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The introduction of new generics and biosimilars is expected to help curb future spending by offering lower-cost alternatives to high-priced brand-name drugs.

For example, doxorubicin (DOX) has cardiac side effects that lead to irreversible dilated cardiomyopathy and congestive heart failure, and acetylcarnitine has been shown to prevent cardiac functional and structural damage caused by DOX-induced oxidative stress [289]

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Other RyR1 mutations cause myopathies, including central core disease (CCD), a form of progressive muscle weakness 14 , and many patients with CCD are also susceptible to MH