Dr. Stephen M. Hahn Profile picture
Jul 8, 2018 19 tweets 10 min read Twitter logo Read on Twitter
For this week’s #FDA #SUNDAYTWEETORIAL, I want to talk about #biosimilars. It's a critical moment in the development of the market for these products. We'll advance major policy changes in this area soon. Enhancing biosimilar competition is a key to reducing overall drug spending
Congress charged #FDA with maintaining balance between encouraging and rewarding innovation and facilitating robust and timely competition. We must ensure that this balance exists across the spectrum of pharma products; from small molecules to more complex products to biologics
Biologics play a key role in treating many serious illnesses like cancer or genetic disorders. While they offer many therapeutic benefits, biologics often come at high expense. While <2% of US patients use biologics, they represent ~40% of total Rx spend bit.ly/2EsWDOr
In contrast to most drugs, which are chemically synthesized and have well-characterized structures, biological products are typically complex molecules like proteins that are produced in living cells bit.ly/2lTTDQ9
Recognizing the cost and complexity of biologics and need to enhance access for patients, Congress passed the Biologics Price Competition & Innovation Act, providing an abbreviated pathway for FDA to approve follow-on versions of biologics, aka biosimilars bit.ly/2Kj2qpf
Biosimilars are biological products that are highly similar to and have no clinically meaningful differences from an existing FDA-approved reference product bit.ly/2KL4uKo
The BPCI Act provides a pathway for increased biologics competition to emerge, similar to the pathway created under Hatch Waxman for generic drugs, which has saved the US health care system more than $1.67 trillion in the last decade bit.ly/2ua5ugE @AccessibleMeds
Biosimilar sponsors may leverage FDA’s finding of safety and effectiveness for the reference product to support approval of the biosimilar at a lower cost than a development program for an originator product bit.ly/2u7MtLJ
Unlike the generic pathway for small molecules, some clinical studies may be necessary to demonstrate that a product meets the “biosimilarity” standard for approval bit.ly/2KUR3EE bit.ly/2HmGxEc
To demonstrate that its proposed biosimilar is highly similar to the reference product, the sponsor extensively analyzes the structure and function of the reference product and its proposed biosimilar. Minor differences in clinically inactive components are acceptable
State-of-the-art technology is used to compare characteristics of the products, such as chemical identity and bioactivity bit.ly/2t9mpQJ
An interchangeable product, in addition to being biosimilar, meets additional requirements, for example showing it is expected to produce the same clinical result as the reference product in any given patient bit.ly/2sLKJIw
If a product is approved as an interchangeable product, it may be substituted for the reference product without consulting the prescriber bit.ly/2BABbBG
The reduced need for multiple large clinical outcomes studies as a part of biosimilar product development can significantly lower development costs. This can result in significantly lower prices for patients and payors, as is already seen in Europe hbs.me/2NuuNDa
FDA approved 11 biosimilars, including 5 in 2017. Despite this progress I’m concerned patients aren’t seeing the full benefits of competition. We’ll continue to approve biosimilars but appropriate reimbursement and market access are needed to lower prices bit.ly/2BQwQig
We will soon unveil a comprehensive Biosimilars Action Plan (BAP) that will include policies and actions to improve the efficiency of FDA’s review of biosimilar marketing applications and increase regulatory certainty for biosimilar manufacturers and other stakeholders #BAP
#BAP will include elements like enhancing our education campaign for HCPs and patients bit.ly/2qiwU5s, reducing gaming that may delay market competition, strengthening int’l regulatory partnerships and providing clarity for product developers via guidance and meetings
Although there are barriers to marketing biosimilars outside FDA’s purview, we're committed to advancing policies to facilitate efficient development, approval of biosimilars to reduce costs, enhance access, without reducing incentives to innovate. #BAP will advance these goals
I'm looking forward to speaking at @BrookingsInst event on July 18th to discuss #BAP and our new efforts to cultivate a vibrant U.S. market for biosimilars and other efforts to enhance competition and reduce drug costs brook.gs/2KWhEAW

