Yesterday, the FDA approved Actemra for use in the treatment of Systemic-Onset Juvenile Idiopathic Arthritis. Also known as Still’s Disease, I’ve written about this before.
You might be saying, “I don’t have Still’s, so why would I care?” I think it matters, because it’s an important step and might be the start of a new trend.
So many times drug companies get their initial approval and then move on to new pastures. Often this doesn’t matter because once the FDA has approved a drug, doctors can prescribe it for other uses (known as off-label prescribing). The pharmaceutical company has their medication approved, doctors prescribe the medicine, patients feel better; everyone’s happy.
The catch is that the person taking the medication often isn’t the one paying for the medication, and with the more expensive drugs (such as biologics) the third-party might decide not to pay. Insurance companies understandably don’t want to shell out $2000 per month if there’s a way to get out of it. One way is to deny coverage of off-label medications.
If a biologic is approved for use in RA, but not in USpA or MCTD, insurance won’t pay for it even though the medication would be a great help. Drug companies could make a lot more money if they’d do the extra work to get extra uses added to the label, but they don’t often make the effort. Thus, I am very excited to see the expanded labeling for a biologic – and hope that other pharmaceutical companies follow suit.
Not only is yesterday’s announcement exciting for kids with SJIA, it holds out hope for all of us for expanded uses of biologics to treat other forms of autoimmune arthritis.