In recent years, many of the bestselling new medications haven’t been traditional drugs chemically synthesized in labs. Instead, they belong to a growing class of “biologics” — substances that are cultivated from living cells, often by altering the DNA that carries genetic information.
Biologics have been a boon to those with a variety of conditions, and are widely used to treat rheumatoid arthritis as well as to fight infections in chemotherapy patients. But these products often are expensive to develop and buy, racking up $66.3 billion in sales nationally in 2013. That’s why the 2010 Affordable Care Act included a provision to encourage the development of generic products that would be similar to but cheaper than the name-brand biologics.
New Jersey laws don’t cover how these so-called biosimilars should prescribed, which is why the Legislature is grappling with ways to regulate them. Biologics-industry representatives have supported state-level legislation addressing biosimilars prescriptions across the country. In fact, biosimilars aren’t yet available in the United States but could result in significant savings if the federal Food and Drug Administration approves.
Assemblywoman Pamela R. Lampitt (D-Burlington and Camden) noted estimates that biosimilars — which are currently sold in France, Canada, and other countries — could cut the cost of biologics by by 30 percent. That would translate into significant savings to the State Health Benefits Program.
Since state laws governing generic drugs don’t cover biosimilars, which are different from conventional drugs, Lampitt is working on legislation that would determine how pharmacies dispense this emerging class of medications. Without a new law, patients will only be able to receive lower-cost biosimilars if their doctor prescribers a biosimilar instead of a name-brand biologic.
Similar legislative efforts are ongoing in state legislatures across the country, as the FDA moves closer to approving biosimilars.
Lampitt noted that prescriptions for biologics should be treated differently than for traditional drugs, citing concerns over how subtle differences between name-brand biologics and biosimilars — and even between different batches of the same biologic — will affect patients.
She wants to require pharmacies to notify doctors every time they fill a prescription for a biologic, giving them a chance to respond if they have concerns about how the prescriptions are being filled.
Dr. Thomas Felix, research and development policy director for California-based Amgen, said his company is developing nine different biosimilars designed to compete with brand-name biologics whose patent protection is ending.
He said state-level legislation would ensure that doctors receive more information about biologic prescriptions than they currently do for traditional kinds of generic drugs.
Lampitt is working to revise the original version of a bill, A-2477 /S-1705, which currently would require pharmacists to directly inform patients when they substitute a biosimilar for a name-brand biologic. It’s expected to be amended so that the pharmacists would only have to notify doctors. Pharmacists would be required to notify doctors about all biologic prescriptions, not just when pharmacists substitute biosimilars.
John Holub, executive director of pharmacy trade group the New Jersey Council of Chain Drug Stores, said the industry would prefer that any new requirements for pharmacies be based on specific requests from doctors.
“This bill definitely deviates from the time-tested substitution laws,” Holub said, adding that the state could simply change current laws governing generic drugs to include biosimilars.
Holub also questioned the timing of the bill, saying that the FDA hasn’t even laid out its plans for how biosimilars will be regulated.
Sarah M. Adelman, vice president of insurance industry group the New Jersey Association of Health Plans, said insurers want to ensure that biosimilars are treated fairly and that patients aren’t wrongly led to fear that they are inferior to name-brand biologics.
The bill “should not limit, narrow or thwart the use of biosimilars in New Jersey by requiring notification; consent; reporting; or unnecessary barriers to access,” said Adelman.
Providing doctors with more information about biologics prescriptions drew support from groups that advocate for research and treatment of specific diseases.
Ethan Hasbrouck of the American Cancer Society Cancer Action Network said sharing more information with doctors about how prescriptions are filled would ensure that they have accurate records and contribute to patient safety.
“We’re very supportive of the advancement of both biologics and biosimilars because of their enormous potential as an effective tool in the fight against cancer and improving the quality of life of those cancer patients,” he said.
East Brunswick resident Christine Citera, who has psoriatic arthritis, said biologic medication has been essential in improving her quality of life.
“I’ve maintained my full-time job, I’ve hiked, I’ve gotten married — I was able to dance at my wedding,” she said. “Last year, I didn’t think that that was possible, and the biologic medication really allowed me to do this.”
But she said she’s had difficulty getting prescriptions filled and said it would be helpful to have legislation that made it clear what the responsibility of pharmacies are regarding biologics.