Feb. 12, 2016: This story has been clarified.
Debbie Mann can barely afford the drug that banishes the stabbing pain rheumatoid arthritis causes in her joints. Although Medicare helps cut the $40,000-per-year list price for prescription Enbrel, she said she still paid more than $3,800 last year.
She thought about going off of it but doesn’t want to return to what she was like before — sleeping most of the day.
“You just want to sit in a chair and not be part of life,” said the 56-year-old retired nurse from Goshen, Indiana.
Mann would love a cheaper alternative, but Enbrel, made by Amgen Inc., is a biologic medicine, among the most expensive and difficult type to make because they are derived from sources such as live cells rather than chemicals in a lab. Less costly drugs that function in much the same way — called “biosimilars” — are expected to hit American markets in the next few years.
Yet if an Enbrel biosimilar becomes available in the U.S., as it already is in Europe, Mann will face more hurdles to obtain it in Indiana. That's thanks to the quick work done by the pharmaceutical companies that swooped in to lobby the legislature there. Drug lobbyists have helped push through bills limiting pharmacists’ ability to dole out biosimilars in more than a third of the states since 2013.
The biosimilar campaign is just one example of the wide-reaching power of state-level lobbying — a power that’s grown as Congress stalemates and federal lobbying declines.
More companies and interest groups are pushing their agendas in the states, according to a Center for Public Integrity analysis of five years of lobbyist registrations from all 50 states gathered by the National Institute on Money in State Politics. Since 2010, the number of entities with either in-house lobbyists or part-time hired guns working in the states has grown more than 10 percent.
That means, on average, every state lawmaker was outnumbered by six companies, trade associations, unions or other groups angling for their attention from 2010 to 2014.
And more special interests are finding it worthwhile to scatter lobbyists in dozens of states — or even all 50 — to make sure increasingly important state legislatures don’t leave them out of the picture.