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AMENDMENT TO SENATE JOINT RESOLUTION 48

2     AMENDMENT NO. ___. Amend Senate Joint Resolution 48 by
3 replacing everything after the heading with the following:
 
4     "WHEREAS, With approximately $16 billion in biologic drug
5 patents set to expire next year, the average price of a
6 traditional drug is about $45, while the average cost of a
7 biologic can be about 4 times as much, and with Medicaid
8 accounting for about 19% of federal government drug
9 expenditures, the 110th United States Congress will be
10 considering legislation to authorize a regulatory pathway at
11 the federal Food and Drug Administration (FDA) for the
12 determination and approval of safe comparable versions of
13 biologic drugs that are expected to produce the same clinical
14 results as the innovator product; and
 
15     WHEREAS, Biologics are a major driver of increasing
16 prescription drug costs; for the first time, 5 of the 20

 

 

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1 top-selling drugs in 2005 were made by biotech companies;
2 additional competition for biotech pharmaceuticals has the
3 potential to offer consumers real savings, while also lowering
4 America's healthcare bill; and
 
5     WHEREAS, Illinois spends nearly $200 million for 61
6 biologics under its Medicaid pharmacy benefits and Part D wrap
7 around programs and an estimated 12% of its drug benefits on
8 biologics for State employees and retirees; and
 
9     WHEREAS, The science to create safe comparable biotech
10 drugs exists today in other countries; raw materials are
11 available today for many comparable protein products including
12 insulin, GCSF, epoetin, interferons, and others; in many
13 countries around the world, competitive biotech products are
14 already available to consumers; in these countries, patients
15 have access to safe comparable biological products and receive
16 cost savings from additional competition; and
 
17     WHEREAS, Significant investment is made by biotech drug
18 developers in intellectual property, and appropriate
19 intellectual property protection and the ability to recoup
20 their investment and make a fair profit is needed; however, as
21 has been proven under the Drug Price Competition and Patent
22 Restoration Act of 1984, competition fuels innovation;
23 competition from safe comparable biologics will ensure

 

 

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1 continued innovation in biotech drugs; it is critical to
2 preserve the incentives for innovation that drive the
3 development of new biologics, recognizing that data
4 exclusivity and patents work together to create the environment
5 to support investments in discovering new biologics in order to
6 keep this country's biotech innovators strong and growing; and
 
7     WHEREAS, A Citizens Petition was submitted to the FDA in
8 August 2006 requesting that the FDA use its statutory and
9 regulatory authority to issue guidelines that will facilitate
10 the availability of more affordable versions of insulin and
11 human growth hormone (HGH); and
 
12     WHEREAS, American patients currently spend approximately
13 $1.5 billion on insulin products to treat diabetes and
14 approximately $433 million on HGH, which is used to treat a
15 variety of conditions, including growth deficiencies in
16 children and adults, chronic renal insufficiency, and AIDS
17 wasting syndrome; and
 
18     WHEREAS, The FDA has repeatedly and publicly indicated that
19 guidance on the approval process for insulin and HGH would be
20 forthcoming; this guidance would provide generic
21 pharmaceutical manufacturers with the criteria for
22 demonstrating safety and efficiency of comparable versions of
23 insulin and HGH; however, it appears that issuance of

 

 

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1 appropriate regulatory requirements for these products has
2 come to a standstill resulting in our citizens and taxpayers to
3 continue to shoulder the burden for costs because no comparable
4 version of either of these products is available; insulin and
5 HGH have less complex biologic structures with a long history
6 of safe use and a wealth of data available about the innovator
7 versions of those products; and
 
8     WHEREAS, While such guidance unnecessarily languishes in
9 the United States, the European Medicines Agency (EMEA) has
10 adopted final guidelines on quality, non-clinical and clinical
11 issues regarding similar biological medicinal products in
12 December 2003 and a general regulatory guideline on such
13 products in September 2005; the EMEA also issued final
14 product-specific guidance documents on similar biologic
15 medicine products, including one for insulin, in February 2006;
16 and
 
17     WHEREAS, In 2004, national Medicaid expenditures for
18 insulin alone were approximately $500 million; insulin was
19 historically approved for sale in the United States under the
20 Federal Food Drug and Cosmetic Act; this fact should make it
21 eligible to generic competition under the Drug Price
22 Competition and Patent Restoration Act of 1984; diabetes is on
23 the rise, and, if current population and diagnosis rates
24 continue as projected, the number of people with diabetes could

 

 

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1 reach 17.4 million by 2020 with attendant costs rising to an
2 estimated $192 billion; insulin is a less complex
3 biopharmaceutical product and many versions are no longer
4 patent protected; if the FDA were to issue guidance in a timely
5 manner and approve a lower cost, safe, comparable form of
6 insulin, patients could begin realizing savings; and
 
