Manitoba Biosimilars Initiative

October 29, 2024

For business owners, plan sponsors and administrators

The Manitoba government has announced its biosimilar initiative–expanding the use of biosimilar medications in place of biologic medications for certain conditions, where they are available. This means Manitoba residents with coverage under the provincial plan and using certain biologic drugs covered by the Manitoba provincial program will need to ​transition to the biosimilar versions, where they are available, to continue to receive coverage through the provincial plan.

When is the change happening?

The change is effective now and the province is allowing a transition period, which gives patients time to talk to their health care provider to learn more about the biosimilar version of their medication and request a new prescription for the biosimilar medication. Manitoba residents with coverage under the provincial plan and using certain biologic drugs will need to transition to a biosimilar version, where they are available, by the transition period end dates noted below to maintain coverage under the Manitoba provincial program and their plan with Manulife.

Please refer to the table below to see the biologic drugs affected, the biosimilar drugs to transition to and the date members are required to make the transition.

What does this mean for Manitoba residents taking a biologic?

Manitoba residents with coverage under the provincial plan and using certain biologic drugs listed for one of the conditions noted will need to transition to a biosimilar version, where they are available, by the transition period end dates noted to maintain coverage under the Manitoba provincial program. After that date, for certain biologic drugs, the Manitoba provincial plan will only cover the biosimilar version – not the biologic.

How does this affect Manulife drug plans for members in Manitoba?

For Manulife plan members, we are aligning to the coverage that is offered through the Manitoba provincial plan. As such, these plan members will be required to make the transition to the biosimilar drug as noted in the chart above to receive continued coverage under their Manulife plan.

For members that make the transition before the transition period end date noted above, there is no change to the process. We will consider claims for any portion unpaid by the Manitoba provincial plan for biosimilars. We won't consider claims for biologic drugs after the transition period end date.  This is supported by our current contract wording and no changes to the contract or booklet will be required.

How will our plan members know?

Manitoba Health has communicated these changes publicly and provided resources to specialist, doctors and nurse practitioners. It is likely many affected members are already aware of the change. In some cases, they may have already made the transition. Also, we are directly communicating with affected members to let them know what is happening and when.

What if a member is unable to transition to a Biosimilar?

Manitoba will consider exceptions on a case-by-case basis for members who are medically unable to transfer to a biosimilar. The member's doctor would need to submit a request for exceptional coverage on their behalf. If approved, the member would need to provide Manulife with proof of their approval and Manulife will consider balances for the biologic drug according to policy provisions.​

For more details, visit the Manitoba Government website or talk to your Manulife representative.

_{¹ Glatiramer is a non-biologic complex drug.}