April 2020
MRx PIPELINE A VIEW INTO UPCOMING SPECIALTY & TRADITIONAL DRUGS
TABLE OF CONTENTS Introduction Pipeline Deep Dive
EDITORIAL STAFF Maryam Tabatabai, PharmD Editor in Chief Senior Director, Drug Information Carole Kerzic, RPh Executive Editor Drug Information Pharmacist
Keep on Your Radar
Consultant Panel
Pipeline Drug List
Lara Frick, PharmD, BCPS, BCPP Drug Information Pharmacist
Becky Borgert, PharmD, BCOP Director, Clinical Oncology Product Development
Robert Greer, RPh, BCOP Senior Director, Clinical Strategy and Programs
Glossary
Sam Leo, PharmD Director, Clinical Strategy and Innovation, Specialty Troy Phelps Senior Director, COAR - Analytics
Nothing herein is or shall be construed as a promise or representation regarding past or future events and Magellan Rx Management expressly disclaims any and all liability relating to the use of or reliance on the information contained in this presentation. The information contained in this publication is intended for educational purposes only and should not be considered clinical, financial, or legal advice. By receipt of this publication, each recipient agrees that the information contained herein will be kept confidential and that the information will not be photocopied, reproduced, distributed to, or disclosed to others at any time without the prior written consent of Magellan Rx Management.
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INTRODUCTION Welcome to the MRx Pipeline. In its fourth year of publication, this quarterly report offers clinical insights and competitive intelligence on anticipated drugs in development. Our universal forecast addresses trends applicable across market segments. Traditional and specialty drugs, agents under the pharmacy and medical benefits, new molecular entities, pertinent new and expanded indications for existing medications, and biosimilars are profiled in the report. Clinical analyses, financial outlook, and pre-regulatory status are considered as part of the evaluation process. The products housed in the MRx Pipeline have been researched in detail and developed in collaboration and in consultation with our internal team of clinical and analytics experts. Emerging therapeutics continue to grow and influence the clinical and financial landscape. Therefore, Magellan Rx Management has developed a systematic approach to determine the products with significant clinical impact. For the in-depth clinical evaluations, the products’ potential to meet an underserved need in the market by becoming the new standard of care and the ability to replace existing therapies were investigated. The extent to which the pipeline drugs could shift market share on a formulary and their impact on disease prevalence were also important considerations. In order to assist payers with assessing the potential impact of these pipeline drugs, where available, a financial forecast has been included for select products. Primarily complemented by data from EvaluateTM, this pipeline report looks ahead at the 5-year projected annual US sales through the year 2024. These figures are not specific to a particular commercial or government line of business; rather, they look at forecasted total US sales. Depending on a variety of factors, such as the therapeutic category, eventual FDA-approved indications, population within the plan, and other indices, the financial impact could vary by different lines of business. In the past few years, game changers, such as chimeric antigen receptor (CAR) T therapies and antibody drug conjugates (ADCs), deliver drug therapy directly to the site of action in the body. In 2020, first-time drugs for peanut allergies were approved by the FDA. The agency also continues to approve select therapies under new programs. Examples include the real-time oncology review (RTOR) pilot, in which the FDA reviews clinical data prior to the formal submission of the drug application, leading to an approval well in advance of the FDA goal date; and Project Orbis, a framework for concurrent submission and review of oncology drugs among international regulatory counterparts. Moreover, in response to the COVID-19 pandemic, the FDA has established a special emergency program, the Coronavirus Treatment Acceleration Program (CTAP), as well as a public-private partnership (Accelerating COVID-19 Therapeutic Interventions and Vaccines [ACTIV]) with the National Institutes of Health (NIH) and other partners, to speed the development of treatments and vaccines for COVID-19. As we look ahead, a continued trend toward the approval of specialty medications, drugs for rare diseases, growth of biosimilars, new treatment modalities using gene therapy, and additional CAR T therapies are expected. Noteworthy pipeline trends to watch in 2020 include therapies for COVID-19, the first gene therapy for hemophilia A, and the first treatment for NASH. In the upcoming quarters, development of complex therapies, therapeutic options for rare hereditary diseases, oncology, immunology, neurology, cardiology, and investigational agents will be monitored on the MRx radar. Moreover, sprouting products for ophthalmology, hematology, and women’s health await on the horizon. The drug pipeline ecosphere will continue to evolve as it faces challenges and successes. Novel agents that apply innovation to show positive results without compromising patient safety and access offer true therapeutic advances and hold the promise to alter the treatment paradigm.
