Survey Overview

Crohn’s and Colitis Canada surveyed patients and caregivers affected by British Columbia’s non-medical switch policy to gain further insights into the patients’ post-switch experience.

This survey complements the Crohn’s and Colitis Canada report prepared with CAG that identified that 1 in 11 patients would have worse clinical outcomes with a non-medical switch. The survey focused on patient and caregiver experiences with being switched from a biologic to biosimilar medication.

Survey participants

Patients in British Columbia with Crohn’s disease or ulcerative colitis (or their caregivers) who were switched from Remicade® to its biosimilar version (Inflectra® or Renflexis®) due to the policy direction from BC PharmaCare.
  • 112 respondents between November 2019 and October 2020
    • 11 people were excluded because they did not live in BC
  • 84% of respondents have IBD; 16% were caregivers

Study method

  • Online survey
  • Promoted by email, newsletters and social media

Summary of findings

1 in 2 surveyed reported a change in wellness post-switch

  • 52% reported a change in their health after switching to the biosimilar:  
No Forced Switch Pandemic chart indicating changes to wellness

  Frequent bathroom use


  Blood in stool

  Multiple doctor visits

  Emergency department visits

  Days off work/school

  Mental health issues

  Tests/Investigations by doctor

  • 52% reported a change in their health after switching to the biosimilar
  • 97% reported health was well managed prior to the switch
  • 89% remained on the biosimilar to which they first switched
  • 11% had to switch to another biosimilar or a different biologic
  • 8% reported that they incurred additional out-of-pocket expenses as a result of switching treatments

  • 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.