“Lengthy periods of exclusivity will harm patients by diminishing innovation and unnecessarily delaying access to affordable drugs.” Nancy-Ann DeParle, director of the Office of Health Reform, and Peter Orszag, director of the Office of Management and Budget *
Over the past couple of months, Rheumatoid Arthritis Guy has paid quite a bit of attention to the importance of staying calm. Even during some of the roughest periods in my recent flares, one of my goals always remained unchanged: the need to maintain a sense balance both in my mind and in my thoughts.
Yesterday, all of this was thrown out the window. Oh, it was not because of anything related to my rheumatoid arthritis, per se. In fact, yesterday was one more great day in the series of great days that I have been lucky enough to have this past week. (I got on the elliptical machine at the gym for the first time in months, and then went to power pilates class.)
This is what happened. I was reading some comments on my blog, when the news ticker at the top of the page was showing results related to the term “biologics”.
(I must admit that since I currently do not take any biologics, reading and research in this area has not been one of my highest priorities. Chances are that I will need to take biologics in the future, but my attitude has been that I will cross that bridge when I come to it. As of yesterday, I have changed my approach.)
Needless to say, the following headlines piqued my interest: “Blood Boils Over Bill To Protect Biotech Drugs”, “Study Endorses Longer Market Exclusivity For Drugmakers”, and “When Should Biotech Drugs Face Generic Competition?” Thanks to the Wall Street Journal (defender of the common man – extreme sarcasm), I was thrown head first into a debate that is currently raging in the United States.
Brand name drugs have a certain period of exclusivity after their patent is granted. No generic drugs can be produced during this period of exclusivity. The shorter the period of exclusivity, the sooner it takes for generic versions to hit the market. The longer the period of exclusivity, the longer it takes for generic versions to come to market.
In March 2009, Representative Henry A. Waxman (D-California) introduced H.R. 1427: Promoting Innovation and Access to Life Saving Medicine Act. This legislation calls for a 5-year exclusivity period for biologics.
In March 2009, Representative Anna G. Eshoo (D-California) introduced H.R. 1548: Pathway for Biosimilars Act. This legislation calls for a 12-14 year exclusivity period for biologics.
It should come as no surprise that the Biotech Industry is supporting Representative Eshoo’s version of the bill. Anyone who has followed the pharmaceutical business in the past few years know the supposed reasons all too well. Research costs need to be recouped. Brand name drugs are safer than generic drugs. If companies don’t get these provisions to control the market to their advantage, it will no longer be in their favor to continue the development of these medicines. Thus, medical advances and innovation will stop.
I have heard arguments big and small in support of delaying generic medicines as long as possible. In fact, when I read the articles in The Wall Street Journal (and corresponding studies that were no doubt funded by the pharmaceutical and biotech industries), one is actually left with the impression that these big corporations are on the verge of financial collapse should the law not be changed to their favor.
I would like to present my argument to the contrary, and I would like to keep it as simple as possible.
The “Bottom Line” Of Companies Who Manufacture And Market Biologics
Abbott Laboratories (Humira)
2006: $1.7 billion
2007: $3.6 billion
2008: $4.9 billion
Amgen, Inc. (Enbrel)
2006: $2.9 billion
2007: $3.2 billion
2008: $4.2 billion
Biogen Idec Inc. (Rituxan)
2006: $217 million
2007: $639 million
2008: $783 million
Bristol-Myers Squibb (Orencia)
2006: $1.6 billion
2007: $2.2 billion
2008: $5.2 billion
2006: $2.1 billion
2007: $2.8 billion
2008: $3.4 billion
2006: $4.2 billion
2007: $4.6 billion
2008: $4.4 billion
Net income: the income that a firm has after subtracting costs and expenses from the total revenue.
All of the above figures represent net income, as shown on the companies’ annual income statements. (Google Finance)
Don’t forget, these figures represent the ANNUAL bottom line. Contrast these numbers above with the number below.
