Section 1498 May Be a Potential Government Remedy for Approved, Unlaunched Etanercept Biosimilars

A method for government intervention in long-simmering patent disputes on biosimilar medications seems have been hiding in plain sight. And it can be instituted immediately. This is according to a new white paper from New York University School of Law, which highlights a piece of existing legislation that has been on the books for decades but is rarely discussed.

For several years, the biosimilar industry and government has sought ways to utilize the tools at its disposal to deal with patent evergreening and patent thickets contrived by the makers of reference biologics. The Biologics Price Competition and Innovation Act’s (BPCIA) patent dance was insufficient to address the more than 75 patents on individual biologics typically filed by their manufacturers over the course of time.

The Federal Trade Commission (FTC) seemed to be the governmental authority best positioned to tackle anticompetitive patents. However, hope has faded in this respect, with the undercutting of a 2019 Senate bill that would have pushed the FTC to do just that. In a private E-mail discussion with a highly placed lawyer with the FTC, BR&R was told that the agency did not have the authority to invalidate patents it considered anticompetitive.

Section 1498 and Pharmaceuticals

Part of the Patent and Trademark Amendments Act of 1980, 28 U.S.C. §1498 allows the federal government to use any technology assigned a US patent with immunity from patent claims. This means that a technology or product can be used by the US government without permission by offering the holder of the patent “reasonable and entire compensation,” which in the past has been no more than 10% of sales.

Kevin Nelson, JD

The question over use of Section 1498 was raised in 2016 over the production of hepatitis C virus and more recently regarding methods of increasing COVID-19 vaccine production. However, the authors of the white paper, §1498: A Guide to Government Patent Use: A Path to Licensing and Distributing Generic Drugs, also focused on its application to the biosimilar industry. The Technology Law & Policy Clinic at NYU evaluated different scenarios that might occur, while only one actually would realistically apply: An FDA-approved biosimilar is prevented from being prescribed because of patent issues. This would directly address the situation with Humira® and Enbrel® and their biosimilar competition.

In a 2019 interview with Kevin Nelson, Esq., Partner with Schiff Hardin LLP, Chicago, and our expert on intellectual property issues, we discussed FTC’s past actions in the realm of pharmaceutical patents. We asked Mr. Nelson about the use of Section 1498 as a potential remedy for these long-delayed biosimilars, the exclusivity periods for which have expired years ago. He replied, “Section 1498 operates sort of like eminent domain, but with patent and copyright rights. The government (or an entity at its designation) can make or use something that is protected by patent or copyright without the owner’s consent, but has to pay the owner reasonable compensation.”

To date, the question of negotiating reasonable compensation with patent holder has not yet been tested in the pharmaceutical context. The threat of implementing Section 1498 in the pharmaceutical industry was made by Health and Human Services Secretary Tommy Thompson in 2001. The US sought urgently to create a national stockpile of the antibiotic ciprofloxacin (Cipro®), which was owned by the pharmaceutical maker Bayer, to address the potential menace of anthrax. Secretary Thompson made it known that the government was prepared to utilize Section 1498 to allow generic manufacturers to produce massive quantities of ciprofloxacin. Reacting to the threat, Bayer agreed to reduce its price substantially and fulfill the government’s demand.

“From a technical standpoint,” said Mr. Nelson, “Section 1498 appears to allow the government to assign a manufacturer to produce an FDA-approved biosimilar product, and then the issue would be what would constitute reasonable compensation to the brand.” He continued, “Negotiations could take place before or after launch of the product. I would expect the government would try to work out something beforehand. But none of this has ever been tested. I cannot see that process as a possibility for biosimilars that have not yet been approved as there would be safety/efficacy concerns.”

Importantly, by invoking Section 1498, government patent use would be limited to use in federal healthcare populations (e.g., Medicare, Medicaid, Department of Defense, Veterans Affairs). In other words, private health plans and their members would not benefit from this move. Granted, once large quantities of a drug has been produced beyond the factories of the reference manufacturer, it might be hard to “put the genie back in the bottle.” In any case, the reference manufacturer would have to be compensated, at least through the expiration of any remaining, significant patent.  

Denosumab Biosimilar Competitors Gathering Data for February 2025 Launch

The osteoporosis drug market has evolved markedly since the introduction of the bisphosphonates in 1995. Developed to help prevent bone loss and the complications of bone fracture, and to increase bone mass overall, the market grew to include the selective estrogen receptor modulators in the 2000s, and then biologics in 2010.

