A central Alberta man with Crohn’s disease says he is ready to fight the province for the right to continue receiving the form of medication he prefers.
“I’m going to make it a point that they know my name, and that they know my face. I’m not going to back down from this. If it means going up to the legislature and putting my face out there, then that’s what I’ll do,” said Travis Dutkiewicz, 37, of Penhold, even though stress can make Crohn’s symptoms worse.
The province recently announced it would no longer fund Remicade, a biologically based drug that treats autoimmune diseases such as Crohn’s, colitis and psoriasis, in favour of cheaper biosimilar medications.
Health Minister Tyler Shandro said in a statement that exceptions will be made for any patient whose doctor shows a valid clinical reason they cannot switch.
“But we need to be clear, exceptions are rare in B.C., where switching is well underway,” Shandro said.
“We realize the change will be stressful for some patients and that’s why we’re allowing six months for them to switch. There is plenty of time to make sure patients are supported,” the minister said.
Dutkiewicz said this is not a decision for the government to make, especially by a health minister who has a law degree and not a medical degree.
Dutkiewicz, who was diagnosed with Crohn’s 15 years ago and has used Remicade for about nine years, said he tried other drugs, but it was Remicade that controlled his symptoms and has kept him out of hospital for years.
“I’m not saying the biosimilar is bad. I just know, based on what I’ve gone through in the past 15 years, and knowing what Remicade has done for me, I have no desire to go back to that.
“I have seven kids and a wife and they need a father and a husband. This very much could take that from them.”
He said once a patient stops using a biologic like Remicade, they can’t use it again, because their body starts producing antibodies that make it almost impossible to take it.
Biologics are also always produced the same way, and biosimilars are not, which can be detrimental for patients, said Dutkiewicz.
He said about three weeks ago, he received a letter from Janssen, the company that makes Remicade, about future access to the drug in Alberta.
“This very much came out of the blue for us.”
Dutkiewicz receives an infusion of Remicade in Red Deer every six weeks, which costs the publicly funded health-care system $16,000.
The government says it wants to reduce health-care costs, and biosimilars are less expensive. But if people who need Remicade can’t get it, there will be costly hospital stays, loss of work and unemployment claims, said Dutkiewicz.
Dutkiewicz said plenty of doctors oppose eliminating access to Remicade, and Janssen has agreed to reduce the cost to make it comparable to biosimilars.
Shandro said Alberta is following B.C. and Manitoba in switching to biosimilars.
“Biosimilars are safe and effective. Our decision is based on expert opinion and evidence from B.C. and Europe, that shows they are clinically equivalent to biologics.
“The European Medicines Agency states that 10 years’ experience with many different biosimilars shows no difference in safety or efficacy between them and their reference biologics.
“The evidence is so clear that Crohn’s and Colitis UK has endorsed biosimilars, as has CC Europe. As has the NDP in B.C., and the federal Liberal advisory committee on national pharmacare.”
He said the claim that switching put patients at increased risk stems mainly from a paper by five Alberta physicians. All five disclosed past payments from Janssen, the maker of Remicade.
That doesn’t mean their work can’t be valid, but it’s a reminder that this issue involves a company trying to hold onto a lucrative market and avoid competition.
He said the unpublished paper has not been peer-reviewed and is not validated evidence.
“In spite of that, we took it seriously and asked the Institute of Health Economics to review it. The CEO of IHE, Dr. Chris McCabe, said at the news conference last week that the paper was systematically flawed and its conclusions were meaningless. Dr. McCabe said the BC Therapeutics Initiative agreed.”
Dr. Peter Bouch, with the Red Deer Primary Care Network, said the province should discuss changes with Alberta’s medical community before making decisions about the health-care system.
“We understand there is a money shortage. No one is under the illusion that there’s a lot of money floating around. Cuts can be made, but they’ve got to be made rationally.
“They’ve got to be made with some background information and speaking to the right people. You can’t just be yanking drugs off the market,” Bouch said.