No Generic for Enbrel, Only Biosimilars
Enbrel is a "biologic" medication derived from living sources, unlike traditional chemical-based drugs. This complexity means it cannot be replicated as an identical generic drug. Instead, a similar product is called a "biosimilar". Biosimilars are highly similar to the original biologic and have no meaningful clinical differences in safety, purity, and potency.
The Generic Name: Etanercept
The active ingredient in Enbrel is etanercept, which is its generic name. However, a pharmacist cannot automatically substitute another etanercept product for Enbrel unless it is specifically prescribed or is an FDA-designated "interchangeable" biosimilar.
FDA-Approved Biosimilars: Erelzi and Eticovo
Two biosimilars for Enbrel have been approved by the FDA but are not yet available in the U.S. market:
- Erelzi (etanercept-szzs): Approved in August 2016 for conditions like rheumatoid arthritis and plaque psoriasis.
- Eticovo (etanercept-ykro): Approved in April 2019 for the same indications as Erelzi.
The FDA requires a four-letter suffix for biosimilar names to distinguish them. Neither Erelzi nor Eticovo has the interchangeable designation.
Why Are Enbrel Biosimilars Unavailable?
Market availability of Enbrel biosimilars has been delayed by patent litigation. The manufacturer's patents are currently protected, preventing competitors from launching their approved biosimilars until at least 2029.
Understanding Biologics and Generic Drugs
The differences between generic drugs and biosimilars are crucial for patients. The table below outlines these distinctions:
Feature | Generic Drugs | Biosimilars |
---|---|---|
Reference Product | Small-molecule chemical drug | Complex biologic drug (like Enbrel) |
Composition | Identical chemical structure | "Highly similar" but not identical |
Manufacturing | Standardized chemical synthesis | Complex process using living cells |
FDA Approval Process | Abbreviated New Drug Application (ANDA) | Abbreviated Biologics License Application (BLA) |
Automatic Substitution | Often permissible by pharmacists | Only permissible with an "interchangeable" FDA designation |
Market Availability | Enters when patents expire | Delayed by patents and regulatory hurdles |
How Does Etanercept (Enbrel) Work?
Etanercept is a TNF blocker that reduces inflammation in autoimmune conditions such as rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, ankylosing spondylitis, and polyarticular juvenile idiopathic arthritis. It works by blocking TNF, a protein that promotes inflammation.
Conclusion
While there is no generic version of Enbrel, the active ingredient is etanercept, and two biosimilars are FDA-approved though not yet available in the U.S. due to legal challenges. Patients seeking to manage costs should discuss alternative treatments and financial assistance programs with their healthcare provider. The future availability of biosimilars is expected to increase competition and potentially lower prices.