Let’s say you have high cholesterol, you go to the pharmacist to refill your Lipitor prescription, and she gives you a generic version which saves you money. That’s good. The same thing should be available for your diabetes, arthritis or migraine medication.
Only Big Pharma doesn’t want you, the consumer, to benefit from those savings. The California legislature is in a position to do something about that, and they should.
Many drugs are chemically synthesized and classified as small-molecule drugs. The non-name brand, less expensive but equally effective versions of these drugs are called generics and your pharmacist can easily switch them out for you, saving you money.
Other drugs are derived from living organisms and they’re large-molecule drugs called biologics. There are also non-name brand, less expensive but equally effective versions of those called biosimilars. But currently, your pharmacist can’t switch these out for you easily, meaning you pay more.
And that’s just how Big Pharma likes it.
But the California Senate is considering a bill, Senate Bill 1094, that would authorize pharmacists to substitute a biosimilar when filling a prescription, just like a generic, provided your doctor has not explicitly prohibited the change. There’s no reason they shouldn’t pass this bill.
A 2024 study published in the Journal of the American Medical Association Health Forum compared out-of-pocket spending between seven biologics and their biosimilar alternatives. The study found that average patient out-of-pocket costs for the biosimilars were 23% lower compared to their reference biologic, or around $200 less, on average.
The California Health Benefits Review Program analyzed SB 1094 and estimates that it would result in an $87.7 million reduction in total annual premiums paid by employers and enrollees. Individuals switching to a biosimilar would save between $92 and $310 per year.
And the same study found SB 1094 would have “no short-term public health impact because the evidence suggests that the switching of patients to biosimilar prescription drugs does not negatively impact health outcomes.”
The Food and Drug Administration states, “Expensive biologic medications make up only 5% of prescriptions in the U.S. but account for 51% of total drug spending as of 2024. FDA-approved biosimilars are as safe and effective as the branded drugs, yet their market share remains below 20%.”
With such a big payday, you can bet that Big Pharma doesn’t want you to get lower-cost versions. In 2023, seven of the top ten highest grossing medications were biologics, raking in hundreds of billions of dollars. That’s why drugmakers file scores of patent applications to extend their monopolies far beyond the 20 years of protection intended under U.S. patent law.
The FDA is trying to make it easier for new biosimilars to come to market. Commissioner Marty Makary said, “By streamlining the biosimilar development process and helping advance interchangeability, we can achieve massive cost reductions for advanced treatments for cancer, autoimmune diseases and rare disorders affecting millions of Americans.”
In the meantime, the least California lawmakers can do is make it easier for patients in the Golden State to access the biosimilars that are already available to us. These include drugs to treat cancer, autoimmune disease and the diabetes that affects so many in my Asian American community.
According to the FDA, “Biosimilar and interchangeable biosimilar products have the potential to reduce health care costs, similar to how generic drugs have reduced costs. Biosimilars marketed in the U.S. typically have launched with initial list prices 15% to 35% lower than comparative list prices of the reference products.”
My small business and the many others I work with could certainly use that money. And so could the millions of Californians trying to make ends meet. SB 1094 makes all kinds of sense, the legislature should pass it, and the governor should sign it into law.
Marc Ang is an estate and financial planner at Mangus Finance and President of Asian Industry B2B.
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