More than 20,000 patients with chronic diseases including diabetes and rheumatoid arthritis will have six months to switch to less expensive copycat drugs as B.C. becomes the first province to stop covering some expensive, formerly patented drugs.After the transition, Pharmacare will stop public funding of three injectable drugs for such conditions, although private insurance plans may continue to do so.Health Minister Adrian Dix said no harm will come from the change, expected to save nearly $100 million over three years.The savings will be spent to fund drugs that have not been covered by the public drug insurance plan, including Jardiance, an SGLT2 inhibitor for diabetes, and Taltz, for psoriatic arthritis.Dix acknowledged the change may be an inconvenience since most patients go to clinics to get the intravenous treatments and some will have to go to different locations. But he said he’s confident patients and doctors will work to make the switch to so-called biosimilar drugs, which are equally safe and effective as the original bioengineered drugs called biologics.The government will monitor the switch by watching for such things as increases in physician and hospital visits.Biosimilars are similar to generic drugs in that they are manufactured after the 20-year patent expires on the original biologics. They cost 25 to 50 per cent less than the original drugs. The medications involved in the B.C. switch are used for such conditions as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, plaque psoriasis, inflammatory bowel disease, diabetes and Crohn’s disease. Dix, who has Type 1 diabetes, said he made the switch to a 15 per cent cheaper biosimilar months ago and there were no negative effects. But he said he empathizes with those who will be affected because change is often difficult “even if it’s just a brand change.”In 2018, B.C. spent $125 million on the three biologic drugs affected by the policy change. People using Lantus, or insulin glargine, will switch to Basaglar. Patients using Enbrel, also known as etanercept, will switch to Erelzi or Brenzys. Those on Remicade (infliximab) will switch to Inflectra or Renflexis.Dr. Tom Elliott, medical director of B.C. Diabetes, said it was a “joyous day” because, with the expected savings, diabetics will now get coverage for “life-saving” Jardiance for which he and 60 other diabetes expert have long advocated. About 22,000 diabetics will likely be prescribed the drug, which is expected to cost Pharmacare about $19 million over three years.After Nov. 25, Pharmacare will provide coverage for the original drugs only in exceptional cases, to be decided on a case-by-case basis. Nearly 3,000 Crohn’s and ulcerative colitis patients will also be transitioned to less expensive drugs but details are still being worked out.B.C. has spent nine years studying the matter before announcing the decision Monday. The ministry of health consulted with physician and patient groups like the B.C. Society of Rheumatologists, endocrinologists, Doctors of B.C., Arthritis Consumer Experts, Canadian Arthritis Society, B.C. Pharmacy Association, Neighbourhood Pharmacy Association, regional health authorities, Health Canada, and the Patented Prices Medicine Review Board. Notably absent on the list were Big Pharma companies like Janssen Biotech which distributes Remicade.Rheumatologist Dr. John Esdaile said B.C. becomes an overnight Canadian leader with the cost-saving policy change, something which he and his colleagues have been asking for.He said many European countries have had such a policy for 10 years with no evidence of detriment to patients. “I don’t know of any bad news,” said Esdaile, scientific director of Arthritis Research Canada.“For years, B.C has been spending money it doesn’t need to spend on expensive biologics instead of using biosimilars, which I call biogenerics since they work just as well,” Esdaile said.Cheryl Koehn, president of Arthritis Consumer Experts, said society will benefit from the new policy because coverage for other conditions and drugs will expand. Koehn, who has been living with rheumatoid arthritis for over 30 years, said in the publicly funded health care system, money doesn’t fall off trees so “courageous” policies like this one are crucial.Biosimilars Canada also praised the B.C. government for expanding the use of such medications. It said there are nearly 100 studies involving over 14,000 patients and that such “real world” evidence confirms the safety and efficacy when patients made the switch.The government has provided a full list of the medications and conditions involved in the new email@example.comTwitter: @MedicineMattersBIOLOGICS AND BIOSIMILAR DRUGSBiologic drugs are made by using live organisms such as yeast or bacteria to produce proteins that are then purified to treat various health conditions. They are given by injection.Biosimilar drugs are not unlike generic versions of once patented drugs; they are developed after the 20-year patient protection expires.Biologics and biosimilars are highly similar but not identical.LISTEN: Why aren’t taxes part of an inquiry into skyrocketing gas prices? What’s the latest in the latest standoff between teachers and the provincial government? Mike Smyth and Rob Shaw break down the latest B.C. political news.