Lawmakers grant final approval to Right to Try bill

Alabama lawmakers granted final passage Thursday to a bill that would allow physicians to prescribe terminally ill patients promising, but unapproved medical treatments.

House Bill 463, known as the Right to Try Act, passed the House of Representatives by a vote of 97-0. The bill says that doctors caring for people with terminal illnesses can prescribe medications that the Food and Drug Administration has deemed promising, but not yet ready for mass consumption. Thursday’s vote makes Alabama one of at least 12 states that have passed right to try legislation this year.

House Bill 463 and Senate Bill 357  were inspired by 9-year old Gabe Griffin of Shelby County. At age 3, Gabe was diagnosed with Duchenne, one of nine types of Muscular Dystrophy. The disease causes generalized weakness and muscle wasting that increases over time and with muscle activity. Not only is the disease incurable, according to the Muscular Dystrophy Association, boys with Duchenne typically did not survive beyond their teens.

Two Alabama lawmakers, Sen. Cam Ward and House health committee chair Rep. April Weaver, agreed to sponsor legislation that would help Gabe and other terminal patients work with their doctors to access medication in the earliest stages of FDA approval. Ward’s bill has already passed the Senate.

When he introduced the Senate version of the bill, Ward said in a prepared statement: “Terminal patients should have a right to try, and as a father and an elected official I believe we should do everything we can to help remove unnecessary bureaucratic red tape from the process so that doctors and terminally ill patients can determine the best course of action in each individual situation.”

The initial barriers, according to Gabe’s father, Scott Griffin, came from the Food and Drug Administration when the family tried to gain accelerated access to experimental treatments for Gabe. In a recent interview with Alabama Today, Griffin recalled one of his conversations  with FDA administrators.

“The first argument was that the patient population of one of the studies was too small: just 12 kids. Then they said the results in the study may have been just the natural difference in the disease … They said, ‘Well we have the best drug approval process in the world’ and ‘You have to understand that we have to worry about long-term side effects.’ And I said to them, ‘Explain to me what a long-term side effect is to a child who is going to die.’”

The Food and Drug Administration has acknowledged that the accelerated approval process can be daunting for patients and medical providers. In a statement on the FDA website, assistant commissioner Peter Lurie M.D. said that although approvals can happen within days – or even hours – of a finished application, the process has given them cause for concern. “It called for 26 separate types of information and seven attachments,” Lurie wrote. “In fact, it was originally designed for manufacturers seeking to begin human testing, not for physicians seeking use by single patients.”

According to Lurie, those concerns are what drove the FDA to announce a new streamlined process to allow patients access to experimental drugs. The FDA website says that the new forms “will be used for requesting the medications, and is designed to greatly simplify and accelerate the process by which a physician can request that FDA permit the use of an experimental — so-called ‘investigational’ — drug or biological product while it’s still being tested to establish its safety and effectiveness.”

However, the forms are still going through the administrative rulemaking process and not yet available to the public. The official website gave no indication on when the final guidelines would be available for patients or providers.

For the Griffins, the FDA roadblocks helped fuel their decision to lobby Alabama lawmakers. “We believe those drugs could save him, but we can’t get them because they’re not FDA approved,” Griffin said. “And after years of petitioning the FDA, we decided to take our fight to the state level.”

The Griffins aren’t alone. According to the National Conference of State Legislatures, a growing number of states are considering legislation to work around those barriers and help patients gain access to experimental drugs.

Thursday’s vote makes Alabama one of 12 states that have passed right to try bills so far this year. The NCSL reports that lawmakers in at least 36 states proposed “right to try” measures in 2015.