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PIPELINE DEEP DIVE Objective evidence-based methodology was used to identify the Deep Dive drugs in the upcoming quarters. This section features a clinical overview and explores the potential place in therapy for these agents. Moreover, it addresses their FDA approval timeline and 5-year financial forecast.
SPECIALTY
PRIORITY REVIEW
89%
BREAKTHROUGH THERAPY
44%
39% BIOSIMILAR
ORPHAN DRUG
44%
28%
pecialty drug names appear in ï‚« S magenta throughout the publication.
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ONCOLOGY
belantamab mafodotin IV GlaxoSmithKline PROPOSED INDICATIONS
Relapsed or refractory multiple myeloma (R/R MM) after prior therapy with an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 antibody
CLINICAL OVERVIEW
B cell maturation antigen (BCMA) is expressed by mature B lymphocytes. BMCA is overexpressed in multiple myeloma (MM). Belantamab mafodotin is an antibody drug conjugate (ADC) that contains a humanized antiBCMA monoclonal antibody linked to the cytotoxic agent auristatin F. ADCs are designed to deliver potent cytotoxic therapy directly to tumor cells using the selectivity of the monoclonal antibody. The phase 2, open-label DREAMM2 trial enrolled adults with R/R MM with disease progression after ≥ 3 lines of therapy who were refractory to an immunomodulatory drug and proteasome inhibitor and refractory and/ or intolerant to an anti-CD38 antibody. Patients had undergone or were ineligible for autologous SCT. Among 97 patients who received belantamab mafodotin 2.5 mg/kg, the ORR was 31%, including 18.6% of patients who achieved a very good partial response or better. At 6 months, overall survival (OS) was not reached among those who achieved a response. Although DREAMM2 included a 3.4 mg/kg dose, the 2.5 mg/kg dose demonstrated a similar efficacy and more favorable safety profile and was the only dose submitted to the FDA. The most common serious (grade 3 or 4) adverse events reported were keratopathy (e.g., corneal epithelium changes, 27%), thrombocytopenia (20%), and anemia (20%). One death due to sepsis and 1 death due to hemophagocytic lymphohistiocytosis occurred in the 2.5 mg/kg and 3.4 mg/kg groups, respectively. Both were considered potentially related to the study drug.
PLACE IN THERAPY
Over 32,270 new cases of MM are predicted in the US in 2020, and approximately 12,830 deaths could occur due to the condition. Median age at diagnosis is 69 years. Newly diagnosed MM responds to initial cytotoxic chemotherapy; however, eventual treatment-resistant relapse usually occurs. During the past decade, the introduction of more effective, less toxic treatments, including immunomodulatory drugs, proteasome inhibitors, monoclonal antibodies, histone deacetylase (HDAC) inhibitors, and a nuclear export inhibitor, has brought significant improvements in survival. Nonetheless, an unmet medical need still exists. If approved, belantamab mafodotin will be the first anti-BCMA treatment for heavily pretreated patients with R/R MM. The BCMA-targeting chimeric antigen receptor (CAR) T cell therapy idecabtagene vicleucel, by Bristol-Myers Squibb and Bluebird Bio, has also been submitted to the FDA for heavily pretreated R/R MM. The ORR for idecabtagene vicleucel was 73.4% across all doses studied. The FDA decision for idecabtagene vicleucel is expected in the first quarter of 2021. Several other BCMA-directed therapies are on the horizon, including CAR T therapies by Janssen, Poseida, and Cartesian, and bispecific antibodies targeting BCMA and CD38 by Amgen and Regeneron (phase 2 development for all).
FDA APPROVAL TIMELINE August 14, 2020
Breakthrough Therapy
Orphan Drug
Priority Review
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$46
$148
$231
$318
$397
The forecast is a projection of total US sales per year.
