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Health care and medical spending are a significant portion of the total U.S. economy. According to National Health Expenditure data, spending related to health care amounts to approximately $9,900 per person annually. Representing almost 18% of the entire national economy, the healthcare sector and policy that impacts spending on health care has a significant effect on your family finances and government budgets.
This session two of my bills relating to health care have been unanimously advanced to General File by the Health and Human Services Committee. Both are issues I have worked on over the course of the past two years. LB 223 further defines aspects of Nebraska’s Prescription Drug Monitoring Program and was prioritized by Senator Sara Howard of Omaha as her personal priority. LB 481 creates a state framework for the prescription and use of biosimilar and follow on biologic pharmaceuticals within Nebraska. Speaker Jim Scheer designated LB 481 as a speaker priority bill.
LB 223 makes technical and procedural changes to statutory language passed by LB 471 in 2016, which established Nebraska’s comprehensive Prescription Drug Monitoring Program. The PDMP is a reporting system that provides comprehensive prescription information to prescribers to promote patient safety and improve delivery of medical care. Nebraska was one of the last states to launch statewide prescription drug monitoring, but has quickly received national recognition for an ambitious program that is embedded within the Nebraska Health Information Exchange system. This integration was the driving force behind federal grants that have provided seed funds for development of the PDMP free of charge to prescribers.
The system is also a vital tool in the prevention of prescription opioid abuse, a growing problem throughout Nebraska. Prescribers can now identify drug seekers in real time across the state, as well as provide valuable information to other prescribers. Additionally, avoidance of possibly fatal drug interactions is improved through information shared through the PDMP.
LB 481 is a critical piece of legislation for Nebraska to provide guidance for clinicians and dispensers as biosimilar products pass through the FDA approval process. Biosimilars, also known as follow-on biologics, are biologics manufactured using different cell lines mirroring the composition and treatment profile of an innovator product produced by another company. Biologics are an innovative class of medicines manufactured from living organisms. Unlike “small molecule” drugs that are chemically synthesized, biologics are derived from cells lines to produce a desired therapeutic substance. While the drugs you most commonly think of are chemically identical batches, biologics are complex, heterogeneous mixtures. While they have the same treatment and therapeutic uses, biologics using different cell lines will not be exactly the same.
Biosimilars present therapeutic and cost-effective alternatives to innovator products for providers and patients. Transparent communication between the patient, physician, and pharmacist is the hallmark of high quality patient care. LB 481 provides guidance to facilitate the communication when an approved interchangeable biosimilar product is substituted by the dispenser. Proactively establishing the communication framework for use of interchangeable biologics is a common sense step for promoting patient understanding of their own health care and communication among all members of the health care team. To date, 28 states have adopted similar legislation. Although the FDA is responsible for the approval of biologic and biosimilar medicines and their interchangeability, state law governs the the substitution by dispensers when a different biologic was prescribed.
Common sense steps to adopt the use of new technology to improve both efficiency and safety in health care ultimately help reduce costs and improve patient outcomes. I am grateful to Speaker Scheer and Senator Howard for utilizing their priority designations to ensure both of these bills receive consideration by the full Legislature this session.