Biogenerics’ Potential Savings to the U.S. Public: $71 Billion Over 10 Years…But What About the Potential Risks?
Feb. 15, 2007
Express Scripts just released (summary pasted below) an extensive report on the Potential Savings of Biogenerics today, projecting potential savings from biogenerics and commending Senators Clinton et al for sponsoring legislation that would help facilitate their commercialization.
But questions of patient safety must still be addressed, and the analytical and other characterization methods required still aren't "there" yet...although they're getting closer, very quickly.
FDA's already taking a lot of heat for inadequate supervision of drug safety. If the industry is having difficulty ensuring the safety of small molecule drugs, biopharmaceuticals pose far greater challenges and risks, so who can blame the Agency for exercising due diligence in finalizing approval guidelines?
But one can guess they'll be released within the next two to three years, if not sooner.
Generic biotech medicines could save U.S. plan sponsors and
patients $71 billion over ten years, with $3.5 billion of the savings
occurring the first year, according to a report issued by Express
Scripts, one of the nation's largest managers of pharmacy benefit
plans. Savings for plan sponsors could amount to $1,900 in the first year
for a multiple sclerosis patient with a therapy treatment that
includes biotech medicines. "Given the savings potential for plan sponsors and the patient, we
believe it is critical that an approval pathway for generic biotech
medicines be established," says Steve Miller, Express Scripts chief
medical officer and vice president, specialty pharmacy. A pathway for generic biotech medicines would be created with the
enactment of The Access to Life Saving Medicine Act of 2007, which is
sponsored by Senators Charles Schumer (D-NY), Hillary Rodham Clinton
(D-NY), David Vitter (R-LA) and Susan M. Collins (R-ME) and
Representatives Henry Waxman (D-CA) and Jo Ann Emerson (R-MO). Miller
says, "Express Scripts applauds and supports this important
legislation to make biotech drugs more affordable." In addition to increased savings for plan sponsors and patients,
the use of generic medicines has been shown to lead to better outcomes
such as improved medication adherence for chronic conditions. Most biotech medicines are injectable, infused, oral or inhaled
and generally require special handling along with close supervision
and monitoring of the patient's medication therapy. These medicines
treat chronic or complex illnesses that affect less than three percent
of the general population, but they come with a significant price tag
-- these patients account for 25 - 30 percent of a company's overall
pharmacy costs. Biotech medicines differ from traditional drugs in that they are
derived from living sources such as humans, animals or microorganisms
as opposed to drugs synthesized using chemical reactions in the lab. The $71 billion savings potential could be achieved if the Food
and Drug Administration (FDA) were able to release guidelines for the
approval of generic biotech medicines. Without the guidelines, generic
manufacturers are unable to offer Americans the lower-cost
alternatives to brand biotech medicines. Controlling the cost of biotech medicines, one of the fastest
growing segments of health care, is a top priority for employers,
insurers and the federal government. Spending for biotech medicines in
the U.S. is expected to reach $90 billion in 2009. Increasing the use
of generics is a proven tool in decreasing costs. The report's conclusions were based on a review of four biotech
medicine therapy classes for which key patents have already expired.
The therapy classes represent medicines used to treat multiple
sclerosis, anemia, growth hormone deficiencies, and diabetes. The largest estimated savings of $40.7 billion over ten years is
found in erythropoietins, the class of medicines used to treat anemia.
There are 350,000 dialysis patients and 450,000 oncology patients
using erythropoietins. There are 15 million Americans diagnosed with diabetes. More than
25 percent of the market could move to a generic biotech medicine and
save $797 million in the first year. Fifty percent of the 320,000 multiple sclerosis patients treated
with interferons could move to a generic biotech medicine and achieve
a $678 million savings in the first year. Generic biotech medicines could be used to treat 80 percent of
patients with a growth hormone deficiency, leading to $27.7 million in
first year savings. The report also includes an analysis of savings for each state and
the District of Columbia. Twenty-six states would save more than $1
billion dollars over a ten year period with California and New York
achieving the greatest savings of $7.7 and $5.8 billion respectively. The Express Scripts analysis used a conservative discount of 25
percent off the branded equivalent medicine. This is consistent with
the discount on the biotech medicine somatropin, which was released
last year in Europe. The analysis is also based on an 83 percent
generic market share and a 15 percent annual increase in biotech
medicine costs, which is consistent with industry forecasts. Both the discount and the generic biotech medication fill rate are
more conservative numbers than used for traditional drugs where a 95
percent market share can be achieved and, on average, a generic drug
costs approximately 60 percent less than a brand name drug.
