Joint Statement from the Canadian Association of Gastroenterology and Crohn’s and Colitis Canada

October 24, 2019 (Toronto, ON) – The Canadian Association of Gastroenterology and Crohn’s and Colitis Canada today announced a joint statement that has been accepted for publication in the Journal of the Canadian Association of Gastroenterology. The paper, entitled Joint Canadian Association of Gastroenterology and Crohn’s and Colitis Canada Position Statement on Biosimilars for the Treatment of Inflammatory Bowel Disease, was co-authored by esteemed Canadian gastroenterologists including: Drs Paul Moayyedi, Eric Benchimol, David Armstrong, and Grigorios I. Leontiadis. 

Using the GRADE approach, authors reviewed evidence comparing biosimilars (available in Canada) to originator biologics for the treatment of patients with inflammatory bowel disease. They evaluated efficacy, safety, cost and acceptance by patients.

Ultimately, this joint paper made the following recommendations:
  1. Patients may be started on a biosimilar if they have active disease and have not been exposed to that biologic previously. This is with the understanding that the price differential between the originator biologic and biosimilar is significant. 
  2. Non-medical switch is not recommended for patients stable on biologic treatment.
  3. Automatic substitution from a biologic to its biosimilar is not recommended.
Dr. Paul Moayyedi, Audrey Campbell Chair of Ulcerative Colitis Research at McMaster University says “there are a number of position statements from various organizations but none of these provide an explicit literature search or assessment of the quality of evidence of a defined clinical question according to GRADE criteria. We felt that this was critical in demonstrating the evidence base for our joint position.”

“Gastroenterologists across Canada and indeed government and private payers need to understand the evidence, or lack of evidence on this topic. Based on what we learned, we cannot recommend a non-medical switch policy for patients stable on biologic treatment,” added Dr. Grigorios Leontiadis, Associate Professor of Medicine, Division of Gastroenterology at McMaster University.

Crohn’s and Colitis Canada released their own Position Statement in early September. “Opposition to a non-medical switch policy affecting patients with Crohn’s and colitis has been irresponsibly characterized as an emotional reaction to change. This work invalidates this portrayal and firmly indicates to policy makers that non-medical switch is not in the best interest of patients as this may result in worsening of disease in some patients,” says Mina Mawani, President and CEO of Crohn’s and Colitis Canada. “We are hopeful that this joint statement gives government pause and opens up discussion toward alternate policy interventions.”

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.

The Canadian Association of Gastroenterology (CAG) represents more than 1,100 members across Canada, including physicians, basic scientists, and affiliated health care providers who work in the field of gastroenterology. The CAG is a member-focused organization with a mission to support and engage in the study of the organs of the digestive tract in health and disease, as well as to promote and advance gastroenterology by providing leadership in patient care, research, teaching and continuing professional development. Visit for more information. 
Canadian Association of Gastroenterology logo

To download this press release in PDF format, click here.

  • 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.

Other Areas of Interest