ST. PAUL — Joined by pharmacy leaders, a pair of Minnesota lawmakers on Wednesday, Feb. 24, kicked off a bid to drive down the sticker price of certain expensive, name-brand medications by expanding access to generic versions.
If approved, Minnesota would be the first in the country to implement such a law and the legislators carrying the bill said they expected a strong push from pharmaceutical companies to prevent its passage through the Statehouse. But the bill has a strong benefit in surviving the divided Legislator: a bipartisan set of authors.
Biologic drugs have been used to treat cancer, rheumatoid arthritis, diabetes and gastrointestinal diseases. And they contain bits of living organisms, which makes them more complex (and often more expensive) to produce compared to other drugs.
Right now, health plans and pharmacy benefit managers cover only name-brand versions of some of the treatments. So while a physician might want to prescribe a non-brand name biologic, called a biosimilar, they might not be able to.
"It would be like saying, 'Well, an apple a day keeps the doctor away, but only if it is a red delicious apple from this orchard,'" one of the bill's authors, Sen. Carla Nelson, R-Rochester, said. "Now, all the other orchards in the state or the nation are not eligible."
Nelson and Rep. Jen Schultz, D-Duluth, said they drafted a bill that would require health insurance plans and pharmacy benefit managers to cover all versions of the biosimilars. That way, doctors and patients would have more options when considering treatment, they said.
The Center for Biosimilars in 2017 reported that increased use of biosimilars could lead to $54 billion in savings in the United States over a decade.
Pharmaceutical companies have threatened to pull rebates for other drugs they manufacture if the health plans broadened treatments available to include biosimilars alongside biologics, the pair along with Mayo Clinic and Essentia Health pharmacists, said.
"There's so much happening behind the scenes with rebates and discounts. We really need to make this information more transparent and make better decisions that benefit patients and consumers," Schultz said.
Without some of the red tape for doctors and other prescribers, patients could see more treatment options. And those options could come at a lower cost. Biosimilars are federally regulated, like biologic treatments, and don't pose significant disparities for safety or purity.
"This would really level that playing field and bring that decisionmaking back to the prescriber along with the patient of which product to use," David Sperl, senior clinical pharmacy manager of acute care at Essentia Health, said.
Nelson, Schultz and the pharmacists who'd worked with them on the bill said they expected the pharmaceutical industry would put up a fight to block the bill but noted that the industry had previously conceded when lawmakers pushed to allow generic versions of other drugs. They also said the drug companies creating biosimilars could help neutralize the push against the proposal.
A spokesman for PhRMA, Pharmaceutical Research and Manufacturers of America, on Wednesday said the group didn't have a position on the bill.
Eric Tichy, vice-chair of pharmacy supply solutions at the Mayo Clinic, said many of the biologic treatments holding a monopoly in the market were decades old. And patients could benefit from another push to bring newer treatments to the market.
"It causes pharma to work on new and innovative therapies instead of trying to hold on to old therapies and continuing to profit from things that have been available for 20 or 30 years," Eric Tichy, Mayo Clinic vice-chair of pharmacy supply solutions, said. "They need to be working on new and innovative therapies and that's where we want to be spending our dollars."