Debbie Mann can barely afford the drug that banishes the stabbing pain rheumatoid arthritis causes in her joints. Although Medicare helps cut the $40,000-per-year list price for prescription Enbrel, she said she still paid more than $3,800 last year.
She thought about going off of it but doesn’t want to return to what she was like before — sleeping most of the day.
“You just want to sit in a chair and not be part of life,” said the 56-year-old retired nurse from Goshen, Indiana.
Mann would love a cheaper alternative, but Enbrel, made by Amgen Inc., is a biologic medicine, among the most expensive and difficult type to make because they are derived from sources such as live cells rather than chemicals in a lab. Less costly drugs that function in much the same way — called “biosimilars” — are expected to hit American markets in the next few years.
Yet if an Enbrel biosimilar becomes available in the U.S., as it already is in Europe, Mann will face more hurdles to obtain it in Indiana. That’s thanks to the quick work done by the pharmaceutical companies that swooped in to lobby the legislature there. Drug lobbyists have helped push through bills limiting pharmacists’ ability to dole out biosimilars in more than a third of the states since 2013. […]
Across America, lobbyists for drugmakers — including Enbrel’s maker Amgen — have worked at a feverish pace to push state laws that make it harder for pharmacists to substitute cheaper biosimilars for brand-name biologic drugs, as is commonly done with regular generic drugs.
The laws in many cases require the pharmacist to take extra steps before dispensing the cheaper drugs, including notifying the doctor, retaining extra records or, in some cases, getting patient consent.
Opponents say these laws make it less likely a pharmacist will substitute a biosimilar and more likely to instill doubt in patients about the alternate drugs. That could mean fewer patients get access to cheaper versions of specialty drugs that treat a range of diseases, including cancer, hepatitis C and Crohn’s.
“It’s going to cost some patients more money. It’s certainly going to cost the health care system more money,” said Diana Zuckerman, president of the nonprofit National Center for Health Research, a nonpartisan think tank that vets new medical treatments. “And it’s certainly going to benefit the brand-name companies. That’s the whole point.” […]
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