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| AMENDMENT TO SENATE JOINT RESOLUTION 48
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| AMENDMENT NO. ___. Amend Senate Joint Resolution 48 by |
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| replacing everything after the heading with the following:
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| "WHEREAS, With approximately $16 billion in biologic drug |
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| patents set to expire next year, the average price of a |
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| traditional drug is about $45, while the average cost of a |
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| biologic can be about 4 times as much, and with Medicaid |
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| accounting for about 19% of federal government drug |
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| expenditures, the 110th United States Congress will be |
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| considering legislation to authorize a regulatory pathway at |
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| the federal Food and Drug Administration (FDA) for the |
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| determination and approval of safe comparable versions of |
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| biologic drugs that are expected to produce the same clinical |
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| results as the innovator product; and |
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| WHEREAS, Biologics are a major driver of increasing |
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| prescription drug costs; for the first time, 5 of the 20 |
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| top-selling drugs in 2005 were made by biotech companies; |
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| additional competition for biotech pharmaceuticals has the |
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| potential to offer consumers real savings, while also lowering |
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| America's healthcare bill; and
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| WHEREAS, Illinois spends nearly $200 million for 61 |
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| biologics under its Medicaid pharmacy benefits and Part D wrap |
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| around programs and an estimated 12% of its drug benefits on |
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| biologics for State employees and retirees; and |
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| WHEREAS, The science to create safe comparable biotech |
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| drugs exists today in other countries; raw materials are |
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| available today for many comparable protein products including |
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| insulin, GCSF, epoetin, interferons, and others; in many |
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| countries around the world, competitive biotech products are |
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| already available to consumers; in these countries, patients |
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| have access to safe comparable biological products and receive |
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| cost savings from additional competition; and
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| WHEREAS, Significant investment is made by biotech drug |
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| developers in intellectual property, and appropriate |
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| intellectual property protection and the ability to recoup |
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| their investment and make a fair profit is needed; however, as |
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| has been proven under the Drug Price Competition and Patent |
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| Restoration Act of 1984, competition fuels innovation; |
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| competition from safe comparable biologics will ensure |
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| continued innovation in biotech drugs; it is critical to |
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| preserve the incentives for innovation that drive the |
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| development of new biologics, recognizing that data |
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| exclusivity and patents work together to create the environment |
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| to support investments in discovering new biologics in order to |
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| keep this country's biotech innovators strong and growing; and
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| WHEREAS, A Citizens Petition was submitted to the FDA in |
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| August 2006 requesting that the FDA use its statutory and |
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| regulatory authority to issue guidelines that will facilitate |
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| the availability of more affordable versions of insulin and |
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| human growth hormone (HGH); and
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| WHEREAS, American patients currently spend approximately |
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| $1.5 billion on insulin products to treat diabetes and |
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| approximately $433 million on HGH, which is used to treat a |
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| variety of conditions, including growth deficiencies in |
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| children and adults, chronic renal insufficiency, and AIDS |
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| wasting syndrome; and |
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| WHEREAS, The FDA has repeatedly and publicly indicated that |
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| guidance on the approval process for insulin and HGH would be |
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| forthcoming; this guidance would provide generic |
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| pharmaceutical manufacturers with the criteria for |
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| demonstrating safety and efficiency of comparable versions of |
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| insulin and HGH; however, it appears that issuance of |
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| appropriate regulatory requirements for these products has |
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| come to a standstill resulting in our citizens and taxpayers to |
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| continue to shoulder the burden for costs because no comparable |
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| version of either of these products is available; insulin and |
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| HGH have less complex biologic structures with a long history |
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| of safe use and a wealth of data available about the innovator |
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| versions of those products; and |
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| WHEREAS, While such guidance unnecessarily languishes in |
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| the United States, the European Medicines Agency (EMEA) has |
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| adopted final guidelines on quality, non-clinical and clinical |
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| issues regarding similar biological medicinal products in |
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| December 2003 and a general regulatory guideline on such |
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| products in September 2005; the EMEA also issued final |
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| product-specific guidance documents on similar biologic |
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| medicine products, including one for insulin, in February 2006; |
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| and |
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| WHEREAS, In 2004, national Medicaid expenditures for |
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| insulin alone were approximately $500 million; insulin was |
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| historically approved for sale in the United States under the |
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| Federal Food Drug and Cosmetic Act; this fact should make it |
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| eligible to generic competition under the Drug Price |
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| Competition and Patent Restoration Act of 1984; diabetes is on |
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| the rise, and, if current population and diagnosis rates |
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| continue as projected, the number of people with diabetes could |
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| reach 17.4 million by 2020 with attendant costs rising to an |
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| estimated $192 billion; insulin is a less complex |
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| biopharmaceutical product and many versions are no longer |
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| patent protected; if the FDA were to issue guidance in a timely |
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| manner and approve a lower cost, safe, comparable form of |
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| insulin, patients could begin realizing savings; and |
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| WHEREAS, On average, African-Americans are 2.4 times as |
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| likely to have diabetes as Caucasians; the highest incidence of |
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| diabetes in African-Americans occurs between 65 and 75 years of |