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More from @SteveFDA

Sep 30, 2018
It’s the start of flu season – time to protect yourself and your family by getting vaccinated! In today’s #FDA #SUNDAYTWEETORIAL I’m going to talk about #FDA’s role in ensuring the safety, effectiveness, and availability of the 2019 influenza vaccines. #VaccinesWork #FightFlu
I know there are questions about the effectiveness and benefits of the flu vaccine given the severity of last year’s flu season, so I want to update you on what we’ve learned, the effectiveness of this year’s vaccine and why vaccination is important go.usa.gov/xPWhS.
We've made important modifications to this year's #Flu vaccine to improve its effectiveness; changing two of the strains (for the H3N2 and Influenza B components) to better reflect the influenza strains that we believe are most likely to circulate this winter. More on this later.
Read 22 tweets
Sep 9, 2018
Compounded drugs serve an important medical need for patients who can’t use an FDA-approved medication. In today’s #FDA #SUNDAYTWEETORIAL, I’m going to talk about what FDA is doing to preserve access to appropriately compounded drugs while protecting patients from serious risks.
In drug compounding, ingredients are combined, mixed or altered to create a sterile or non-sterile medication tailored to a patient - such as those with an allergy who need a drug without a certain dye or a child who can’t swallow a tablet and needs medicine in a liquid form.
But compounded drugs, which aren’t FDA-approved, may pose serious risks if not produced properly, potentially resulting in contamination or medications that do not possess the strength, quality or purity they are supposed to have bit.ly/2G7IpjB
Read 23 tweets
Sep 2, 2018
As kids are heading back to school, for this #FDA #SUNDAYTWEETORIAL I’m going to talk about MEASLES and the vital importance of vaccination. You may’ve seen recent news stories reporting cases of measles in parts of the US and EU. Most cases have occurred in unvaccinated people
In 2018 there have been 124 individual cases of measles in 22 states and D.C. Measles can spread when it reaches a community where there are groups of unvaccinated people. And travelers with measles continue to bring the disease into the United States go.usa.gov/xUzwa
Measles is caused by the rubeola virus and is highly contagious. It is normally passed through direct contact or through the air. The virus infects the respiratory tract, then spreads throughout the body, causing a skin rash, fever, cough and runny nose.
Read 19 tweets
Aug 19, 2018
Consumers want and expect safe, wholesome and affordable food. They deserve nothing less. In today’s #FDA #SUNDAYTWEETORIAL I’m talking about what steps the FDA, the states and produce farmers are taking - in collaboration - to ensure the safety of fresh fruits and vegetables.
We hear too often about food safety concerns involving fresh fruit and vegetables -most recently the outbreak of E. coli O157:H7 infections associated with romaine lettuce from the Yuma growing region, the largest such outbreak in the U.S. in more than 10 years.
From 1998-2008 there were 455 produce-associated food outbreaks, with more than 16,000 people becoming ill, more than twice the number of produce-associated illnesses from 1973-1997. This is a significant public health burden that should be largely preventable.
Read 25 tweets
Jul 30, 2018
THREAD ON NEW ENFORCEMENT ACTION: We’re taking action against manufacturers marketing “vaginal rejuvenation” devices to women by deceptively claiming the procedures treat conditions and symptoms related to menopause, urinary incontinence, & sexual function fda.gov/NewsEvents/New…
These products have serious risks and don’t have adequate evidence to support their use for these purposes. We’re deeply concerned women are being harmed by these procedures
In some cases, the devices are marketed to women who’ve completed treatment for breast cancer and experience symptoms caused by early menopause. Deceptive marketing of a dangerous procedure with no proven benefit, including to women who’ve been treated for cancer, is egregious.
Read 7 tweets
Jul 29, 2018
For this weekend's #FDA #SUNDAYTWEETORIAL I’m going to talk about what FDA is doing to modernize clinical trials to reduce the cost of drug development, potentially lower drug costs and bring more safe, effective therapies to patients.
FDA’s mission is to both promote and protect public health. For medical products, this means ensuring that they are safe and effective for their intended use. Clinical trials are the primary vehicle for generating the evidence FDA needs to ensure that.
The traditional drug development paradigm calls for 3 clinical trial phases: A small phase 1 tests safety and dosing, phase 2 tests short-term side effects and effectiveness over a range of doses; and the large phase 3 assesses whether the product’s benefits outweigh its risks.
Read 22 tweets

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