Amgen’s denosumab (Prolia®), a RANKL monoclonal antibody, is indicated for the treatment of osteoporosis in postmenopausal women. At Amgen’s November 2020 investor conference, the company stated that its net US sales of Prolia reached $478 million for the third quarter of 2020 (or an annualized figure of about $1.9 billion). Global third-quarter sales were $701 million, which was an increase of 11% from the third quarter of 2019. Sales of Prolia are expected to increase significantly until 2025, when biosimilar competition may arrive in the US.

Xgeva® is the same compound as Prolia, but Amgen branded it separately for its different dosage schedules and indications. Xgeva is specifically indicated for (1) the prevention of skeletal-related events in patients with multiple myeloma and in patients with bone metastases from solid tumors and (2) the treatment of adults and skeletally mature adolescents with giant cell tumor of bone that is unresectable or where surgical resection is likely to result in severe morbidity. Amgen cited third-quarter net sales of Xgeva separately, with a total of $363 million, or annualized sales of more than $1.4 billion.

It is an open question as to whether a biosimilar manufacturer will seek the indications of both Prolia and Xgeva; the principal patents for both products expire in 2022 in the EU, and in 2025 in the US. According to Drug Patent Watch, Amgen holds more than 100 patents on denosumab; some of these have already expired.

The Likely Denosumab Biosimilar Competition: The Outlook in 2021

A couple of biosimilar makers who are active in the US market and prospective foreign manufacturers have embarked on denosumab development programs. The furthest along seems to be Samsung Bioepis and its partner Biogen.

Samsung Bioepis/Biogen. This prolific South Korean biosimilar maker announced December 14, 2020 that its phase 3 trial for SB16 had begun recruitment. The study is a double-blind, randomized design that will enroll 432 women with postmenopausal osteoporosis, and will compare efficacy, safety, and other outcomes of SB16 with US-licensed Prolia. The study aims to be completed in full by March 2023 (primary completion date September 2022).

Of interest, Samsung Bioepis started their phase 3 trial soon after beginning its phase 1 investigation (which began in October 2020 and is scheduled for completion in August 2021). The latter will test the agents pharmacokinetics and pharmacodynamics in healthy volunteers. Therefore, one may wonder if Samsung Bioepis is taking a considerable risk in initiating the more expensive, late-stage trial. On the other hand, Samsung may simply be extremely confident of its preclinical physiochemical analysis results and wants to gear up for 2022 EU regulatory submission. Based on the phase 3 trial end date, and assuming a successful result, 351(k) filing with the Food and Drug Administration could occur as early as Q2 2023.

Celltrion. Celltrion also has a long history of biosimilar development, and in November 2020, it initiated a phase 1 pilot study of its agent CT-P41. The phase 1 test will comprise 30 healthy volunteers and conclude in April 2021.  

Other Potential US Competitors

Four companies from China and one from Taiwan have begun clinical trials of their denosumab biosimilars. It is unclear whether any of the companies listed below intend to seek US Food and Drug Administration approval. If they do, these manufacturers will likely need to acquire a partner for commercialization. Another company, Neuclone, which we profiled in 2020, is in the preclinical development for its denosumab biosimilar.

Qilu Pharmaceutical. A phase 1 study of this company’s denosumab biosimilar, QL1206, was completed in October 2020 with 144 healthy volunteers. A phase 3 trial was reported to have begun in November 2019 and been completed in July 2021 in 216 patients with postmenopausal osteoporosis.

Another interesting aspect of Qilu Pharmaceutical’s efforts is that it reported a phase 3 trial testing QL1206 against Xgeva’s indications. This double-blind study of 700 patients with bone metastases from solid tumors is due to complete in June 2022, with preliminary results available in March 2021.

Shanghai Biomabs Pharmaceutical Co, Ltd. Shanghai Biomabs Pharmaceutical began its phase 3 trial of CMAB807 this month. The study includes 278 Chinese participants, and is scheduled to be completed in June 2023. A phase 1 investigation of CMSB807 wrapped up in June 2020.

Kunming Pharmaceuticals, Inc. This company’s denosumab biosimilar, MV088, is in the midst of a phase 1 trial, the estimated completion date of which is October 18, 2021.

Shanghai Henlius Biotech. A phase 1 investigation of HLX14 appears to have just gotten underway, and the final completion date is listed as August 2021. In this very small trial (24 healthy volunteers), the pharmacokinetics and safety of the biosimilar will be compared with EU-licensed Prolia.

JHL Biotech. This Taiwan-based company announced a three-arm, phase 1 trial of JHL1266 in healthy Australian subjects in May 2020. This study is not listed on http://www.clinicaltrials.gov and thus could not be verified. No further information was available.