Insurance & Commerce- House

Under the table. You would just introduce yourself and you may proceed with your presentation. Thank you Mr chairman representative acre I am the lead house sponsor on Senate bill one nine two along with fellow pharmacist Senator Justin Boyd so. I am excited to present a us a bill that is essentially clean up language that allows for a increasing definitions and the current stepped therapy act it's a small amendment to that act that will create a massive cost saving impact for patients. essentially what we're trying to do here is recognized a new definition of drugs which is biosimilars so for all intents and purposes biosimilars you can think of as generics as far as other considered so their safety profile their efficacy everything that has to go into how they are effective so their potency are all registered with the FDA as being cleared products so. My best analogy is in the current state when it comes to stepped therapy insurance companies will often list a singular product that a patient has to fail therapy with before they'll advance to a more costly for newer product so In an analogy when it comes to vehicles before an insurance company will pay for a semi truck the will list that you must fail therapy with a Ford pickup truck. Some patients will come to them and say I've been driving a Chevy pickup truck for the last five years that has just failed its use and No physician finds value and switching from a Chevy to afford and this will allow the insurance company to recognize those years of therapy in the Chevy truck to allow them to move forward with therapy. So with that I welcome questions concerning these products thank you for presentation representative or any questions by the committee. Last year where you're recognized for a question. Thank you Mr chair Representative Baker when used when you're comparing them for and shall be are you are you referring to one is like the name brand and the other is a generic no ma'am those would to those would be considered generics in this analogy so with biosimilars the reason that the definition of generics cannot be applied to them currently is because biosimilar products such as insulin or immunotherapy treatments are very complex and size and they're actually grown out of bacteria or live living cells were as generic drugs by definition are synthesized in a lab similar to like mixing ingredients together so that's why the definition of generic. The conceptually applies here but literally doesn't that make sense what can I rephrase my question so are you saying that if you've got to drugs that a bio similar yes ma'am. And one of them is not working The New moved to the name brand you would spend set one The New not necessarily the name brand as the name brand in that analogy would be We went to what they've already failed this would be they're able to move to a a new product altogether that is more expensive or whatever purposes the insurance company has deemed a step three so it's a different correct formulation correct so patients who have failed therapy with the Ford truck and they want to move on to the semi truck the insurance company will list for. Those patients who have failed for immediately move forward to the next level patients who have been driving others pick up trucks that are agreed our file similar to Ford are not automatically. Viewed as Ford this would allow the insurance company to view those other failed therapies that are about similar to Ford as a failure of for therapy thanks makes sense appreciate that thank you. Thank you Ladyman you're recognized for a question. Thank you Mr chairman of so while similar that's a fairly new time isn't. It is so give us some kind of history on they have been around long or lease a term as an so would it come from homes of men around in are these are these things being developed now in the presentation process yes there so there are multiple biosimilars out in the marketplace right now the term biosimilars relatively new because there hasn't been a requirement to have Something that is in reference to an existing product so you had original biologics which is for example Lantis insulin is a very common one that's dispensed the day that is a biologic that is when the process of approval after that got the process of approval other people market want to try and formulate generic alternatives to that however the term generic can apply to a molecule that is as complex as insulin so they invented the term biosimilar because these products while they do show the same efficacy potency and in result as the reference product they cannot be synthesized identically at the same terms that apply to generic thank your question it is a relatively new term an amount of products are relatively small compared to drug therapies overall but this does incentivize companies to invest in developing those products that result in lower cost at the point of sale for the patient thank. Representative flowers you're recognized for a question. Thank you this is just so I'm clear about your analogy and thank you for the amount of analogy. are used are used. Is what you're saying that there's sort of a a lateral when you're when you're talking about the biosimilar drugs. And you're making the analogy of the Chevy and afford this sort of a lateral sort of schedule of drugs and this will allow. This will allow the insurance companies to pay for the next level or to pay for those lateral schedules and tracks it would be both essentially but the issue that it's addressing is you will allow insurance companies to recognize all of those lateral. Once in one group so right now the term biosimilar isn't in the current legislation so even though the insurance company wants to recognize Chevy they don't have the freedom to do so residents were allowed them to recognize that and that would and so that's where it in when your bill talks about promoting savings yes it would allow if it made sense for the patient to explore some of those biosimilar drugs and not have to. Go up to the next run to the semi correct it would allow those to happen but more importantly it would not force the patient to make a lateral move after they've invested so much time in therapy in this level aha it would be very disheartened for the patient to explain to them that you have to go try this product that you've already technically been on for five or six years that has failed to meet your needs an advocacy and so now