My name is Peyton Agard Miles and I am a young adult patient from Lynchburg, Virginia, living with multiple chronic and rare illnesses, including New Daily Persistent headache, which presents as a constant migraine.
Generation Patient was created and is led by young adults living with chronic and rare health conditions, such as lupus, arthritis, Crohn’s disease, and many more conditions. We are one of the few patient groups that has declined all private industry funding, including from brand drug companies, generic drug manufacturers, pharmacy benefit managers, and insurance companies, to retain the integrity of our policy priorities. Our community depends on medications that can cost tens or hundreds of thousands of dollars a year, and the patent system directly shapes whether those treatments are affordable to the millions of young adults across America who need them. I am a member of the Generation Patient community where I have been a 2024 Health Policy Scholar, 2025 Health Policy Lab Co-Chair, and am currently a peer support facilitator, working to support young adult patients across America.
Medication allows me to function, and I rely on being able to afford my medication to lead a meaningful life.
I am grateful for the opportunity to share how important the passage of the Eliminating Thickets to Increase Competition (ETHIC) Act would be for anyone who struggles with affording medication, but especially for young adult patients like me.
But affordability is not the only reason that I share my story today. It is also about the innovation that young adult patients like me need now and will need for our entire lives.
I am always incredibly eager to learn about new migraine treatments that have the potential to aid in symptom management. When I heard about Symbravo, a migraine medication approved in 2025 by the Food and Drug Administration (FDA), I became incredibly excited because I initially thought it was a new type of biomedical breakthrough that I could benefit from. Then I learned that Symbravo is a combination of two older drugs that have been on the market for more than a decade.
I personally have tried Meloxicam and Rizatriptan, which are the two primary components of Symbravo. As someone who has had a constant headache for the past four years, I have had a lot of different treatments to treat my migraine symptoms. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and triptans are commonly used in tandem to decrease or eliminate migraine symptoms. This is why it is puzzling to me how Axsome Therapeutics has been able to obtain more than 90 patents on Symbravo and assert 75 of them in court against a prospective generic manufacturer.
Seeing companies combine two older drugs and create large patent thickets around them gives me false hopes. Allowing drug companies to obtain duplicative patents on minor variations of known drugs drives incentives away from meaningful biomedical innovation and towards patent gamesmanship and litigation.
Young adult patients like me deserve a strong research and development system that encourages the type of meaningful biomedical breakthroughs that we desperately need. However, patent thickets serve an entirely different purpose. Patent thickets are about gaming the patent system to restrict generic and biosimilar competition and keeping drug prices high. For me and for many young adult patients across America, high drug prices undermine our ability to afford medication and lead a meaningful life.
The ETHIC Act is especially important for young adult patients. Navigating the uncertainty of insurance changes, financial instability, and health can create stress around affording medications. Young adult patients rely on affordable medications rooted in novel biomedical innovation to navigate this period of life. We also need access to truly novel therapeutics.
Patent thickets and high drug prices are not an unavoidable feature of our research and development system. They are the results of policy choices. The ETHIC Act would help curb patent thickets and drive incentives towards meaningful biomedical innovation. I call on Congress to enact the ETHIC Act.
Thank you.