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Original Article

Mexico at the vanguard: A new era in


medicines of biotechnological origin
Received (in revised form): 30th September 2009

Ernesto Saro Boardman


is Senator of the Republic for the State of Coahuila, Mexico where he is the Chairman of the Health Committee, a member of
the Municipal Development Committee, a member of the Committee on Urban Development and Planning and a member of the
Committee on Foreign Relations Non-Governmental Organizations. He graduated from ITESM (Tecnológico de Monterrey) as a
Chemical Engineering Administrator in 1972. He was a Federal Representative from 2000 to 2002 and was Municipal President of
Ramos Arizpe, Coahuila between 1997–1999 and 2003–2005.

ABSTRACT This paper seeks to highlight Mexico’s interest in being at the forefront in
Latin America and at the same time at the international level with the major players in the
field of biotech medicines. Mexico has just adopted an amendment to the General Health
Law that would allow the regulatory approval of biocomparable drugs (some countries refer
to these as biosimilar or biogeneric drugs). Such reform consists in the incorporation of
Article 222 Bis, which describes what is regarded as a biotechnology medicine, distinguishes
between innovative and biocomparable medicines, sets the requirements to obtain sanitary
registration and for marketing, describes the regulations regarding the pharmacovigilance
of these products, as well as the studies that are necessary to demonstrate the quality, safety
and efficacy of a biocomparable medicine which is supported with reference to an innovative
medicine, and taking into consideration the Opinion of the Committee of New Molecules
through the Subcommittee for the Evaluation of Biotechnology Products. This amendment
also includes the assignment of the same International Non-propriety Name (INN) as for
the reference product. The goal of the reform is to encourage competitiveness in Mexico by
regulating the manufacture and approval of these medicines making them more affordable
and hence fostering their access to the population.
Journal of Generic Medicines (2010) 7, 4–7. doi:10.1057/jgm.2009.38; published online 10 November 2009

Keywords: innovative biotechnological medicines; biocomparable medicines; amendment to Article


222 Bis of the general health law; access to biotech medicines at affordable prices

WHAT ARE highly dependent on their production and


BIOTECHNOLOGICAL purification processes, so that minimal
MEDICINES? changes in their process can cause variations
Biotechnological medicines contain proteins in the generation of immunological reactions.
with very complex and unstable structures, The particular characteristics of medicines
of biotechnological origin have made it
necessary to have a special regime within
Correspondence: Ernesto Saro Boardman
Paseo de la Reforma 136, Torre Azul, Floor 15, Oficina A Col.
health regulations to specify their general
Juárez Del. Cuauhtémoc, CP 06600, Mexico, DF characteristics, as well as the clinical tests that
E-mail: ernesto.saro@pan.senado.gob.mx they will be subject to for their authorization.

© 2010 Macmillan Publishers Ltd. 1741-1343 Journal of Generic Medicines Vol. 7, 1, 4–7
www.palgrave-journals.com/jgm/
A new era in medicines of biotechnological origin

Owing to the novelty of these technologies various forums to address scientific, medical,
and products, their incorporation into the clinical and regulatory aspects, and to assess
pharmaceutical market has been conducted the problems associated with the absence of
through a precautionary principle, which specific provisions to authorize this type of
consists on a case-by-case assessment by medicines in our health legislation.
health authorities, since until recent years Mexican health regulations currently
there were only innovative medicines. This allow only the approval of two types of
has led to new criteria, rules and regulatory drugs: (a) innovative drugs, which are those
procedures applicable to this type of that comply with clinical trials; and (b) the
medicines, both at the level of the European so-called ‘interchangeable generics’, which
Medicines Agency and the Food and demonstrate their safety and efficacy in terms
Drug Administration of the United States. of their interchangeability with respect to
Mexico has begun to lay the foundations to innovative products through bioequivalence
progressively develop a regulation that is studies.
harmonized with the regulatory framework In the case of biotechnological medicines,
of the communities of countries with greater it is not possible to demonstrate in all cases
development in this area. that a non-innovative medicine is identical to
the medicine of reference, as bioequivalence
NEGOTIATION AND studies are not applicable to this type of
REGULATION IN MEXICO medicines. Therefore, those non-innovative
Biotechnological medicines appeared almost biotechnological medicines have to submit
three decades ago and have revolutionized the abbreviated clinical and pre-clinical tests,
methods for treating serious diseases like which does not mean that these tests are less
cancer. Mexico, in particular, has welcomed strict. As it is not possible to predict the
the pharmaceutical industry for this purpose. immunological response derived from these
Although it is certain that these drugs are medicines, these tests have to be requested
highly effective for fighting against deadly based on the individual characteristics of each
diseases, it is also true that they are the most product to verify their safety and efficacy.
expensive drugs in the market, which makes Finally, after many meetings and
them inaccessible to the population, to such a negotiations to incorporate into the Mexican
degree that the treatment for one person for legal framework an adequate regulation for
1 year can cost up to US$300.000.1 these novel medicines, was adopted an
However, patents granted to the amendment to Article 222 Bis to the General
manufacturers of biotechnology medicines Health Law. This amendment was approved
throughout this time have already begun to in the Senate with 92 votes in favor, 3
expire, so competition of biocomparable abstentions and 0 votes against, and in the
drugs should start providing consumers Chamber of Deputies with 331 votes in
greater access to these important but favor. Among other things the amendment
expensive drugs. Before 2009, such incorporates definitions that distinguish
approvals were not regulated in the between innovative biotechnological and
Mexican legal system extending the facto biocomparable medicines (those
the patents of such products. biotechnological medicines approved through
Given the technical complexity involved in an abbreviated approval process).
defining a legal process for the approval of This new reform establishes that the Mexican
biocomparable medicines, scientists, academics, Federal Commission for the Protection
physicians, health authorities, legislators, Against Sanitary Risks (COFEPRIS) shall
representatives of national and international determine the requirements that are necessary
industries were convened to participate in for these drugs to obtain their Sanitary