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IMMUNOLOGY
filgotinib oral Gilead PROPOSED INDICATIONS Rheumatoid arthritis (RA)
CLINICAL OVERVIEW
Filgotinib is a selective Janus kinase 1 (JAK1) inhibitor. Safety and efficacy of filgotinib were evaluated in the phase 3, randomized FINCH trial program in adults (n=3,452 total) with moderate to severe active RA. The 3 studies enrolled patients who had an inadequate response to methotrexate (MTX) (FINCH 1), an inadequate response to biologic DMARDs (FINCH 2), or who were MTX-naïve (FINCH 3). Oral daily doses of filgotinib 100 mg and 200 mg were studied in each trial, either as monotherapy (FINCH 3), in combination with MTX (FINCH 1 and 3), or added to a stable background conventional synthetic DMARD (csDMARD) (FINCH 2). In the study program, filgotinib was compared to placebo (FINCH 1 and 2), adalimumab (FINCH 1), and MTX (FINCH 3). Across the trials, both doses of filgotinib demonstrated a significantly greater clinical response rate compared to placebo at week 12 (FINCH 1 and 2) and week 24 (FINCH 3). This was reported using ACR20 and DAS28-CRP, among other measures. FINCH 1 also demonstrated non-inferiority of both doses of filgotinib to adalimumab based on DAS28-CRP. Clinical remission (DAS28-CRP ≤ 2.6) was achieved in 23.8% and 33.9% of patients on filgotinib 100 mg and 200 mg, respectively, compared to 23.7% on adalimumab, while low disease activity (DAS28-CRP ≤ 3.4) was reported in 38.8%, 49.7% and 43.4% of patients in each group, respectively. In FINCH 3, both doses of filgotinib plus MTX demonstrated significantly higher ACR20, ACR50, ACR70, and clinical remission at 24 weeks compared to MTX alone. Incidences of serious adverse events were similar among the groups. Few cases of VTE and MACE were reported across the groups.
PLACE IN THERAPY
An estimated 1.3 million adults in the US suffer from RA. DMARDs (MTX preferred) are considered first-line treatment for RA. If disease activity remains moderate or severe, a combination of DMARDs or a TNF inhibitor or a non-TNF biologic, with or without MTX is recommended. Oral JAK inhibitors are available and include baricitinib (Olumiant®; JAK1 and JAK2 inhibitor), tofacitinib (Xeljanz®/Xeljanz XR®; JAK1 and JAK3 inhibitor), and upadacitinib (Rinvoq™; selective JAK1 inhibitor). Tofacitinib and upadacitinib are indicated after inadequate response or intolerance to MTX. Baricitinib is indicated in patients with an inadequate response to ≥ 1 TNF inhibitor. These agents are taken once daily and may be used as monotherapy or in combination with MTX or a nonbiologic DMARD. If approved, filgotinib may compete with the other selective JAK1 inhibitor, upadacitinib, for moderate to severe RA. Both agents may provide more desirable efficacy and safety profiles compared to baricitinib and tofacitinib. Moreover, baricitinib and tofacitinib are associated with an increased risk of thromboembolic events and dose-limiting anemia, which have not been reported with filgotinib or upadacitinib in clinical trials; however, labeling of all approved JAK inhibitors for RA carries a boxed warning for thromboembolic events. Market uptake of filgotinib may be limited by its late entry to the market among JAK inhibitors and by increasing availability and uptake of anti-TNF biosimilars. Tofacitinib is also approved for PsA and UC, indications for which filgotinib is in late-stage development, along with CD.
FDA APPROVAL TIMELINE August 19, 2020
Priority Review
FINANCIAL FORECAST 2020
2021
2022
$19
$138
$278
2023
2024
$445 The forecast is a projection of total US sales per year.
$628
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INFECTIOUS DISEASE
fostemsavir oral Viiv PROPOSED INDICATIONS
Multidrug-resistant (MDR) human immunodeficiency virus-1 (HIV-1) infection in adults
CLINICAL OVERVIEW
Fostemsavir inhibits HIV attachment to the cellular CD4 receptor by binding to the viral envelope glycoprotein gp120. The phase 3 BRIGHTE trial studied fostemsavir in 2 cohorts of heavily pretreated adults with MDR HIV-1 infection. In Cohort 1 (n=272; randomized 3:1), fostemsavir or placebo was added to optimized background therapy in a double-blind manner. Viralogic suppression (HIV-1 RNA < 40 copies/mL) was reported in 53%, 54%, and 60% of patients at the 24-, 48-, and 96-week timepoints, respectively, in the fostemsavir-treated patients. The mean increase in CD4 at 96 weeks was 205 cells/µL. After 1 week of treatment, the study demonstrated a statistical superiority of fostemsavir over placebo (0.79 log10 c/mL versus 0.17 log10 c/ mL; p<0.0001). In Cohort 2 (n=99), all patients were without any fully active ARV option and all received fostemsavir. Virologic suppression in the group was reported in 37%, 38%, and 37% of patients at the 24-, 48-, and 96-week timepoints, respectively. Higher rates of serious TEAEs, including death, were reported among Cohort 2 compared to Cohort 1 (serious adverse events, 48% versus 34%; death, 16% versus 4%). Most deaths were due to complication of the disease and acute infection. Fostemsavir 600 mg was administered orally twice daily.
