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Nevada Rheumatologists Take on Biologic and Biosimilar Substitution

Kelly Tyrrell  |  April 19, 2017

On March 22, 2017, Ewa Olech, MD, testified at a hearing before the Nevada State Assembly to voice support for A.B. 245, a bill governing biologic medications and biosimilar substitution in that state. She spoke on behalf of the Rheumatology Association of Nevada (RAN), as its president and founder.

The bill establishes guidelines regarding biosimilars and requires pharmacists to notify providers within three business days when a biosimilar is substituted for a prescribed biologic, unless prohibited by the prescriber.

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“We are in support of this bill and excited about the opportunity to use biosimilars in the near future,” says Dr. Olech, a practicing rheumatologist based in Las Vegas. “We are in support of having the law in Nevada because it’s important to make sure our patients are safe; … it’s crucial to have the pharmacy communicate that information with physicians.”

Personal Experience Stresses Importance
At the hearing, she helped legislators and others understand the law’s importance by describing her personal story: Her mother has rheumatoid arthritis and was once wheelchair bound because of the severity of her disease. Biologics have restored her mobility.

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“These drugs … are very potent and change the lives of our patients,” Dr. Olech says. “I think as long as biosimilars are interchangeable, they will be safe, but just in case my mother lost her response or had side effects, we would want to know what she was taking.”

Small Society, Big Plans
For now, this has been RAN’s primary advocacy issue, Dr. Olech says, but she expects that as it grows and matures, RAN will take on other issues of importance to Nevada rheumatologists. With the help of Illinois-based WJ Weiser and Associates Inc., Dr. Olech founded RAN in 2016. It hosted its first continuing medical education meeting in Las Vegas last March and drew physicians from California and Arizona.

“We are a small society, because we don’t have many rheumatologists in Nevada,” she says. Before RAN, “everyone was by themselves—most rheumatologists here are in solo private practice—and everyone was competing with each other instead of getting together. I thought it would be important to have a society.”

Despite a population of nearly 3 million people, Nevada has roughly only 30 rheumatologists and rheumatology physician extenders, most of whom are located in or near Las Vegas and Reno, Dr. Olech says. In the future, RAN may work to encourage more rheumatologists and specialists in general to practice in the state. Dr. Olech says Nevada currently lacks adequate fellowship opportunities to train specialists, and reimbursement rates in the state are much lower than those of its neighbors.

Upcoming Annual Meeting
This May, RAN will host its second annual meeting, again in Las Vegas, which will focus on continuing medical education and more, offering talks from national experts, including Cleveland Clinic’s Carol Langford, MD; Mark Genovese, MD, from Stanford University Medical Center; and Dan Wallace, MD, from the University of California, Los Angeles. It will also feature local speakers, including Mitchell Forman, MD, from Touro University, and Sandra Pagnussat, MD, from Southwest Medical, and include a session on the Medicare and CHIP Reauthorization Act of 2015 (MACRA). Registration is currently open, and more information can be found on RAN’s website. RAN will host its 2018 meeting next May in Lake Tahoe.


Kelly April Tyrrell writes about health, science and health policy. She lives in Madison, Wis.

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Filed under:Biologics/DMARDsLegislation & AdvocacyProfessional Topics Tagged with:Biologics & BiosimilarsRheumatology Association of Nevada (RAN)

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