© 2010 Macmillan Publishers Ltd. 1741-1343 Journal of Generic Medicines Vol. 7, 1, 4–7 5
Saro Boardman

Registration and be marketed, always taking • In order to receive the sanitary registration
into consideration the opinion provided by for biotechnology drugs, the applicant must
the Committee of New Molecules through comply with the requirements and tests
the Subcommittee for the Evaluation of that demonstrate the quality, safety and
Biotechnology Products. Such subcommittee efficacy of the product, in accordance with
is a body of consultation and support – the provisions of this Law, the regulations
integrated by at least five representatives of and other applicable legal provisions, and
the National Institute of Genomic Medicine, once the biotechnology drug is marketed,
the National Autonomous University of it shall be necessary to subject it to
Mexico and the National Polytechnic pharmacovigilance in accordance with the
Institute, in addition to the representation corresponding norms.
of the health authorities and the General • The applicant of a sanitary registration for
Health Council. It will be responsible for biocomparable drugs that supports the
recommending to the Health Secretariat application on a reference biotechnology
(COFEPRIS) the clinical and pre-clinical drug must submit the clinical studies and,
trials necessary and applicable to each when appropriate in vitro studies that are
biocomparable medicine, with the aim of necessary to demonstrate the safety, efficacy
ensuring on a case-by-case basis, that is to say and quality of the product.
individually and in optimal conditions, their • In the case that the provisions regarding the
safety and efficacy, their safe consumption studies that are necessary and their
and hence their acceptance by physicians and characteristics that are mentioned in this
patients at a lower cost. article have not been issued, these shall be
In addition, one important aspect that is determined on a product by product basis
included in this reform is the one related to taking into consideration the opinion of the
pharmacovigilance, which requires including Committee of New Molecules which, for
in the labels the name of the manufacturer of the purposes of this article, shall have a
the biotechnological medicine and its origin, Subcommittee for the Evaluation of
the place of packaging and the importer; they Biotechnology Products that shall be made
must also assign the same INN as to the up of specialists and scientists on
corresponding reference medicine. pharmaceutical biotechnology.
The legislative reform to the General • Biotechnology drugs shall include in their
Health Law is as follows: labels the name of the manufacturer of
the biotech drug and its origin, the place it
• Article 222 Bis – for the purposes of this was packed/bottled and if applicable the
Law, a biotechnology drug shall be any importer, having to assign to it the same
substance that has been produced by INN as to the corresponding reference
molecular biotechnology, that has a drug, which shall not imply a separation in
therapeutic, preventive or rehabilitation the categories of the basic formulary and
effect, that is presented in pharmaceutical catalogs of medicines of the health
form, that is identified as such by its institutions assigned to this purpose.
pharmacological activity and its physical,
chemical and biological properties.
Innovative biotechnology drugs may be the OUTLOOK FOR ACCESS
reference drugs for non-innovative TO BIOTECHNOLOGICAL
biotechnology drugs, which shall be known MEDICINES
as biocomparable drugs. The form of With this reform, Mexico has become a
identification of these products shall be pioneer by incorporating the issue of
determined in the regulatory provisions. biotechnological medicines in its health

6 © 2010 Macmillan Publishers Ltd. 1741-1343 Journal of Generic Medicines Vol. 7, 1, 4–7
A new era in medicines of biotechnological origin

legislation, ensuring the safety and efficacy of legal pathway for the approval of biocomparable
both innovative and biocomparable medicines; medicines. In this way, Mexico is positioned
making their availability for institutions, to become the leading Latin American
physicians and patients both possible and pharmaceutical market in this area. Furthermore,
expedited; fostering the development of this effort reflects the concern of the Mexican
pharmaceutical biotechnology in Mexico; government to foster competition from
establishing clear rules for identifying the biocomparable medicines for the benefit of
products to provide greater certainty to the most disadvantaged. Competition among
physicians who prescribe and to patients who manufacturers, increases the supply of
consume biotechnological medicines; as well biotechnological medicines which should
as ensuring the implementation of the existing inevitably result in the reduction of their
norms on pharmacovigilance for medicines. prices, given that their development requires
Mexico has scientific, technical and less clinical and pre-clinical tests, and as a
manufacturing capabilities in the field of result, an easier access for the population.
biotechnology, particularly in pharmaceutical
biotechnology, so it was a priority for REFERENCE
Mexican legislators to provide the private 1. New York Times. (2008) When a drug costs
sector and the government with the necessary $300 000. Editorial – 23 March.

© 2010 Macmillan Publishers Ltd. 1741-1343 Journal of Generic Medicines Vol. 7, 1, 4–7 7
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