PLACE IN THERAPY
It is estimated that approximately 1.2 million people in the US are HIV-positive and about 10,000 of those people have MDR HIV. While several antiviral agents are available to treat HIV-1 infection, treatment failure may occur due to the virus’s ability to mutate and become resistant to available ARV drugs. Patient choices among ARVs may also be limited based on tolerability and the potential for drug-drug interactions. Resistance testing, viral load monitoring, and access to care and ARV therapy may decrease acquired drug resistance and stabilize rates of transmitted drug resistance. The use of regimens with greater potency and genetic barriers, such as integrase strand transfer inhibitors (INSTIs), provide additional options for second- and third-line regimens. Despite these strategies, there continues to be an unmet need in patients with drug-resistant HIV due to the nature of viral mutation. If approved, fostemsavir will be a first-in-class attachment inhibitor. It will also be the first oral agent approved for the treatment of HIV-1 infection for use in combination with other ARVs in heavily treatment-experienced adults with MDR HIV-1 infection. This follows the 2018 approval of the CD4-directed post attachment HIV-1 inhibitor ibalizumab-uiyk (Trogarzo®) that is administered IV every 2 weeks. Also on the horizon for treatmentresistant HIV-1 is leronlimab, a weekly SC injected monoclonal antibody viral-entry inhibitor that targets chemokine receptor 5 (CCR5). Final data submission for leronlimab is expected in 2Q 2020.
FDA APPROVAL TIMELINE October–December 2020 Breakthrough Therapy
Fast Track
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$25
$55
$94
$134
$156
The forecast is a projection of total US sales per year.
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ONCOLOGY
lisocabtagene maraleucel IV Bristol-Myers Squibb PROPOSED INDICATIONS
Relapsed or refractory (R/R) diffuse large B cell lymphoma (DLBCL) after ≥ 2 prior therapies
CLINICAL OVERVIEW
Lisocabtagene maraleucel (liso-cel) is an CAR T cell immunotherapy. T cells taken from the patient are reengineered to express a CD19 CAR and a truncated form of human EGFR (EGFRt). The cells are expanded and infused back into the patient. In the body, the CAR T cells are directed to the CD19 antigen on the surface of tumor B cells where they exert their toxic effect. The EGFRt domain and administration of the EGFR inhibitor cetuximab stimulate elimination of the CAR T cells to mitigate severe toxicities. The open-label, phase 1 TRANSCEND NHL trial enrolled patients with aggressive R/R B cell NHL, including DLBCL, who had received a median of 3 prior therapies. Among 256 evaluable patients who received liso-cel, ORR and completed response (CR) rates were 73% and 53%, respectively. The median time to first response was 1 month, and the DOR was 54.7% at 12 months. Liso-cel was associated with a 79% rate of adverse events of grade ≥ 3 severity, including cytopenias. Cytokine release syndrome (CRS) of any grade was reported in 42% of patients, 2% of which were grade ≥ 3. Neurologic events (NE) were reported in 30% of patients, 10% of which were grade ≥ 3. A total of four grade 5 TEAEs were reported, which included diffuse alveolar damage, pulmonary hemorrhage, multi-organ dysfunction, and cardiomyopathy. Liso-cel was infused as a single IV dose of 50 x 106 (n=51), 100 x 106 (n=177), or 150 x 106 (n=41).
PLACE IN THERAPY
Over 25,000 new cases of DLBCL are diagnosed annually in the US. While some aggressive forms are often curable with intensive chemotherapy, others are less responsive. For patients who are refractory to or relapse after chemotherapy and SCT, there remain few options. In recent years, therapies that target tumor biomarkers or stimulate the body's immune response against tumor cells have been approved. If approved, lisocabtagene maraleucel will be the third CD19-directed CAR T therapy approved for DLBCL salvage therapy, following the 2017 FDA approvals of axicabtagene ciloleucel (Yescarta®) and tisagenlecleucel-T (Kymriah®). In clinical trials, liso-cel demonstrated a CR rate (53%) in adults comparable to or higher than axicabtagene ciloleucel (CR, 51%) and tisagenlecleucel-T (CR, 32%). Moreover, lido-cel incorporates an EGFRt domain that diminishes toxic effects when used with cetuximab. Clinical studies with liso-cel demonstrated lower rates of serious (grade ≥ 3) CRS and NE than studies with axicabtagene ciloleucel or tisagenlecleucel-T (CRS: 2%, 13%, and 23%, respectively; NE: 10%, 31%, and 18%, respectively). Notably, across 3 liso-cel clinical studies, a total of 43 patients received the dose in an outpatient setting at the discretion of the investigator. This approach required patient education, a caregiver, and proximity to the treatment facility. A total of 24 (55%) required hospitalization. The CR rate in outpatients was consistent with the overall TRANSCEND NHL trial. While approximately 10% of liso-cel doses administered in TRANSCEND NHL were nonconforming (out of quality standard specification necessary to achieve desired clinical response), efficacy produced was similar to conforming doses. Concern may remain regarding manufacturing of liso-cel.
