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Express Scripts and PCMA Follow-On Biologics Studies Are Based on 
Flawed Assumptions That Undermine Their Credibility: BIO Analysis 
Raises Serious Concerns Over Two Cost Savings Studies

Feb 22, 2007 - Two recent studies examining potential savings in 
health care costs resulting from the establishment of a pathway for 
regulatory approval for follow-on biologics contain significant flaws 
and assumptions that call into serious doubt their validity, said the 
Biotechnology Industry Organization (BIO) today in an analysis of two 
separate studies released by the Pharmaceutical Care Management 
Association (PCMA) and by Express Scripts. 

"As a result of numerous flawed assumptions, and the lack of any 
credible evidence to support these alleged savings, we believe these 
studies should be rejected as unscientific and unreliable," stated 
BIO President and CEO Jim Greenwood. 


 
"This debate should be focused on and driven by credible science, 
fact-based studies and patient safety. These studies fail to meet 
these standards. They cannot be relied upon in lieu of a more 
rigorous analysis," stated Greenwood. "Congress should recognize 
these flaws and misleading assumptions and reject these studies as it 
evaluates proposals regarding follow-on biologics." 

The BIO analysis details nine serious flaws in the PCMA and Express 
Scripts that call into serious doubt the validity of their claimed 
savings. These flaws include: 

-- Assumptions about patent expirations that are inconsistent with 
credible analyst reports seriously call into question more than $40 
billion of the alleged savings cited by the Express Scripts study; 

-- Calculation errors in the PCMA study result in an overestimate of 
savings of 40 percent, even taking their other assumptions as 
correct; 

-- Internally inconsistent allegations of interchangeability in the 
Express Scripts study call into question an additional $13.8 billion 
in alleged potential savings; 

-- Presuming that a pathway under one law would generate savings for 
products approved under another law calls into question over $17 
billion in additional alleged savings in the Express Scripts study; 

-- Market penetration rates for follow-on biologics incorrectly 
modeled on generic drug experience are inconsistent with credible 
published analyses; 

-- Calculations based on determinations of interchangeability that 
include presumption of savings beginning in 2007 are unsupported in 
both studies. 

"No credible analysis of follow-on biologics suggests that we will 
see anything close to the savings we've seen from generic drugs, nor 
any savings close to the flawed estimates claimed in these studies," 
stated Ted Buckley, Ph.D, BIO's Director of Economic Policy. "As 
leading health economists have pointed out, the traditional generic 
drug business model is simply inapplicable when dealing with these 
complex biological products." 

BIO's analysis details flaws in the PCMA and Express Scripts studies 
regarding claims of immediate savings from follow-on biologics. The 
assumption made in both studies that follow-on products will be 
promptly rated as interchangeable by the FDA and that as a result 
market substitution will occur rapidly ignores existing regulatory, 
scientific and market experience. 

In fact, as noted in BIO's analysis, the U.S. Food and Drug 
Administration (FDA) has not determined how interchangeability can be 
established for complex proteins. FDA has stated that, "Different 
large protein products, with similar molecular composition may behave 
differently in people and substitution of one for another may result 
in serious health outcomes." According to the European Medicines 
Agency, "(d)ue to the complexity of biological/biotechnology-derived 
products the generic approach is scientifically not appropriate for 
these products." 

The faulty assumption of interchangeability likely results in a 
significant overestimation of savings, as products not designated as 
interchangeable would very likely experience slower adoption rates. 
These differences do not appear to be taken into consideration in 
either the PCMA or the Express Scripts studies. 

BIO's analysis also finds that both studies are based on dubious 
claims regarding patent expiration timelines leading to significant 
overestimates of savings. The Express Scripts report acknowledges 
that "additional patents have been granted, which may extend the 
protection of Procrit and Epogen," but then goes on to make the 
explicit assumption that, "This model assumes that these patents 
would not be a barrier to biogeneric entry in this therapeutic area." 
Using Express Scripts' own estimates, reliance on this unexplained 
assumption accounts for more than half of their total projected 
savings. 

Furthermore, both studies also implausibly assume that the current 
market share of the biologics will not evolve over time, despite the 
fact that this has not been borne out by experience. "One of the 
basic facts of a dynamic marketplace is that products are replaced by 
newer, more innovative products," stated Buckley. 

Finally, the PCMA study assumes that for every biologic that comes 
off patent there will be an associated follow-on product. There is no 
credible evidence to suggest that it is scientifically possible to 
develop a follow-on for every biologic that is currently on the 
market. Further, many biologics have a limited market, and therefore, 
it likely will be economically less attractive for companies to 
pursue manufacturing of follow-ons for many of these products. 

"Overall, we find that these studies contain claims of potential 
savings based on a seriously flawed set of assumptions that defy 
current experience and lack credible evidence," concluded 
Greenwood. "Congress should move deliberately as it examines 
proposals to develop a pathway for follow-on biologics." 

The full BIO analysis can be found at 
http://www.bio.org/healthcare/followon/20070222.pdf . 

About BIO 

BIO represents more than 1,100 biotechnology companies, academic 
institutions, state biotechnology centers and related organizations 
across the United States and 31 other nations. BIO members are 
involved in the research and development of healthcare, agricultural, 
industrial and environmental biotechnology products. BIO also 
produces the annual BIO International Convention, the global event 
for biotechnology. -0-     Upcoming BIO Events
    -------------------

--  2007 World Congress on Industrial Biotechnology and Bioprocessing
    March 21-24
    Orlando, FL

--  BIO International Convention
    May 6-9, 2007
    Boston, MA

--  BIO VentureForum-East 2007
    June 18-20, 2007
    Montreal, Canada

--  BIO Mid-America VentureForum 2007
    Sep. 24-26, 2007
    Milwaukee, WI


Contact 

Biotechnology Industry Organization (BIO)
Stephanie Fischer, 202-312-9263
www.bio.org 




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