Crohn’s and Colitis Canada Response to Alberta Non-Medical Switch Policy

Patient-Doctor Choice

December 12, 2019 (Toronto, ON) - Crohn’s and Colitis Canada is extremely disappointed in Minister Shandro and his very short-sighted and potentially harmful policy announced today that risks the health of people with inflammatory bowel disease (IBD).

Premier Kenney, Minister Shandro and the bureaucrats in Alberta Health were all provided with ample evidence to stay their hand – but they did not listen. “We are at a loss,” says Mina Mawani, President and CEO of Crohn’s and Colitis Canada. “We provided the Alberta government with an evidence-based counter-argument against a non-medical switch for patients with IBD, fully supported by Canadian gastroenterologists and yet they still went ahead – putting people’s health at risk and putting cost back into the system through avoidable surgeries, increased hospitalizations and lost productivity. And for what? The manufacturer of the biologic drug in question has publicly stated they will match the biosimilar price. No money will be saved – just cold policy affecting real people in Alberta.”

Minister Shandro held a press conference to announce his switch today. “The Minister dismissed the evidence review by esteemed gastroenterologists and scientists in Canada in order to plow blindly ahead.”

The non-medical switch policy affecting patients with IBD in Alberta also includes a restrictive tiering component. “The tiering component forces patients onto intravenous therapy, meaning at least 6 to 10 days per year where they must seek treatment at an infusion centre. Taking away the option of a subcutaneous IBD therapy is a hard hit for young people in the workforce and those in remote areas of the province. This is a huge quality of life issue for people living with IBD in Alberta” says Mawani.

Most recently, a paper authored by prominent gastroenterologists in Alberta was shared in confidence with the Alberta government. The study, The Argument Against a Biosimilar Switch Policy for Infliximab in Patients with Inflammatory Bowel Disease Living in Alberta (in press at the Journal of the Canadian Association of Gastroenterology [JCAG]) specifically studies implications of a non-medical switch policy on patients with IBD in Alberta. The review offers information regarding:

  • risk of harm
  • logistical and ethical implications
  • vulnerable populations
  • cost-effectiveness issues
  • patient perspective
  • collaborative solutions
Most notably, authors suggest that in the best-case scenario, 63 avoidable surgical procedures would occur among patients with IBD, directly attributable to a biosimilar switch policy. In the worst-case scenario, 184 avoidable surgical procedures would occur. Minister Shandro also misguidedly dismissed this study.

Dr. Remo Panaccione, Director, Inflammatory Bowel Disease Clinic in Calgary has been outspoken in his opposition to a non-medical switch for people living with Crohn’s or colitis. “We have gone out of our way to educate the Minister and his staff about the potential harm this policy may bring. We understand that we all need to act fiscally responsible but not at the expense of the health and wellness of patients. I simply don’t understand the policy in an environment where similar cost savings are on the table. It is a sad day for IBD patients in the province.”   

The Chair of the Crohn’s and Colitis Canada Scientific and Medical Advisory Council, Dr. Gilaad Kaplan, a gastroenterologist and Professor at the Cumming School of Medicine, University of Calgary considers this non-medical switch policy affecting patients with IBD to be flawed. “In order for Minister Shandro to have made this policy decision, he and his office had to have simply disregarded the evidence and ignored health consequences for vulnerable patients with IBD. Albertans deserve more from their government” says Dr. Kaplan.

Crohn’s and Colitis Canada implores the Alberta government to reconsider this policy and put patients’ health first.

For further information:
Please contact: Angie Specic, VP, Marketing and Communications, Crohn's and Colitis Canada, 1-800-387-1479 ext. 210,

Crohn’s and Colitis Canada is the only national, volunteer-based charity focused on finding the cures for Crohn’s disease and ulcerative colitis and improving the lives of everyone impacted by these diseases. We are the world’s second largest health charity funder of Crohn’s and colitis research, and our patient programs and advocacy efforts support the people affected by these chronic autoimmune diseases, which cause the body to attack healthy tissue, leading to the inflammation of all or part of the gastrointestinal tract. Visit for more information.

Biologics are drugs produced from living organisms. In the context of inflammatory bowel disease (IBD), biologics are designed to target and block the cells responsible for inflammation. As patents expire on innovator biologics, drug manufacturers are developing new drugs based on existing biologics. These new drugs are called biosimilars. Biosimilars are not identical to their innovator biologic, though they are highly similar including its effectiveness and safety profile.

  • Canada has among the highest incidence rates of Crohn's and colitis in the world.
  • 1 in 140 Canadians lives with Crohn’s or colitis.
  • Families new to Canada are developing these diseases for the first time.
  • Incidence of Crohn’s in Canadian kids under 10 has doubled since 1995.
  • People are most commonly diagnosed before age 30.

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