Adalimumab (Humira) is the most expensive drug in the world in terms of total sales: $19.9 billion in 2018. Five biosimilars (generic equivalents) have been approved by the FDA, but none have been marketed because they have been locked up in patent disputes by the manufacturer, Abbvie.
The story is much different in Denmark, which implemented a national campaign to encourage patients and doctors to make the switch in 2018 as soon as the cheaper equivalent became available. 2 became available for adults; 1 for children. There was an almost immediate switch to the generic versions, which held steady for a year. By that, I mean that the switch was successful in most cases and patients had no reason to go back to the branded drug, Humira.
As a result of this national courage to confront the unknown, the cost of adalimumab decreased by over 82% in a matter of a little over a month, and has held steady ever since.
There are a few similar success stories in the U.S., such as Kaiser Permanente replacing infliximab with generics, which led to an 80% decrease in its costs for that drug.
If the entire healthcare system had the courage to stand up to Pharma, the RAND Corporation estimated that we could save $54 billion over ten years. The incredible profitability of these drugs means that hundreds are in the pipeline and many will likely offer small to negligent improvements over existing options. Denmark, other European countries, and even Kaiser Permanente show us that with a little courage, we can fight back against these strong inflationary pressures.
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