Optum: 3 (more) drugs in the pipeline payers should be watching

While much of the energy in the drug pipeline has centered on orphan drugs, novel therapies in more crowded markets have also been marching toward approval, according to a new report from Optum.

Analysts at OptumRx released the pharmacy benefit manager's quarterly drug pipeline report, which highlights therapies in the pipeline insurers should be keeping an eye on. All three drugs mentioned in this quarter's report would enter hot markets should they be approved.

"Even in these competitive landscapes, we do see novel therapies approved," Arash Sadeghi, clinical pharmacist at OptumRx, told Fierce Healthcare.

The report includes three drugs: tezepelumab—which was approved in December under the brand Tezspire—cabotegravir and vadadustat.

RELATED: Optum: Why payers should be watching flurry of drug development activity around eczema

Tezspire enters a crowded market for severe asthma, which includes a number of drugs that are already quite popular. However, what makes this drug one to watch is that it was approved with a broad indication, a rarity in the space, Sadeghi said.

Alternative biologics in the market tend to secure approval for more narrow subsets of patients, such as those with allergic asthma, he said. However, despite the broad approval, there are limited data for how this drug stacks up directly against popular competitors like Dupixent, which could post a conundrum for insurers as they consider formulary placement.

"From a payer perspective, competition is always good," Sadeghi said. But, "we don't know how it compares against those drugs."

Cabotegravir, meanwhile, offers a potentially long-term option for people taking preexposure prophylaxis (PrEP) therapies for HIV. The drug is injectable and would be administered six times per year, while popular PrEP options on the market are daily pills.

Sadeghi said there are potential adherence pros and cons to this drug. Long-term treatments may be more convenient for some consumers compared to daily pills, but it must be administered by a provider, which could prove a barrier.

The report's final drug, vadadustat, would enter the kidney care market, one that has been quite busy across the industry over the past several years. The drug would offer a novel treatment for anemia associated with chronic kidney disease.

Sadeghi said this drug could also be one that poses a challenge to insurers, as other therapies in the market have established a standard of care in this space.

He added that while the drugs highlighted in the first quarter's report aren't orphan drugs, that trend isn't going away. More orphan drugs than non-orphan drugs have been approved by the Food and Drug Administration over the past several years, he said.

"My expectation is that will continue this year as well," Sadeghi said.