Health plans cut back on biologics payments

Managed care executives are understandably stressed by the cost of biologic drug treatments which, in extreme cases, can run as much as $100,000 per year. To address the problem, many plans are asking patients to pay larger percentages of the medications' cost. With some patients already spending hundreds of dollars a month, some are cutting back, and others can't afford to raise doses when necessary, physicians say. Other doctors have complained that health plans are using less-direct tactics to limit biologic drug costs, such as making them bend over backwards to justify individual treatments. The net result may be that doctors prescribe old-line drugs which aren't as effective, some suggest.

This problem may let up somewhat if a pending federal bill passes making it easier for the FDA to approve generic biologic drugs. In the mean time, some drug makers are responding by expanding patient-assistance programs. For example, drug maker Centocor (a Johnson & Johnson subsidiary) has launched a program designed to help new Remicade patients carry co-payments.

To find out more about this trend:
- read this San Francisco Chronicle article

PLUS: The U.S. Senate voted to allow drug imports from a lineup of other countries--but only after scuttling the whole initiative by first requiring health officials to sign off on the safety of any drugs that are imported. Report

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