you're starting a similar product paying out of pocket for product you know doesn't have the potential to help you just to meet a statue requirement and this and nothing in this mandates that of a physician or insurance company go in any any direction known as recognizing the other lateral drugs that could be correct by more efficacy or if it doesn't allowing the patient to be able to go to the next level correct this is not infringe on any sort of prescriptive authority in anyway it just allows insurance companies to recognize the patient's current therapy by the time it comes to assess them for the next date thank you thank you for bringing this bill yes ma'am. Webserver Allen you're recognized for a question. Thank you Mr chairman. Thank you for bringing this bill I will tune pharmaceutical sales for three and a half years so which biosimilar drugs do you all have any specially drugs live full ATP and hypertonic taste that emotions of those kind of things at least as a local drugs. so biosimilars as a term can enter into that market so the the market that's seen the most investment into it is going to be oncology that's re see a lot of. Yes certain cancer drugs for this thing but then you also see rheumatoid arthritis Crohn's disease and a lot of these psoriasis medications that biosimilar products again this allows the insurance company to recognize the work that those have done to prove that they are just as safe just as effective and just as potent as the reference product or the original product follows yes so would the barrel similar drills the calls will. The last in the regulatory system that is the idea so that the concept yes or the concept is to incentivize and not and to remove barriers that by a similar investments currently have to allow that competition to flourish and so that you you have greater competition in the market that honestly represents about two percent of all prescriptions written but constitutes over forty percent of all drug costs so this allows an induction of competition into an extremely expensive market thank you I like the concept yes Sir thank you. Lundstrum you're recognized for a question thank you want to reunite make sure we were not interfering with the doctors ability to prescribe any type of medication we're actually opening a doctors ability to prescribe yes ma'am that is correct okay. Representative wouldn't you're recognized thank you representative or recently had a situation where the my insurance company denied use of a particular and selling products on the floor of a of our product. Yushin and but the insurance company permitted the addition of a new. product uses similar action that you're asking for here so this is in regards to stepped therapy so I but I meant what I meant this will permit the insurance companies to be able to move into another. This is this prevents insurance companies from being solely focused on a singular product to require you to move to the next level okay thank you thank you. Okay I see no further questions by the committee you would Bills. There's no one signed up if anyone in the audience would like to speak for or against this bill. Saying no one would okay would you like to close for the bill yes Sir I'm close for the bill do I make a motion to do pass myself present for the committee that is not for you not for me. I appreciate a motion produced whoever says to do that Rep represent Ladyman you're recognized. Hey we have a motion do pass birds of Ladyman that the proper motion is a discussion on the motion. Okay saying none all in favor motion do pass say aye. Impose no regulations are acre skews me to represent of acre he pastor bill thank you very much. The representative Eubanks what do you like to present twelve forty two. Thank you Mr chair representative Wardlaw is in another committee presenting ability asked me to present HB twelve forty two this was something that the Legislative Council pot they address back in before the session began this is to. Reinstate the opportunity for of pharmacy benefit for a teacher retirees that are Medicaid Medicare eligible. He said it was a great bill. I don't know if I would have said that well I know I understand just give um. Any further testimony. Redbacks I don't have any okay any questions by the committee. Represent each you're recognized for a question your opening statements that we thought we took care that a see what exactly are you referring to this population this group of people that were left out because this this applies to the folks that didn't take the United advantage plan. Thank you for the question surveys any further questions by the committee so this is just correction were mopping up this correction okay that's good. Yes that's my understanding any further questions. Okay it there's no one signed up with anyone like to speak for or against this bill in the audience okay saying no one of the banks would you like. I'm close and I'll make a motion to pass okay so I have a motion to pass by reserve Eubanks proper motion is our discussion on the motion. Okay Ladyman you're recognized for discussion on the motion do pass there seems to be some confusion I wanna make sure I was a vice chair of the be the committee and this was something that we thought was included in the overall program and we didn't go out remain people are going to opt out of this but quite a few did so just an oversight that we thought was fix but we found out later that it was not so. Thank you for that clarification of the Ladyman any further discussion on the motion. Okay saying none all in favor the motion do pass say aye. Impose no regulations are to be thank you pastor bill. Committee members I believe that is all the bills that we have I was contacted by representative Hudson McGrew and they want to do it next week I do anticipate trying to commence HB thirteen seventy next week but I'll try to keep informed what all we're going to hear represent Allen you're recognized thank you Mr chairman shall the Bill about three weeks ago maybe a month ma'am and we're still waiting on the financial impact statement yes you have an ideal when we will be seat receiving those results that that's a great question I can certainly tell you that it varies based on the bill we've gotten some reports this summer going to take much much longer than others I met with him about that may be what you not talk about that off on weekend up is my bill Williams let's talk about that okay. We're doing.