7     WHEREAS, On average, African-Americans are 2.4 times as
8 likely to have diabetes as Caucasians; the highest incidence of
9 diabetes in African-Americans occurs between 65 and 75 years of
10 age; African-American women are especially affected; when
11 adjusted for age, African-American women are more likely to be
12 diagnosed with diabetes than non-Hispanic Caucasians,
13 African-American men, or Hispanics; African-Americans with
14 diabetes are more likely to experience complications of
15 diabetes; diabetic retinopathy, an eye disease, is 19% more
16 common in African-American men than Caucasian men; amputations
17 of lower extremities are also more common in African-Americans
18 with diabetes; and
 
19     WHEREAS, As of 2002, 2 million Hispanic adults age 20 years
20 and older and about 8.2% of the population have diabetes;
21 diabetes is more prevalent in older Hispanics with the highest
22 rates in Hispanics 65 and older; on average, Hispanics are 1.5
23 times as likely to have diabetes as Caucasians;
24 Mexican-Americans, the largest Hispanic subgroup, are more

 

 

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1 than twice as likely to have diagnosed diabetes than
2 non-Hispanic Caucasians; in 2002, the death rate from diabetes
3 in Hispanics was 60% higher than the death rate of non-Hispanic
4 Caucasians; in 2001, Hispanics of all races experienced more
5 age-adjusted years of potential life lost before age 75 years
6 than non-Hispanic Caucasians for diabetes; and
 
7     WHEREAS, HGH is one of the most expensive prescription
8 regimes, costing a patient upwards of $30,000 a year; HGH has
9 annual sales in the United States that are estimated to be more
10 than $700 million; HGH costs are increasing as the number of
11 growth deficiency-related cases continues to rise and as the
12 FDA approves new uses for HGH; as usage and the subsequent
13 expenses increase, Illinois is paying more for a drug product
14 that has not been patent protected since 2003; and
 
15     WHEREAS, With the availability of safe comparable versions
16 of insulin, HGH, and other biologics there will be savings to
17 the State and its citizens; for example, if only one-third of
18 patients using insulin were converted to a comparable insulin
19 product and it was priced at a modest 10% discount, payers
20 would save $17 million annually; a discount of 30%, more
21 typical of the small molecule generic market, with only
22 one-third of patients utilizing the small molecule generic,
23 would result in savings of more than $50 million annually; if
24 all Medicaid patients were converted to the small molecule

 

 

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1 generic, at a 30% discount to current brand prices, the savings
2 would exceed $150 million annually; and
 
3     WHEREAS, For more than 2 decades, generic pharmaceuticals
4 have offered our State with a mechanism to manage the high cost
5 of providing prescription drugs for State-funded and federally
6 mandated prescription drug programs; at the same time, generic
7 drugs have provided all of the citizens of Illinois with the
8 opportunity to lower their prescription drug costs; therefore,
9 be it
 
10     RESOLVED, BY THE SENATE OF THE NINETY-FIFTH GENERAL
11 ASSEMBLY OF THE STATE OF ILLINOIS, THE HOUSE OF REPRESENTATIVES
12 CONCURRING HEREIN, that we urge the members of the 110th United
13 States Congress and the President of the United States to enact
14 legislation that establishes a regulatory pathway authorizing
15 the FDA to approve, when appropriate, abbreviated applications
16 for comparable biological products that are expected to produce
17 the same clinical results as the innovator product and are
18 deemed by the FDA to be safe and effective; and be it further
 
19     RESOLVED, That the FDA be authorized to approve
20 applications for safe comparable biologics in a manner that is
21 determined to be in the best interests of patients; and be it
22 further
 

 

 

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1     RESOLVED, That the FDA promptly promulgate guidance for the
2 specific approval requirements for forms of insulin and HGH;
3 the issuance of these guidances would open the door for
4 potential savings on these important therapies for consumers
5 across our nation; and be it further
 
6     RESOLVED, That the FDA also commit to working with drug
7 companies developing such products and to expediting the
8 process so that these products may be approved and made
9 available to patients as quickly as possible; and be it further
 
10     RESOLVED, That any new regulatory pathway for safe
11 comparable protein products contain appropriate incentives for
12 new biological products; and be it further
 
13     RESOLVED, That we strongly concur with those Governors who
14 filed the Citizens Petition or sent letters of support for the
15 Citizens Petition to the FDA on this issue; and be it further
 
16     RESOLVED, That we also strongly support the twenty
17 Governors who have sent a letter encouraging Congress to
18 authorize the FDA to provide a pathway for safe comparable
19 biologics; and be it further
 
20     RESOLVED, That we and the Governor have a responsibility
21 for managing the costs that the State incurs for prescription

 

 

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1 drugs in connection with our State Medicaid program, as well as
2 other State programs such as State employees and State retirees
3 that provide a drug benefit; we are also charged with ensuring
4 that high quality, affordable healthcare that provides safe and
5 effective care is available to all citizens of our State; and
6 be it further
 
7     RESOLVED, That suitable copies of this Resolution be
8 provided to the Commissioner of the FDA, the Speaker the United
9 States House of Representatives, the Minority Leader of the
10 United States House of Representatives, the Majority Leader of
11 the United States Senate, the Minority Leader of the United
12 States Senate, and each member of the Illinois congressional
13 delegation.".