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| age; African-American women are especially affected; when |
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| adjusted for age, African-American women are more likely to be |
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| diagnosed with diabetes than non-Hispanic Caucasians, |
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| African-American men, or Hispanics; African-Americans with |
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| diabetes are more likely to experience complications of |
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| diabetes; diabetic retinopathy, an eye disease, is 19% more |
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| common in African-American men than Caucasian men; amputations |
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| of lower extremities are also more common in African-Americans |
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| with diabetes; and |
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| WHEREAS, As of 2002, 2 million Hispanic adults age 20 years |
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| and older and about 8.2% of the population have diabetes; |
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| diabetes is more prevalent in older Hispanics with the highest |
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| rates in Hispanics 65 and older; on average, Hispanics are 1.5 |
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| times as likely to have diabetes as Caucasians; |
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| Mexican-Americans, the largest Hispanic subgroup, are more |
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| than twice as likely to have diagnosed diabetes than |
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| non-Hispanic Caucasians; in 2002, the death rate from diabetes |
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| in Hispanics was 60% higher than the death rate of non-Hispanic |
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| Caucasians; in 2001, Hispanics of all races experienced more |
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| age-adjusted years of potential life lost before age 75 years |
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| than non-Hispanic Caucasians for diabetes; and |
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| WHEREAS, HGH is one of the most expensive prescription |
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| regimes, costing a patient upwards of $30,000 a year; HGH has |
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| annual sales in the United States that are estimated to be more |
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| than $700 million; HGH costs are increasing as the number of |
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| growth deficiency-related cases continues to rise and as the |
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| FDA approves new uses for HGH; as usage and the subsequent |
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| expenses increase, Illinois is paying more for a drug product |
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| that has not been patent protected since 2003; and |
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| WHEREAS, With the availability of safe comparable versions |
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| of insulin, HGH, and other biologics there will be savings to |
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| the State and its citizens; for example, if only one-third of |
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| patients using insulin were converted to a comparable insulin |
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| product and it was priced at a modest 10% discount, payers |
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| would save $17 million annually; a discount of 30%, more |
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| typical of the small molecule generic market, with only |
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| one-third of patients utilizing the small molecule generic, |
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| would result in savings of more than $50 million annually; if |
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| all Medicaid patients were converted to the small molecule |
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| generic, at a 30% discount to current brand prices, the savings |
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| would exceed $150 million annually; and |
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| WHEREAS, For more than 2 decades, generic pharmaceuticals |
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| have offered our State with a mechanism to manage the high cost |
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| of providing prescription drugs for State-funded and federally |
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| mandated prescription drug programs; at the same time, generic |
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| drugs have provided all of the citizens of Illinois with the |
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| opportunity to lower their prescription drug costs; therefore, |
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| be it
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| RESOLVED, BY THE SENATE OF THE NINETY-FIFTH GENERAL |
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| ASSEMBLY OF THE STATE OF ILLINOIS, THE HOUSE OF REPRESENTATIVES |
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| CONCURRING HEREIN, that we urge the members of the 110th United |
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| States Congress and the President of the United States to enact |
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| legislation that establishes a regulatory pathway authorizing |
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| the FDA to approve, when appropriate, abbreviated applications |
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| for comparable biological products that are expected to produce |
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| the same clinical results as the innovator product and are |
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| deemed by the FDA to be safe and effective; and be it further
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| RESOLVED, That the FDA be authorized to approve |
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| applications for safe comparable biologics in a manner that is |
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| determined to be in the best interests of patients; and be it |
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| further |
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| RESOLVED, That the FDA promptly promulgate guidance for the |
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| specific approval requirements for forms of insulin and HGH; |
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| the issuance of these guidances would open the door for |
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| potential savings on these important therapies for consumers |
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| across our nation; and be it further
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| RESOLVED, That the FDA also commit to working with drug |
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| companies developing such products and to expediting the |
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| process so that these products may be approved and made |
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| available to patients as quickly as possible; and be it further |
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| RESOLVED, That any new regulatory pathway for safe |
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| comparable protein products contain appropriate incentives for |
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| new biological products; and be it further |
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| RESOLVED, That we strongly concur with those Governors who |
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| filed the Citizens Petition or sent letters of support for the |
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| Citizens Petition to the FDA on this issue; and be it further |
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| RESOLVED, That we also strongly support the twenty |
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| Governors who have sent a letter encouraging Congress to |
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| authorize the FDA to provide a pathway for safe comparable |
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| biologics; and be it further |
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| RESOLVED, That we and the Governor have a responsibility |
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| for managing the costs that the State incurs for prescription |
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| drugs in connection with our State Medicaid program, as well as |
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| other State programs such as State employees and State retirees |
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| that provide a drug benefit; we are also charged with ensuring |
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| that high quality, affordable healthcare that provides safe and |
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| effective care is available to all citizens of our State; and |
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| be it further |
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| RESOLVED, That suitable copies of this Resolution be |
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| provided to the Commissioner of the FDA, the Speaker the United |
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| States House of Representatives, the Minority Leader of the |
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| United States House of Representatives, the Majority Leader of |
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| the United States Senate, the Minority Leader of the United |
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| States Senate, and each member of the Illinois congressional |
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| delegation.". |