(Pixabay)

There’s a new obstacle to lowering drug prices: the pharmaceutical companies have shot each other in the foot in a circular firing squad.

Specifically it’s about biotechnology drugs, called biopharmaceuticals or biologics, such as vaccines and cancer drugs, which are “large molecule” drugs made partly from biological materials. Because they are large, they can’t cross the blood-brain barrier and adversely affect the central nervous system.

These drugs are expensive. A 2016 Yale School of Management study estimated that US biologic drugs account for more than 27 per cent of total drug spending, but are less than one per cent of all prescriptions filled.

Their cost could be reduced by replacing the out-of-patent drugs with biosimilars, the biologic equivalent of generics, though – as the name implies – they are not identical, just very, very similar.

Big Pharma went out of its way to deride biosimilars as too risky, and they managed to convince a lot of doctors, hospitals, pharmacies and insurance providers. Which is a pity since now they can more easily make biosimilars of their competitors’ biotech, but their words have come back to bite them in the derriere.

Bloomberg News reports that even when doctors, hospitals or pharmacies want to use biosimilars, the insurance companies won’t let them. Insurance companies may be penny-pinchers, especially when it comes out of their profits, but they also are risk averse.

This doesn’t really affect substance use disorder treatment now, but biologic addiction vaccines are being tested. If they work, they could not only reduce the effects of prescription drugs on current users but make their effects less, and thus less attractive, to new users.

Health and Human Services Secretary Tom Price recently called the prospect of such vaccines as “exciting.” If they work, such vaccines would not be given only once or twice in a lifetime, but probably several times a year. That could be very costly, at least until less expensive biosimilars became available..

They also likely would be drug specific, so other drugs could be substituted, even more dangerous and powerful drugs such as fentanyl or carfentanil. Drug rehab will still require behavioral therapies, support groups and other aftercare.

In Europe, the cost for biosimilars is as much as 80 percent less than biologics. That’s another reason their health care costs are so much less than ours.