NCRx Pipeline Report 5.1.19

Erica Guetzlaff  •   May 1, 2019

National CooperativeRx constantly monitors the pharmaceutical pipeline for the latest drugs to share with our members. As treatment options change, it’s important to know which drugs bring the highest value, and that’s where we come in with our new quarterly NCRx Pipeline Reports. Gain access to insight on market changes and how they may impact plan performance directly from our clinical team of experts.

NKTR-181:  The first full mu-opioid agonist designed to provide chronic low-back pain relief without euphoria levels that have been known to lead to opioid addiction and abuse. This should be considered if patients have already tried over-the-counter options such as ibuprofen or naproxen with no success. Studies on NKTR-181 found a significant reduction in pain over a placebo, but it has not yet been studied for effectiveness compared to oxycodone; a 52-week safety and tolerability study is currently underway, and the drug has been fast-tracked for US Food and Drug Administration (FDA) approval.1

Anticipated Launch: Third or fourth quarter of 2019.

Price: Currently unknown.

Impact: Low to moderate. 26 million people in the US suffer from chronic low-back pain. It is unclear how many have failed first-line treatment options. One study suggests 61 percent of patients with low back pain were prescribed opioids and 19 percent of them became long-term opioid users.7

 

Skyrizi: Specialty  An anti-IL-23 antibody taken every 12 weeks meant to treat multiple inflammatory conditions such as Crohn’s disease, psoriasis and psoriatic arthritis. FDA’s first priority is to review its effectiveness for psoriasis.  The drug is expected to rattle the market and be more effective than its competitors, which include Stelara and Tremfya. Skyrizi has already demonstrated superiority over Stelara.2

Anticipated Launch: FDA approved Skyrizi on April 24, 2019 and expected launch is early May.

Price: $88,500 for the first year of treatment and $59,000 every following year. This is lower than Stelara, which is priced at $132,000 for the first year of treatment and $88,000 every following year.

Impact: Not likely to add to existing pool of patients being treated with biologics but will replace existing therapies for many. 7.5 million people in the US have psoriasis and 25-30 percent of them also have psoriatic arthritis. 17 percent of these patients have a moderate to severe version of the disease, necessitating use of disease-modifying therapies.3,8

 

Albuterol: Generic:  A long-anticipated generic rescue inhaler for asthma is finally available for Ventolin and Proair HFA that comes with a reduced price. Generic Albuterol inhalers were available until 2009, when a government mandate forced the removal of chlorofluorocarbon propellants due to ozone layer risks involved. Drugmakers then produced new albuterol inhalers with safer propellants and capitalized on the consequent patents. GlaxoSmithKline is manufacturing an authorized generic inhaler, which is an exact clone of Ventolin HFA, and Prasco is the distributor.  Teva is the manufacturer for Proair’s generic.

Anticipated Launch: Available now.

Price: Around $36.00, compared to the brand-name products which are between $50.00 and $60.00.

Impact: Over 26 million Americans suffer from asthma.4

 

Lyrica: Generic:  Lyrica was initially approved as an anti-seizure drug but was eventually approved to treat neuropathic pain and fibromyalgia. Lyrica is used extensively as a non-opioid option for pain, so current utilization is considerable: 4,889 prescriptions were filled by National CooperativeRx participants at a cost of over $3 million in the last year. On average, generics provide at least a 25 percent savings over the brand-name product, and savings up to 80 percent are seen when multiple generic manufacturers enter the market.

Anticipated Launch: Middle to late summer.

Price: Currently unknown.

Impact: Fibromyalgia affects an estimated 10 million people in the US.5

 

NuvaRing: Generic:  Came off patent in April 2018, but no generics expected to launch until 2019.

Restasis: Generic:  Possible it may launch in 2019.

 

  1. https://www.nektar.com/pipeline/rd-pipeline/nktr-181
  2. Gordon KB, Strober B, Lebwohl M, Augustin M, Blauvelt A, Poulin Y.  Efficacy and safety of risankizumab in moderate-to-severe plaque psoriasis (UltIMMa-1 and UltIMMa-2): results from two double-blind, randomised, placebo-controlled and ustekinumab-controlled phase 3 trials. Lancet. 2018; 392(10148): 650-61.
  3. American Academy of Dermatology
  4. Asthma and Allergy Foundation of America
  5. http://www.fmaware.org/about-fibromyalgia/prevalence/
  6. https://www.medicalnewstoday.com/articles/265504.php
  7. Phillips JK, Ford MA, Bonnie RJ. Pain management and the opioid epidemic: balancing societal and individual benefits and risks of prescription opioid use. National Academies Press 2017.
  8. Hyde K, Cardwell L, Stotts R, Feldman S. Psoriasis Treatment Cost Comparison:  Biologics Versus Home Phototherapy. Am J Pharm Benefits 2018; 10(1): 18-21