Rep. Davis works to save innovation in NC

Rep. Don Davis recently introduced a bill that will help residents of North Carolina’s 1st Congressional District access cutting-edge medications in the years to come.

The Ensuring Pathways to Innovative Cures Act would fix a provision in the Inflation Reduction Act that could force more patients to travel long distances to obtain medications they need. In a largely rural district like North Carolina’s First, that’s a big problem.

Here’s the issue. The IRA allows Medicare to set prices for some prescription medicines. But the law arbitrarily differentiates between certain drugs. 

As written, “small molecule” drugs — usually pills — are eligible for price-setting once they’ve been on the market for nine years. Meanwhile, biologics — drugs administered via injection or infusion, typically in a hospital — get 13 years.

That four-year gap makes a huge difference for investors who finance drug development. Those four years account for about half of the average medicine’s total sales. 

This disparity gives investors an enormous incentive to focus on biologics over small molecules.

That’s bad news. Because small molecules can penetrate the blood-brain barrier, scientists are optimistic for breakthrough small molecule treatments for brain cancer, Alzheimer’s and other neurological diseases. Therapies for cancer and heart disease are disproportionately small molecule drugs.

Small molecules are especially important for patients without easy access to a hospital, since they can usually be dispensed at the pharmacy and stored at home. 

The same isn’t true of biologics, which often have to be administered under the supervision of a doctor or nurse multiple times per month. If the majority of medical breakthroughs come in the form of biologics, rural and low-income patients without reliable transportation to health care facilities may lose out on lifesaving medications.

North Carolinians would feel the impact disproportionately. The ability to take medicines at home is especially pertinent here in the northeastern part of the state, where counties already face hospital bed shortages. The Tar Heel State has the second-largest rural population in the country.

Small molecule development is also a job creator. A recent analysis found that if the small molecule penalty isn’t amended, tens of thousands of North Carolina jobs and $12 billion in state economic output are at risk.

Penalizing small molecule research could blunt the impact of recent investment in our state. In 2022, Eli Lilly announced a $1 billion investment to build a manufacturing facility in Concord. Last year, Raleigh-based Pathalys Pharma announced a $150 million partnership with multiple investment firms.

Rep. Davis’ legislation would protect patient access and research in North Carolina by giving small molecule drugs and biologics each 13 years of ineligibility from Medicare price setting. That way, drug candidates receive funding based on their medical potential — not something as arbitrary as their molecular structure. 

Congressman Davis is forging common-sense policy that reflects the needs of his constituents. Patients in the 1st Congressional District will be better off thanks to his efforts.