MARY LOUISE KELLY, HOST:
Drugs like Humira and Cosentyx have made a huge difference for some patients with devastating conditions, but they're also complex medicines made from living organisms. These drugs called biologics are costly in the U.S. Sarah Jane Tribble of Kaiser Health News has the story of one patient who can no longer afford her biologic drug.
SARAH JANE TRIBBLE, BYLINE: Susie Christoff suffers from debilitating arthritis. The 59-year-old's fingers can swell to the size of sausages. She's endured multiple hip surgeries. And last year, Christoff lost her career in nursing anesthesia because she couldn't stand up long enough to work.
SUSIE CHRISTOFF: It's 24/7 constant pain in, like, the ankles and feet. I can't sleep. It's like restless leg because the pain is so bad. I can't sit still. I cry. I throw pillows. It's just awful.
TRIBBLE: Christoff and her rheumatologist tried a series of medicines before finding Cosentyx, a once-a-month injection.
CHRISTOFF: And it actually started to work. Like, my hands do not look bad at all. My ankles - you can see my ankle bones now. You know, I was able to do walking 15, 20 minutes even though it's slow because of the hip. The limp is permanent, he said.
TRIBBLE: He is her doctor, Angus Worthing, chair of the American College of Rheumatology's Government Affairs Committee. Worthing and Christoff were elated. The drug only cost $50 a month with her employer insurance. Then Christoff went on disability and had to drop her employer insurance. She switched to a Medicare Advantage plan, Worthing says.
ANGUS WORTHING: Susie's case is kind of heartbreaking. The drug that seems to be working after all these years isn't one that's affordable and accessible to her.
TRIBBLE: Each monthly injection now costs nearly $1,300 dollars on Medicare. Worthing and Christoff tried several different biologics for her pain and swelling, including Remicade, Enbrel and Humira. Biologics are not chemical compounds like, say, aspirin, but instead they're created using living organisms. They're among the most costly drugs in the U.S. health care system. U.S. Food and Drug Administration Commissioner Scott Gottlieb...
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SCOTT GOTTLIEB: Biologics represents 70 percent of the growth in drug spending from 2010 to 2015, and they're forecasted to be the fastest growing segment of drug spending in the coming years.
TRIBBLE: Gottlieb was speaking at the Brookings Institution in Washington, D.C. He blamed the business tactics of drugmakers for slowing the entry of copycat biologics called biosimilars in the U.S. market. Indeed, the European Union has 50 biosimilars for cancer, diabetes, fertility and autoimmune diseases like arthritis. In contrast, the U.S. only has six of these lower-priced biosimilars on the market. That frustrates rheumatologists like Worthing, whose patients have fewer choices.
WORTHING: We do have competition. And we have seen lower prices from biosimilars in the United States. It's not what we've seen in Europe where countries such as Norway got up to 70 percent of a discount.
TRIBBLE: Christoff's brand-name drug, Cosentyx, is still on patent and does not have any competition in the U.S. or Europe, yet the difference in pricing is still striking. In the U.S., Cosentyx costs more than $65,000 a year. In England, Cosentyx costs the National Health Service about 10,000 pounds or less than $13,000, and most patients pay nothing. Meanwhile in Virginia, Christoff says she can't pay for the biologic that works for her anymore, and her arthritis is getting progressively worse. How this disease affects her, her three grown children and her family's grandchildren really hit home last summer.
CHRISTOFF: Once a year, we're all together. And we were in Virginia Beach. And, like, I can't get down on the sand to play with my kids without help. I can't get up without help.
TRIBBLE: She asked Cosentyx drugmaker Novartis for financial assistance but didn't qualify.
CHRISTOFF: I'm not ready to stop trying, but I'm also not ready to go through my entire retirement fund to walk.
TRIBBLE: I'm Sarah Jane Tribble in Fairfax, Va.
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