British Columbia And Prince Edward Island Become The First Provinces To Add Erelzi (Etanercept) To Public Drug Plans For The Treatment Of Multiple Inflammatory Diseases

• Erelzi, has been added to public drug plans based on specific criteria in British Columbia and Prince Edward Island for the treatment ofmoderate to severe rheumatoid arthritis and for reducing signs and symptoms of active ankylosing spondylitis.
• Erelzi also becomes the first biosimilar indicated for polyarticular juvenile idiopathic arthritis1 under these provincial public drug plans.

British Columbia and Prince Edward Island are the first provinces to add Erelzi (etanercept) to their public drug plans for the treatment of multiple inflammatory diseases, respectively on November 14 and November 27. The two provincial listings follow the conclusion of an agreement between the pan-Canadian Pharmaceutical Alliance (pCPA) and Sandoz Canada, allowing member provincial, territorial and federal drug plans to fund this therapy for patients. Erelzi, by Sandoz, a Novartis division and the pioneer and global leader in biosimilars, was granted Health Canada approval in April 2017 and was launched in Canada in August 2017.

Erelzi is reimbursed under specific criteria for the treatment of moderately to severely active rheumatoid arthritis (RA) in adults, and for reducing signs and symptoms of active ankylosing spondylitis (AS). In addition, Erelzi will be the only biosimilar to be reimbursed for the treatment of polyarticular juvenile idiopathic arthritis (JIA) in patients aged 4 to 17¹. JIA is a condition that affects about three out of 1,000 children and teenagers in Canada.²

"The biosimilar Erelzi is a further addition to the many choices patients and rheumatologists have to fight chronic inflammatory arthritis such as rheumatoid arthritis," says Dr. John Wade, a leading rheumatologist at Artus Health Centre in Vancouver. "As we successfully improve lives with patients who have crippling diseases, British Columbia has demonstrated the commitment to provide coverage for these important medications. Biosimilars provide cost savings so that more patients can be treated at a lower cost to the healthcare system."

"Sandoz is pleased that British Columbia and Prince Edward Islandrecognize the important impact that access to Erelzi can have on reducing the burden of disease and delivering important savings to the healthcare system and the public drug plan," said Nadia Turchetta, Executive Director, Biopharmaceuticals, Sandoz Canada. "Erelzi is another concrete example of how Sandoz is making access happen by offering high-quality medicines at a more affordable price, which will deliver important savings to the healthcare system."

Erelzi is available in a pre-filled syringe (PFS) and in the SensoReady pre-filled pen (PFP), an ergonomic device for patients with limited dexterity. Erelzi is available in a 25 mg and 50 mg PFS, and is the only etanercept available in a 25 mg PFS.

A biosimilar is a biologic that is launched after the loss of patent exclusivity on the originator biologic. It's a highly similar biological medicinal product, having demonstrated therapeutic equivalence to a biologic reference product and hence comparable efficacy, safety, tolerability and immunogenicity profiles. Biosimilars can increase access to effective treatments for patients, as well as reduce the ongoing economic burden currently existing in the Canadian healthcare system that is impacting patients, physicians and payers. Recently, Canada's Patented Medicine Prices Review Board estimated that the potential cost savings from biosimilars could range from $332M to $1.81B.³

Sandoz is committed to increasing patient access to high-quality, life-enhancing biosimilars. Sandoz markets five biosimilars in Europe. As a division of the Novartis Group, Sandoz is well-positioned to lead the biosimilars industry based on its experience and capabilities in development, manufacturing and commercialization.

About Erelzi
Erelzi is the Sandoz biosimilar of the reference medicine Enbrel. ErelziTM has been studied in a global development program, which included a comprehensive comparison of ErelziTM and Enbrel at the analytical, preclinical, and clinical levels. The program included preclinical studies, pharmacokinetic (PK) studies, and the Phase III confirmatory safety and efficacy EGALITY study between ErelziMC and Enbrel.

Health Canada approval was based on a comprehensive development program consisting of comparative analytical, preclinical, and clinical data demonstrating biosimilarity to the reference medicine, Enbrel.

Studies included: analytical (extensive comparative physicochemical and functional assessment of Erelzi and the reference biologic drug), preclinical, Phase I pharmacokinetic (PK), and the Phase III confirmatory study EGALITY– an innovative safety and efficacy study in a sensitive indication to detect potential differences between Erelzi and Enbrel.

The totality of evidence demonstrates that Erelzi is highly similar to Enbrel in terms of structure, function, PK, efficacy, safety and immunogenicity. Based on this evidence, Health Canada granted market authorization to Erelzi indicated for: treatment of moderately to severely active rheumatoid arthritis (RA) in adults, reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis (JIA) in patients aged 4 to 17 years and reducing signs and symptoms of active ankylosing spondylitis (AS).⁴

About Sandoz
Sandoz Canada is part of Sandoz International GmbH and a subsidiary of Swiss multinational Novartis AG. A leader in its field, Sandoz Canadadevelops, markets and distributes a broad line of generic, biosimilar, consumer and specialty products.

Sandoz, a division of the Novartis Group, is a global leader in generic pharmaceuticals and biosimilars. Our mission is to discover new ways to improve and extend people's lives. We contribute to society's ability to support growing healthcare needs by pioneering novel approaches to help people around the world access high-quality medicine. Our global portfolio of approximately 1000 molecules, covering all major therapeutic areas, accounted for 2016 sales of USD 10.1 billion. In 2016, our products reached well over 500 million patients and we aspire to reach one billion. Sandoz is headquartered in Holzkirchen, in Germany'sGreater Municharea.

¹Sandoz Canada did not seek a marketing authorization for the treatment of psoriatic arthritis or plaque psoriasis.
² The Arthritis Society: http://arthritis.ca/about-arthritis/types-of-arthritis-(a-z)/types/childhood-arthritis : accessed on November 15, 2017
³ Potential savings for Biosimilars in Canada : Government of Canada: http://www.pmprb-cepmb.gc.ca/view.asp?ccid=1304: accessed on November 15, 2017
⁴Sandoz Canada did not seek a marketing authorization for the treatment of psoriatic arthritis or plaque psoriasis.