OBJECTIVES: Pricing of biosimilars relative to originator biologics is a topic of international interest. The Organisation for Economic Co-operation and Development lists Canada as the second highest in pharmaceutical spending, only behind the United States. This study aimed to evaluate the differences in price discounts on biosimilars between Canada and select European countries.

METHODS: Infliximab and etanercept biosimilars were used as examples, as these are the only anti-TNF biosimilars recommended for reimbursement by the Canadian Agency for Drugs and Technologies in Health. Prices for biosimilars and originator biologics were obtained from local drug formularies for the following geographies: Canada (Ontario), Northern Europe (Sweden, Norway, Denmark), Western Europe (United Kingdom, France, Switzerland), and Southern Europe (Italy, Spain, Portugal). T-tests were used to test the statistical significance of differences between regions.

RESULTS: Of the ten countries evaluated, Canada ranked fourth in mean price of anti-TNF biosimilars at €578 (range: €435 - €800). The unit price of infliximab and etanercept reference biologics was higher in Canada (€654 and €1,076 respectively) compared to Western (€542 and €758) and Southern Europe (€556 and €994). The average price discount for anti-TNF biosimilars in Canada was 36%, the highest of all the regions examined: Northern Europe (22%, n=3; p=0.3804), Southern Europe (18%, n=4; p=0.0678), and Western Europe (13%, n=4; p=0.0237).

CONCLUSIONS: The price of anti-TNF biosimilars is comparable between Canada and Europe. Canada’s higher prices on originator biologics makes it appear that the biosimilar price discount is greater in Canada than Europe. This study is limited to publically available data, and does not reflect discounts and prices seen in product listing and commercial agreements, or private tenders. Despite the low number of observations, the differences between discounts applied in Canada and Western Europe were found to be statistically significant.