Starting on a biologic (original-brand or biosimilar)


When a patient and their healthcare specialist discuss whether to start on a biologic therapy, the patient should understand key considerations to enable them to discuss treatment options with their healthcare team.

Key considerations for patients starting on a biologic (original-brand or biosimilar) therapy

Biologic therapies are an important treatment option for patients with many disabling and life-threatening diseases such as inflammatory arthritis, certain types of cancer, diabetes, inflammatory bowel disease, Crohn’s and colitis and psoriasis.

When a patient and their healthcare specialist discuss whether to start on a biologic therapy, the patient should be able to assess treatment (or no treatment) risk against benefit and have tools to enable them to discuss the pros and cons of the treatment with their healthcare team.

Biologics are made from living organisms, such as living cells that have been modified using biotechnology. This allows these living organisms or cells to produce the active substance of the biological medicine. This active substance is then harvested from the cells. The active substance is commonly called a “protein.” Biologics made up of proteins are much larger and more complex in nature than conventional, small molecule medicines such as ibuprofen or methotrexate.

When original-brand biologics lose their patents, biologic biosimilars can enter the marketplace, much like a generic medicine does when a small molecule brand name medicine loses its patent.

Taking a biologic (original-brand or biosimilar)

You may be able to administer a biologic – original-brand or biosimilar - at home by injection (known as “self-injection”) or have the treatment by intravenous infusion (IV) in your doctor’s office or an infusion clinic.

If you choose a biologic taken by self-injection, a nurse will first help you identify where on your body it is safe to administer the shot.

Common and rare side effects of biologics (original-brand or biosimilar)

The greatest risk while taking a biologic is infection. The likelihood of experiencing infection or any other side effects vary from person to person. Biologics – original-brand or biosimilar - make it harder for your body’s immune system to fight off infections. If you take a biologic medicine your specialist will ask you to go for regular lab tests to monitor your blood and watch out for side effects, such as infections.

Also, there are risks of interaction between biologics and medications being taken for other chronic diseases or illness, such as chronic respiratory conditions, diabetes, heart disease and stroke.

If you feel you are experiencing a side effect, your specialist will be able to assess whether it is the medication or another health issue.

The biologic therapy conversation between patient and their healthcare provider

As Health Canada authorizes more biologic medicines for sale – original-brands and biosimilars – and public drug plans provide reimbursement for them, it’s important that patients and their healthcare providers understand the facts around these therapies.

Patients will understandably have many questions when prescribed a biologic, whether it’s an original-brand or biosimilar. This places a great deal of importance on the conversation about biologics between a patient and their healthcare provider that takes into consideration benefits and risks, patient treatment goals and tolerance for side effects, accessibility of treatment and affordability.

Patients who feel they understand the choice of a biologic treatment and why it’s necessary, who trust their healthcare professionals, and who understand that there is a support plan in place are likely to achieve better outcomes.

Seeking biosimilars information

If you are a patient living with a chronic disease and have been prescribed a biosimilar, there are a number of sources for information about the medicine. Your specialist or pharmacist will have valuable information about biosimilars. You should also look for additional evidence-based information from your provincial drug plan or private health insurer, patient groups or patient support program.

Please click on Resources to find links to the current biosimilar policies from public or private drug plans.

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