Here come the biosimilars

The FDA has just approved the first biosimilar for the US. These are drugs which are similar but not identical to the original patented drug. Amgen defines them as:

"Unlike generic medicines where the active ingredients are identical, biosimilars are similar to but not identical copies of the originator biologic. They are similar, but not the same. Biologics made by different manufacturers differ from the original product and from each other."

The first FDA approved biosimilar is Zarzio, which is a biosimilar for Neupogen - the lovely injection many of us got after each chemo infusion to help ward off infections. But not to be confused with Neulasta. This first drug could add up to $6 billion over the next ten years.

"Zarzio’s introduction — primarily as a competitor to the Amgen blockbuster Neupogen — marks a milestone, and could add up to savings of $6 billion over the next 10 years, according to drug benefit manager Express Scripts. But that’s just the start — Express Scripts estimates that if 11 other biosimilars pass muster with the FDA, they would shave $250 billion off spending on comparable existing biotech drugs over that same period."

So as big pharma comes up with these fancy new drugs at sky high prices, upwards of $100,000 per patient per year, which overwhelm the insurance companies, the new biosimilars can cut the market prices by 40-50%, which is not as much as the 70-80% savings with a generic.

I realize that biosimilars and generics are not for everyone but a little competition is good for the industry. Insurance companies can use the availability of a biosimilar to negotiate lower pricing for the original drug and shift many patients to the biosimilar to help with substantial savings.

I welcome these changes as a significant step to help contain medical costs.

Medical marijuana

I will admit that I am of the generation who might have inhaled from time to time but no longer. That was over in the 1980s for me. I stopped because I decided I didn't really enjoy it (and it made me fall asleep).  Now medical marijuana is looming around the corner as it was just voted in here in Massachusetts.

In principle I do not have a problem with medical marijuana as long as it is for medical use only. Based on some personal experience I can see how it could help cancer patients with  pain and nausea. But I have also seen all the stores in California selling 'medical marijuana' all over with ads in the paper touting their new varieties so they look like your basic pot dealer with a website..

I believe there are 17 states which allow medical marijuana and have had resulting drug use increases and crime problems near the stores.Based on these other problems, Massachusetts has a plan, with 120 days to get it implemented, that includes a maximum of 35 medical marijuana stores, no more than five per county, and not near crime areas or schools.I think as long as this is controlled so that patients have access to it but we aren't allowing teenagers or substance abusers to have it that would be fine with me. Someone will have to figure out that barrier.

What I do have a problem with is the most common way to use marijuana is to smoke it. So if a cancer patient is dying, do they have to smoke it to get the benefits? I would have no desire to smoke it - I like living in a smoke free world.Or do I have to make fattening pot brownies and eat the entire batch? Or make spaghetti sauce using it as an alternative to oregano? Or any other of the creative alternative uses of marijuana from the 60s and 70s? (I'll plead the Fifth on these if you ask how I know about them.) Does it come in tablet form?

And if it helps with nausea, what happens if the ensuing 'munchies' occur. It would be better in that case to eat a normal meal instead of the typical pot smokers bag of Fritos or batch of cookies. Would you have to plan your munchies?

So while I am for medical marijuana I do have some issues of it. If it came down to me using it for pain or nausea, I would definitely consider it. But would want to see it controlled properly. As my health continues its lovely downturn I am all for creating legal options for patient treatment but want to ensure the legalities are upheld.

PS My appointment yesterday was fine. I am now on yearly follow ups with my radiation oncologist instead of every six months.