Arizona lawmakers are considering an update to the state law to allow pharmacists to substitute certain biologic medicines.
The Affordable Care Act allows for these replacements, but states get to decide the specifics. Biosimilars have been used in Europe for a while, but the U.S. approved the first one last year.
For example, say a cancer patient gets a prescription from his doctor. The pharmacist gets that order, but realizes there is a biological medicine that is really similar to the treatment the doctor prescribed. Under this proposed process, a pharmacist would have to check with the doctor and the patient to make sure it is OK to prescribe the alternate medicine.
Joan Koerber-Walker, president of the Arizona Bio industry Association likes this idea.
“We need to remember that medicine is not an exact science," she said. "So the doctor is going to look at multiple variables that are affecting his or her patient to try and determine the very best treatment for them, and any time we change a variable it’s something the doctor needs to know about.”
These alternative medicines are different than generics. Generics have the same chemicals as the original. But, biosimilars are derived from biological materials not chemicals. They aren’t exactly the same– hence the name biosimilar.
Kelly Fine with the Arizona Pharmacy Association said once a biosimilar is deemed interchangeable, pharmacists shouldn’t have to go back to the doctors.
“To us it’s not necessary and creates additional complications in our workflow for both the physicians and the pharmacists," Fine said. "In addition, the FDA guidance doesn’t recommend physician notification. We want to be able to treat these medications like we treat generic drugs.”
Fine also said this part of the proposed law is a bit premature because the Food and Drug Administration hasn’t yet given any biologic medicines this interchangeable status. A study from the RAND Corporation estimates these medicines can be more that 25 percent cheaper.
