Some patients concerned as change to generics in Sask. drug plan approaches

When Megan MacLeod was in university, she had to wrap her hands in bandages and take over-the-counter medication to manage the pain from her arthritis enough to play percussion instruments as part of her degree.

Now, with the Saskatchewan Drug Plan scheduled to shift on April 30 from biologic drugs — like the ones MacLeod takes — to generic, more cost-effective copies called biosimilar drugs, MacLeod is fearful she may have to endure the pain again as she tests the new medication.

MacLeod, 33, from Regina, is one of the about 24,000 patients who will be forced to make the shift from one of 10 biologic drugs to biosimilars, a move the province says could could save $20 million annually.

Saskatchewan announced in late October it would start its biosimilars initiative, making it the sixth Canadian province to make the switch. The adjustment will include a range of drugs that treat conditions including Crohn's disease, arthritis, diabetes and multiple sclerosis.

According to the province, biologic drugs costing more than $10,000 per patient per year made up more than 70 per cent of the drug spending in Canada.

The province says clinical studies show that biosimilars have the same efficacy and safety as their originator.

Both Diabetes Canada and Crohn's and Colitis Canada have stated they disagree with the changes, saying medication switches need to be made in conversation with the patients.

Some residents in other provinces that made the switch have reported the new drugs not being effective, while others were concerned about the resurfacing of painful flare ups they had before being put on their current medication.

MacLeod was diagnosed with juvenile rheumatoid arthritis — later called juvenile idiopathic arthritis — at 12 years old, struggling with it until she was offered a biologic drug in her early 20s. She had a total knee replacement in her early 20s as a result of her arthritis, she said.

Her condition deteriorated on the first drug she was prescribed, which she said was chosen for its low cost. Then she was prescribed Humira, a biologic, and while she still grapples with properly medicating, she said it brought a semblance of normal back to her life. She doesn't want her condition to regress if she's required to change medications.

MacLeod's describes her condition as like having the flu constantly. She said that for two years before finding a biologic that worked she could barely walk and has had to crawl on her hands and knees to get up a staircase.

"It's like trying to close your fingers like a normal person would, but feeling a softball stuck in there and being unable to do it ... and it's not just your fingers, it's potentially every joint you have in your body," she said.

"It's scary ... I've already been there and I don't want to be again."

MacLeod said she is frustrated the government is focused more "on their collective wallet than what this is going to do to people who are living with these kinds of conditions."