(Oct. 10 -- By Jason Bandy, Special to The Bee)
California's health care systems, at all levels, are struggling to contain costs at the same time we are working to get more and more people covered. There is not a dollar to waste or a dollar to put at risk.
As a pharmacist, I know this first-hand. I struggle every day to provide my patients with the finest possible care and treatments within the constraints of our health care system. Controlling drug costs is critical.
This is why I am simply astounded that the state Senate and Assembly have rushed to approve a bill, Senate Bill 598, which Sen. Jerry Hill extolled in a recent commentary ("Patients who need biosimilar drugs could go without if bill isn't signed," Oct. 8). Hill's legislation would needlessly cost the state, providers and patients millions or billions of extra drug-spending dollars in coming years. Gov. Jerry Brown still has an opportunity to veto this bill and should do so.
SB 598 is supposed to create a pathway to allow the prescription of less costly biosimilar drugs as substitutes for brand-name biologic drugs whose patents have expired. Biologics are advanced medications for complex diseases and can cost $100,000 or more per year per patient. Their use is growing rapidly. Substituting biosimilars for biologics (much like using generics vs. regular brand name drugs) can create significant savings, up to 50 percent by several estimates.
But, even as it claims to create the needed pathway to substitute biosimilars, SB 598 puts up pointless, red-tape hurdles that will almost certainly get in the way of their use. The bill adds paperwork and administrative costs for pharmacists and doctors who substitute biosimilars, with no real benefit to the patients. So to avoid the pointless bureaucracy, the practical result will be the decreased substitution of biosimilars and the continued use of the more expensive brand-name biologics.
The losers will be all of those - the state, providers and patients - who will pay higher drug prices or co-pays and perhaps wind up not being able to afford the drugs they need.
The winners will be the profit ledgers of the brand-name biologics producers whose drugs that are losing patent protection will continue to be prescribed, instead of lower-cost biosimilars. Perhaps it is no surprise, those brand name biologics producers are the sponsors of SB 598.
What is also confounding about this bad, costly bill's rush to passage is that it is not even needed yet. Biosimilar drugs are years away from being available in the United States, and the FDA has not even approved federal regulations on their use yet.
Federal estimates of how much can be saved by the substitution of interchangeable biosimilars for biologics within California's Medi-Cal system range between $9 million and $68 million per year. More substitutions mean more savings. The roadblocks to substitution in SB 598 will stand in the way and needlessly cost Medi-Cal alone tens of millions of dollars. The overall cost to our state's entire health care system will be many, many times greater.
Jason Bandy is a licensed pharmacist from Elk Grove and a member of the California Society of Health-System Pharmacists and the California Pharmacists.