CSPA - Education

Subsequent entry biologics (SEBs) are a current controversial topic in health care in Canada. Skin patients whose treatment plan may include a biologic (especially those with psoriasis, psoriatic arthritis, metastatic melanoma and hidradenitis supperativa) should be aware of this new category of drugs and the impact it might have on their treatment plan.

• SEBs are not “generics” and cannot be interchanged or substituted without the advice of a physician. This means the pharmacy should not change a prescription to a SEB without written direction to do so from the prescribing physician.

• Patients should know the trade name of the biologic therapy that has been prescribed for them and be sure that is the one they receive.

• While SEBs are designed to be very similar to the reference originator drugs with essentially the same clinical response in terms of efficacy and safety, it should be understood that SEB’s are different drugs from their reference or originator drugs and could have different side effects, different efficacy and different long term safety issues that have not been subjected to the same clinical trial research requirements as the reference drugs

• SEB’s have a short cut* to approval which means

– SEBs will likely be less expensive than their reference drug

– Safety and efficacy on the SEBs haven’t been subjected to the same testing requirements in Canada prior to approval

– More Canadians should have access to this class of treatment given that costs are lower

*Because the current approval process in Canada ( and in many other countries) allows manufacturers of SEBs to present clinical safety and efficacy data from the reference drug rather than having to conduct the same rigorous clinical trials themselves, the rationale is that these new ‘similar’ medications can be offered more quickly and at a lower price.

More information available at http://www.biotech.ca/en/policy-matters/health-bio/seb.aspx

Fill out the form below which will send the letter directly to your HR Manager. Double check that you’ve got your Manager’s correct email address. If you don’t know who your HR Manager is, contact your organization’s HR department and ask for the name and email of the person who liaises with the insurance company.

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Insurance Carrier - (if you know it)

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Because no two patients are the same, we strongly encourage you to add your own personal story to the letter before sharing it. It helps to explain the impact that your condition has had on your life and work; how it affects you emotionally and physically; tell them about how much medication and treatment have helped – or not. Help your HR Manager understand why managing the condition is so important to you, their employee, and the work you do every day.

Email Subject Line: Help Protect Employees: Please Read

Message Body (be sure to READ THIS letter, insert your company name, and feel free to edit the letter as you see fit)

I am an employee at XX INSERT COMPANY NAME XX, and I am asking for your help.  I recently learned that some medical insurance companies are putting a tiered pricing strategy in place that can directly impact the ability of many people living with health conditions to access medications they need to manage their symptoms and live a full, active life.
I am concerned that this strategy affecting how we as patients access treatments is just the beginning of a trend that will see medical decisions being made by plan administrators who have no medical training and don’t know our needs as patients and as employees.  Please tell our medical insurance provider that it’s important that we get the medication that our doctor determines is best.  

Insurers need to understand that every patient has a unique experience and medical history, and that every treatment has benefits, drawbacks, and possible side effects. My doctor has the expertise and training to determine which treatment will keep me and my family members healthiest. Insurers shouldn’t take medical decisions out of our doctor’s hands.
Tiered pricing hurts patients by prioritizing one medication based on cost while restricting access to others.  From what I understand, this means that a medication will only be covered if it is a first tier, or Tier-1, medication. Otherwise we’ll have to pay for our own treatment, and if we can’t afford to, our health will suffer.
Having peace of mind and knowing that my health and my family’s health will be taken care of when we need it, helps me be able to give my absolute best at work.  Before our insurer implements any changes that negatively impact employees’ health and ability to work, please explain that for our organization to thrive, its employees must have access to the treatments that help them and that a tiered pricing strategy will negatively impact those choices.
Thank you,

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General skin health and educational sites:

Canadian Arthritis Patient Alliance (CAPA)
Canadian Cancer Action Network
Canadian Dermatology Association
Canadian Institute for Health Information
Coalition of Skin Diseases
DermWeb
DrugCoverage.ca - Your guide to reimbursement for prescription medications in Canada
Eczema Channel on medbroadcast.com
HealthFinder
Institute of Musculoskeletal Health and Arthritis (IMHA)
Itching for Answers - A diseases state website for Chronic Idiopathi Urticaria Patients
Skin Care Guide
Psoriasis Channel on medbroadcast.com
SkinCell International Forum for Skin Disorders
Sketch an Itch - providing Chronic Idiopathic Urticaria Patients a voice to share their experience. You can share your story and it may be picked by an artist and then drawn to be added to the website!
University of Nottingham - Centre of evidence based Dermatology
World Health Advocacy

The Canadian Skin Patient Alliance (CSPA) is dedicated to providing education and information to Canadian skin patients and their families along with health-care providers and decision-makers.

It’s important for skin patients and their families to have access to the most up-to-date information on their condition or disease. As a crucial member of your care team, you’ll want to be on the cutting edge so you can have informed discussions with your health-care professionals and get the best possible outcomes.

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