Average Cost to Develop a New Biotechnology Product Is $1.2 Billion
BOSTON – Nov. 9, 2006 – The Tufts Center for the Study of Drug Development today announced it has developed the first comprehensive estimate of the average cost of developing a new biotechnology product, and pegged it at $1.2 billion.
These companies are making a lot of money already, and continue to make more money each year. These companies are more than recouping the cost of developing your biologics. So please, don’t try to sell me on the promise that extending the exclusivity period will benefit the patient by bringing more drugs to the market, resulting in lowered costs.
Instead, please focus on lowering the exorbitant cost of the drugs that are already on the market. This is something that might actually benefit us patients.
“Without a fair and sustainable cycle of investment and returns in innovative R&D, biotech discovery will be stifled.” David Polk, a spokesman for Amgen. *
I don’t know about you, but I am so tired of threats like the one above. The fact that this comes from an Amgen spokesman should come as no surprise. It is a little more disconcerting, however, when I hear this same sentiment coming from one of our elected representatives. Take a look at the following press release that I found on Representative Eshoo’s website.
Eshoo, Barton Introduce Pathway for Biosimilars
March 13, 2008
Washington, D.C. – Today, Rep. Anna G. Eshoo (D-California) introduced the Pathway for Biosimilars Act, legislation to create a regulatory pathway for FDA approval of “biosimilars” or “follow-on” biologics with Rep. Joe Barton (R-Texas), Ranking Member of the House Energy & Commerce Committee.
Rule #1: The name that is given to a bill is rarely representative of what is actually contained in said bill. I believe in truth in advertising. My name for this legislation, Representative Eshoo: “Pathway to Continued Overcharging Act”.
“This legislation will establish a regulatory pathway for biosimilars that will promote competition and lower prices, and protect patient safety, drug efficacy and sound science,” said Rep. Eshoo. “The most exciting developments in modern medical science are occurring in the field of biotechnology, and this legislation will ensure that the amazing cures and treatments biotech delivers today will continue and more patients will have access to these revolutionary therapies.”
I’m no economist, but I have no clue how delaying the production of (competing) generic drugs actually “promotes competition and lower prices”. As it is, most individual’s co-payment is actually increasing each month. In terms of ensuring that biotech innovation continues, is it not the case that ALL of the current biologics were bought to market in the absence of the protections that you are requesting?
Many of the original patents in the biotechnology industry are beginning to expire and several patient groups, biotech companies, and healthcare providers have called on Congress to provide a regulatory pathway for follow-on biologics or biosimilars to be approved by the FDA. The Pathway for Biologics Act provides an abbreviated pathway for approval of biosimilars based in part on the safety and efficacy record of an innovative reference product.
The previous paragraph said that one of the aims of this legislation was to “protect patient safety”. This paragraph calls for a streamlined approval process. Is there something I am missing? I went and read the actual text of this bill, and came across this paragraph calling for the permission to waive “analytical studies, animal studies, and clinical studies”. Fewer studies are supposed to mean an increase in patient safety? [Insert the theme song from The Twilight Zone here...]
The Pathway for Biologics Act permits the FDA to make a determination as to whether the biosimilar is interchangeable with the reference product, and gives the FDA the flexibility to determine what clinical testing – if any – is required for approval. To promote continued innovation in biotechnology, the legislation provides 12 years of data exclusivity to allow innovators to market their products and recoup their investments in research and development. Finally, to prevent uncertainty and delays over patent litigation, the bill establishes a process for resolution of patent disputes prior to the time biosimilar products are eligible to come onto the market.
Once again, we are told that this extended exclusivity period allows “innovators to market their products and recoup their investment in research and development”. It seems like they are already quite successful in these regards – please see “The ‘Bottom Line’ Of Companies Who Manufacture And Market Biologics” above. It took me an entire fifteen minutes to collect these figures.
“This legislation will protect patients, promote innovation, and prevent unnecessary litigation,” said Eshoo. “I’m pleased to have my colleague Rep. Joe Barton as a partner on this important bipartisan effort and we will work together to enact this legislation before the end of this Congress.”
