Optum Rx's latest look at the drug development pipeline highlights three drugs for rare and chronic conditions that payers and plan sponsors should have on their radar.
The report includes three pharmaceuticals: A new indication for the drug Tryngolza, oveporexton and brepocitinib. The former secured Food and Drug Administration approval on June 24, while the others are expected to be approved within the third quarter.
All three drugs carry hefty price tags and enter spaces where there is significant unmet need. For example, Tryngolza—the brand name for the drug olezarsen—is a treatment for severe hypertriglyceridemia, and is the first novel therapy for the condition in several decades.
The drug, taken subcutaneously each month, has shown promising efficacy in lowering triglyceride levels as well as reducing the patient's risk of acute pancreatitis.
Sara Guidry, senior director of pipeline and drug surveillance at Optum Rx, said in an interview with Fierce Healthcare that Tryngolza is "the perfect example of how a new indication can dramatically change the impact of an existing therapy."
The drug was originally approved for familial chylomicronemia syndrome, an extremely rare condition. The June approval's addition of a new indication, however, opens up potential utilization of the drug to millions of people.
She added that Tryngolza also fits into an emerging area of interest in the pipeline that payers should have on their radar: therapies for lipid management. GLP-1s have dominated the conversation in the cardiometabolic space of late, but Guidry said she expects to see more activity around lipid management therapies coming soon.
"So we've been talking about GLP-1s for so long, but I kind of feel like GLP-1s aren't going away, but what's going to be maybe the next big category is cardiovascular and lipid management," she said.
Oveporexton, meanwhile, offers a novel treatment for patients with narcolepsy, and a decision is expected from the FDA around Aug. 10. Guidry said the drug would offer another option for individuals who have seen limited results from other therapies.
Many narcoleptic patients take multiple medications to manage their symptoms, according to the report, and data on taking oveporexton alongside other narcolepsy drugs is lacking. The drug, if approved, would also enter a crowded market with generic options.
The final drug in the report, brepocitinib, is currently under review for the treatment of dermatomyositis. A decision is expected on Sept. 3, according to the report.
Similar to oveporexton, brepocitinib offers a novel therapy option for a condition with notable unmet need.
Guidry said that these drugs all follow the trend of high-cost therapies coming to market. Tryngolza is the lowest cost of the three, with a projected wholesale acquisition cost of $40,000 per year.
Oveporexton is projected to carry a WAC of $162,000 annually, while for brepocitinib, the wholesale acquisition cost could range from $86,000 per year to $360,000 per year, based on existing medications on the market.
"High-cost Medications, medications that haven't had as specific of treatment options available, would be the trends that I would kind of fold these into," Guidry said.