In today’s expensive and increasingly complex healthcare environment, the holy grail of positive health outcomes hinges on several variables. Most would believe that these variables go something like this: access to quality physicians and medical experts, early diagnoses, aggressive treatment, patient compliance, and active monitoring. However, if you ask patients with severe chronic diseases what they believe is the one factor most important in achieving a positive outcome for their condition or disease, the vast majority have a similar answer: their relationship with their physician.
In the May 13 article “NJ’s Biotech Industry Backs Bill Setting Rules for New Drug Prescriptions,” which highlights A-2477/S-1705, a bill that provides a pathway in New Jersey for access to lower-cost mimic therapies of expensive biologic drugs, the bill sponsor Assemblywoman Pamela R. Lampitt states, “this is about patient safety … this is about a physician, a prescriber, knowing which product has been dispensed to their patient.”
Assemblywoman Lampitt is spot-on with her assessment. At its core, A-2477/S-1705 boils down to one word: Trust. The patient-physician relationship does not exist without trust. Patients trust their physician to have a comprehensive understanding of their medical history, the treatments available for their condition, and the expertise to prescribe the most appropriate option for them. A physician trusts in a patient’s transparency about symptoms, level of disease activity, and adherence to the instructed course of treatment. Together, through open and active communication with one another, physicians and patients identify the most-effective therapies.
On the other hand, John Holub, executive director of New Jersey Council of Chain Drug Stores states in the article, “There’s no reason to treat these drugs (biosimilars) any differently (than generics).” With all due respect to Mr. Holub, the science disagrees. Biosimilars are not generic drugs. Unlike generics, by definition, biosimilars are scientifically similar to but not the same as the drugs they mimic. So why would it be appropriate to apply policies that control generic drug substitution to biosimilars — an entirely different class of product? A-2477/S-1705, with its communication requirements, accurately recognizes this difference and establishes a new set of notification and recordkeeping standards for substitution.
Mr. Holub went on to also say he was encouraged that a provision in the bill was dropped that would have required pharmacists to inform patients that the drug their physician prescribed was being substituted for a biosimilar. I ask Mr. Holub, why would a pharmacist not want to consult a patient about exactly which medication they are receiving? Isn’t this a pharmacist’s job?
The value that biosimilars represent for New Jersey patients, namely expanded access and cost savings, will never be realized if patients and physicians do not first trust each other and, second, trust the class of product. Trust is achieved through transparency. A-2477/S-1705 with its communication provisions intact, achieves that needed transparency and ensures that the patient-physician relationship is strong. As long as the communication lines are open, the holy grail of cost-efficient positive health outcomes is attainable.