10-year Savings by Therapy Class
----------------------------------------------------------------------
Multiple Growth
Year Sclerosis Erythropoietins Hormone
--------------------- ---------------- ---------------- --------------
1 $678,107,580 $2,004,260,421 $27,657,855
--------------------- ---------------- ---------------- --------------
2 $779,823,717 $2,304,899,484 $31,806,533
--------------------- ---------------- ---------------- --------------
3 $896,797,274 $2,650,634,407 $36,577,513
--------------------- ---------------- ---------------- --------------
4 $1,031,316,865 $3,048,229,568 $42,064,140
--------------------- ---------------- ---------------- --------------
5 $1,186,014,395 $3,505,464,003 $48,373,761
--------------------- ---------------- ---------------- --------------
6 $1,363,916,554 $4,031,283,603 $55,629,825
--------------------- ---------------- ---------------- --------------
7 $1,568,504,037 $4,635,976,144 $63,974,298
--------------------- ---------------- ---------------- --------------
8 $1,803,779,643 $5,331,372,565 $73,570,443
--------------------- ---------------- ---------------- --------------
9 $2,074,346,589 $6,131,078,450 $84,606,010
--------------------- ---------------- ---------------- --------------
10 $2,385,498,578 $7,050,740,217 $97,296,911
--------------------- ---------------- ---------------- --------------
Total $13,768,105,231 $40,693,938,861 $561,557,288
--------------------- ---------------- ---------------- --------------
10-year Savings by Therapy Class
----------------------------------------------------------------------
Year Insulin Total
----------------------------------- ----------------- ----------------
1 $797,059,877 $3,507,085,732
----------------------------------- ----------------- ----------------
2 $916,618,859 $4,033,148,592
----------------------------------- ----------------- ----------------
3 $1,054,111,687 $4,638,120,881
----------------------------------- ----------------- ----------------
4 $1,212,228,440 $5,333,839,013
----------------------------------- ----------------- ----------------
5 $1,394,062,706 $6,133,914,865
----------------------------------- ----------------- ----------------
6 $1,603,172,112 $7,054,002,094
----------------------------------- ----------------- ----------------
7 $1,843,647,929 $8,112,102,409
----------------------------------- ----------------- ----------------
8 $2,120,195,119 $9,328,917,770
----------------------------------- ----------------- ----------------
9 $2,438,224,386 $10,728,255,435
----------------------------------- ----------------- ----------------
10 $2,803,958,044 $12,337,493,751
----------------------------------- ----------------- ----------------
Total $16,183,279,161 $71,206,880,541
----------------------------------- ----------------- ----------------
-0-
10-Year Savings by State
----------------------------------------------------------------------
State Savings State Savings
----------------------------------- ----------------------------------
California $7,715,778,789 South Carolina $951,990,002
----------------------------------- ----------------------------------
New York $5,838,087,017 Oregon $800,330,633
----------------------------------- ----------------------------------
Texas $4,873,089,817 Oklahoma $762,586,938
----------------------------------- ----------------------------------
Florida $4,324,688,078 Iowa $695,314,621
----------------------------------- ----------------------------------
Pennsylvania $3,407,429,578 Kansas $643,970,417
----------------------------------- ----------------------------------
Ohio $2,985,859,433 Mississippi $635,709,705
----------------------------------- ----------------------------------
Illinois $2,974,175,774 Arkansas $592,763,131
----------------------------------- ----------------------------------
Michigan $2,243,581,980 Nevada $483,913,418
----------------------------------- ----------------------------------
New Jersey $2,239,246,247 West Virginia $465,977,176
----------------------------------- ----------------------------------
Massachusetts $2,068,874,768 Nebraska $447,538,902
----------------------------------- ----------------------------------
North Carolina $2,032,819,727 Utah $446,717,395
----------------------------------- ----------------------------------
Georgia $1,888,873,398 Maine $364,475,390
----------------------------------- ----------------------------------
Virginia $1,634,206,146 New Mexico $364,018,997
----------------------------------- ----------------------------------
Tennessee $1,531,791,574 New Hampshire $317,558,197
----------------------------------- ----------------------------------
Indiana $1,504,134,163 Rhode Island $313,405,022
----------------------------------- ----------------------------------
Missouri $1,497,379,547 Hawaii $288,896,721
----------------------------------- ----------------------------------
Washington $1,472,004,101 District of Columbia $276,939,227
----------------------------------- ----------------------------------
Wisconsin $1,425,360,744 Idaho $262,791,046
----------------------------------- ----------------------------------
Minnesota $1,418,971,243 Delaware $240,336,514
----------------------------------- ----------------------------------
Maryland $1,388,575,474 Montana $208,662,845
----------------------------------- ----------------------------------
Arizona $1,111,088,576 South Dakota $200,447,773
----------------------------------- ----------------------------------
Louisiana $1,086,169,522 Alaska $192,552,175
----------------------------------- ----------------------------------
Alabama $1,080,418,971 North Dakota $180,183,927
----------------------------------- ----------------------------------
Kentucky $1,031,995,682 Vermont $164,347,092
----------------------------------- ----------------------------------
Colorado $1,023,004,741 Wyoming $105,016,012
----------------------------------- ----------------------------------
Connecticut $1,002,832,174
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Express Scripts, Inc. (Nasdaq: ESRX) is one of the largest
pharmacy benefit management (PBM) companies in North America,
providing PBM services to over 55 million patients through facilities
in 13 states and Canada. Express Scripts serves thousands of client
groups, including managed-care organizations, insurance carriers,
third-party administrators, employers and union-sponsored benefit
plans. Express Scripts is headquartered in St. Louis, Missouri. More
information can be found at http://www.express-scripts.com.