# # #
If your proposed legislation takes effect, this sentence is probably the ONLY place where patients will actually come first. Thanks for ranking me before innovation and litigation, though – that was a nice touch. It’s going to take much more that this, however, to win my support.
In case you were wondering – the biggest contributor, by industry, to Representative Eshoo’s 2010 Congressional Election Campaign is: [drumroll please...] Pharmaceutical/Health Products. (www.opensecrets.org)
The Arthritis Foundation released a Statement on Follow-On Biologics in April 2009. It is unclear which, if any, of the two versions of the bill is being supported. Exclusivity periods and drug costs are hardly even mentioned in this statement.
The American Association of Retired Persons (AARP) released a public policy statement Biologics in Perspective: The Case for Generic Biologic Drugs in May 2009. This organization comes out strongly support of the shortest possible exclusivity period for biologics. (Be sure the take a look at the PDF – DON’T MISS THE CHART ON THE SECOND PAGE!)
The Obama administration recently called for a 7-year exclusivity period, as a compromise.
This story is still being written, so stay posted in order to find out the details about the final legislation.
Profits Before Patients
Be sure to check out this week’s Bill Moyers Journal: Wendell Potter on Profits Before Patients.
What Can You Do To Help?
Rheumatoid Arthritis Guy has only one voice. Please add your voice to this debate that will have a profound impact on all of us living with rheumatoid arthritis or other autoimmune diseases.
1. Contact your local senator and representative, and tell him/her that you DO SUPPORT H.R. 1427: Promoting Innovation and Access to Life Saving Medicine Act and that you DO NOT SUPPORT H.R. 1548: Pathway for Biosimilars Act.
2. Contact Representative Henry A. Waxman’s office and tell him that you DO SUPPORT H.R. 1427: Promoting Innovation and Access to Life Saving Medicine Act.
WASHINGTON, D.C. OFFICE
House Office Building
Washington, D.C. 20515
Telephone (202) 225-3976
Fax (202) 225-4099
8436 West Third Street, Ste 600
Los Angeles, CA 90048
Telephone 1 (310) 652-3095
Telephone 2 (818) 878-7400
Telephone 3 (323) 651-1040
Fax (323) 655-0502
3. Contact Representative Anna G. Eshoo’s office and tell her that that you DO NOT SUPPORT H.R. 1548: Pathway for Biosimilars Act.
WASHINGTON D.C. OFFICE
205 Cannon Building
Washington, D.C. 20515
Telephone (202) 225-8104
698 Emerson Street
Palo Alto, California 94301
Telephone 1 (650) 323-2984
Telephone 2 (408) 245-2339
Telephone 3 (831) 335-2020
Fax (650) 323-3498
Senate Committee Approves 12-Year Exclusivity Period
Just as I finalized this post last night, the Senate Health, Education, Labor and Pensions committee – by a 16-7 vote – approved an amendment that would grant makers of biologic drugs a 12-year exclusivity period from generic drug competition. *
This amendment was sponsored by Senator Orrin Hatch (R-Utah) and Senator Mike Enzi (R-Wyoming).
The biggest contributor, by industry, to Senator Hatch in the past five years is: Pharmaceutical/Health Products. (www.opensecrets.org)
The biggest contributor, by industry, to Senator Enzi in the past five years is: Pharmaceutical/Health Products. (www.opensecrets.org)
Is anyone else seeing a pattern here?
In closing, please let me state that I am not trying to start a heated debate between red and blue, between republican and democratic, between public and private, between rich and poor, between insured and uninsured, between liberal and conservative. In order to solve the problems that face us, we need to dive much deeper than these labels allow us to.
It is my belief that taking care of our sick is a matter of common sense and human decency.
Here’s hoping that if and when I need to take biologics for my rheumatoid arthritis, that I can actually afford them.
Stay tuned…for the next adventure of Rheumatoid Arthritis Guy!