and express concerns:

“Requiring stable patients to switch from REMICADE to a biosimilar for no medical reason is of great concern and we believe that patients should have a voice in decisions regarding their treatment. Should you wish to voice your concerns regarding any policy decision in Alberta, please contact your Member of Legislature (Globe and Mail, November 22, 2019).”

In a letter to B.C. patients dated November 4, Janssen warned that, as of January 1, the company would no longer be able to provide financial assistance to patients as a result of the government’s decision to stop covering Remicade.

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The threat from Janssen is clear: patients should be concerned about the switch to a cheaper drug and they won’t receive financial assistance. To my knowledge, Janssen didn’t mention that Health Canada has found no difference between biosimilars and the original and that biosimilars accounted for 98 per cent of the replacement used in Norway, 92 per cent in Britain, 78 per cent in Sweden and 60 per cent in France. In Canada, that figure was just eight per cent. Janssen didn’t say how many patients it supports financially or mention that BC PharmaCare already subsidizes drug prescriptions.

Then there is the issue of misuse of patient information in recruiting them as defenders of Janssen. B.C. Health Minister Adrian Dix criticized Janssen’s tactics, which he said were aimed at guarding market share for Remicade.

“I’m obviously concerned,” Dix said, “that confidential patient information that’s held in trust by pharmaceutical companies is being used for other purposes than originally intended.”

Janssen says it wasn’t them who sent letters but a third party that provides administrative services for Janssen’s patient-support program called BioAdvance. It’s a cute trick but it doesn’t wash: the buck stops at Janssen. If BioAdvance wasn’t directed by Janssen, surely they would be fired.

As well, there is the issue of whether Janssen broke federal drug-promotion rules or misrepresented Health Canada’s position on biosimilars. A Health Canada spokesman said that in the letters to Alberta and Ontario, rules were not broken but in B.C.’s case they were –something that Health Canada has rebuked Janssen for in the past.

Janssen has some support in their opposition to biosimilars. Crohn’s and Colitis Canada and the Canadian Association of Gastroenterology recently opposed the switch to biosimilars. They refer to two studies. Independently, neither study shows a statistical difference but combined they suggest there is according to the lead author of the combined study.

Crohn’s and Colitis Canada receives funding from Janssen but the lead author says there was no financial conflict of interest.

Then there is the politics of direct contact to MLAs. Patients have a way of expressing displeasure to politicians. It’s called democracy. If they want governments to spend more of their tax dollars on Remicade than biosimilars, they can elect politicians who will.

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Editor’s Note: This opinion piece reflects the views of its author, and does not necessarily represent the views of CFJC Today or the Jim Pattison Broadcast Group.