Information for Prescribers about the Nova Scotia Biosimilar Initiative

Nova Scotia Pharmacare

Information for Prescribers about the Nova Scotia Biosimilar Initiative

The Government of Nova Scotia is expanding the use of biosimilar medications in Nova Scotia Pharmacare programs. As of 3 February 2023, some original biologic medications won’t be covered by Pharmacare if a biosimilar version is approved and available, unless an exemption is granted.

Switching patients to biosimilars

To switch patients to biosimilars, prescribers need to:

  • identify patients covered by Pharmacare programs who need to switch
  • discuss the switch with patients as soon as possible and write new prescriptions if needed
  • contact patient support programs to enroll patients, where available
  • make sure that the biosimilar prescription includes the name of the patient support program that the patient is enrolled in, where available

Support for prescribers

Pharmacare can provide you with a list of your patients who may need to switch to a biosimilar medication. To receive this list, fill out the Patient List Request Form (PDF) and email it to or fax it to 902-428-3400.

A clinical support staff member is available to help you organize, reduce administrative burden and provide education where needed. To contact the clinical support staff, email

Coverage criteria

The following changes to biosimilar coverage apply:

  • exception status drug (ESD) requests don’t need to be submitted for patients switching to a biosimilar medication
  • coverage for biosimilars will be included in the existing approvals for Humira®, Enbrel®, Remicade® and Rituxan® (pharmacists can contact the Pharmacare office if coverage is not already in place)
  • no ESD is required for biosimilar insulins included in the list of medications that require switching
  • annual ESD renewal requests aren’t required for continued coverage of biosimilars for patients


Prescribers can apply for an exemption if a patient can’t switch to a biosimilar for clinical reasons. Fill out an Exception Status Drug Request Form (PDF) for patients who can’t switch and provide detailed clinical rationale for the exception.

If this exemption is not approved or the patient doesn’t qualify for an exemption, their coverage for the original biologic medication will end.

Medications that require switching to biosimilars

Drug Originator (switch from) Biosimilar (switch to) Indications (if applicable)
Adalimumab Humira®


ankylosing spondylitis
plaque psoriasis
psoriatic arthritis
rheumatoid arthritis
Crohn's disease
adult ulcerative colitis
polyarticular juvenile Idiopathic arthritis
hidradenitis suppurativa
non-infectious uveitis
Etanercept Enbrel® Brenzys®
ankylosing spondylitis
plaque psoriasis
psoriatic arthritis
polyarticular juvenile idiopathic arthritis
rheumatoid arthritis
Infliximab Remicade® Avsola™
ankylosing spondylitis
plaque psoriasis
psoriatic arthritis
rheumatoid arthritis
Crohn's disease
ulcerative colitis
Insulin glargine Lantus® Basaglar™
Insulin lispro Humalog® Admelog® diabetes
Insulin aspart NovoRapid® Trurapi®
Rituximab Rituxan® Riximyo®
rheumatoid arthritis
auto-immune diseases

NovoRapid vials will be covered for those using insulin pumps, until compatibilities are established.

Lantus® cartridges will be covered for those 17 or younger who require ½ unit dosing.

The policy will apply to other medications on the Nova Scotia Formulary as new biosimilar medications are approved.


Contact information

Department of Health and Wellness Clinical Support Staff

Pharmacare office
Toll-free phone: 1-800-563-8880 
Phone: 902-496-7008
Hours: Monday to Friday, 8am to 5pm