FDA APPROVAL TIMELINE August 17, 2020
Breakthrough Therapy
Orphan Drug
Priority Review
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$36
$161
$304
$450
$638
The forecast is a projection of total US sales per year.
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RMAT
ONCOLOGY
nadofaragene firadenovec Intravesical Fergene PROPOSED INDICATIONS
High-grade, Bacillus Calmette-Guérin (BCG)-unresponsive, non-muscle invasive bladder cancer (NMIBC)
CLINICAL OVERVIEW
Nadofaragene firadenovec is a non-replicating adenoviral (Ad5) vector-based gene therapy. It contains the interferon alfa-2b transgene and an excipient, called Syn3, to improve its delivery into the bladder wall cells. Once in the cells, the interferon alfa-2b transgene is incorporated into the cellular DNA causing large amounts of interferon protein to be made intracellularly and enhancing the body’s immune defense. A phase 3, open-label study enrolled 157 patients in the US who were diagnosed with carcinoma in situ (CIS) bladder cancer confined to the superficial layer, with or without concomitant high-grade Ta or T1 papillary disease (CIS ± Ta/T1). At 3 months, a complete response (CR) was achieved in 53% of patients, of which 24% had continued CR at 12 months. Notably, the rate of high-grade recurrence-free (HGRF) survival in patients with papillary disease was 73% and 44% at 3 and 12 months, respectively. TEAEs were typically localized and lasted a median of 2 days, with the exception of fatigue and urinary frequency which lasted a median of 11 and 41 days, respectively. Nadofaragene firadenovec is administered via a catheter directly into the bladder every 3 months.
PLACE IN THERAPY
Bladder cancer is the sixth most common cancer in the US. In 2019, an estimated 80,470 individuals were diagnosed with bladder cancer and an estimated 17,670 deaths occurred due to the condition. The median age at diagnosis is 73 years. Approximately 75% of new cases are NMIBC. Treatment for NMIBC (Ta, T1, and Tis) focuses on reducing recurrences and preventing disease progression to an advanced stage. Current therapy includes intravesical chemotherapy (e.g., gemcitabine, mitomycin), BCG after transurethral resection, and intravesical BCG maintenance therapy. Up to 75% of cases will develop tumor recurrence after BCG therapy, and 20% will experience disease progression within 5 years. Notably, Merck is the sole supplier of TICE BCG strain in the US and in a number of other countries, and supply constraints have impacted availability of BCG live. In patients who do not respond to BCG therapy, radical cystectomy is recommended. In patients who wish to preserve their bladders or who are ineligible for cystectomy, nonsurgical options are limited to IV pembrolizumab (Keytruda®; administered every 3 weeks) and intravesical valrubicin (Valstar®; administered weekly for 6 weeks) which are FDA-approved for BCG-unresponsive CIS bladder cancer. In non-comparative trials, response rates with intravesical nadofaragene firadenovec were similar to pembrolizumab (also produced by Merck) and higher compared to investigational intravesical antibody-drug conjugate (ADC) oportuzumab monatox.
FDA APPROVAL TIMELINE May–June 2020
Breakthrough Therapy
Fast Track
Priority Review
FINANCIAL FORECAST (reported in millions) The financial forecast for nadofaragene firadenovec is not currently available.
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ONCOLOGY – RET-DIRECTED THERAPY
ofatumumab (Arzerra®) SC Novartis PROPOSED INDICATIONS
Relapsing forms of multiple sclerosis (RMS) in adults Current indications for ofatumumab for IV administration are for the treatment of CLL.
CLINICAL OVERVIEW
Ofatumumab is a human, high-affinity antibody targeted at the cluster of differentiation 20 (CD20) molecule in the cell membrane of B cells. Research has demonstrated that anti-CD20 treatment leads to lysis and depletion of B cells, ultimately reducing formation of new inflammatory CNS lesions. The replicate phase 3, double-blind, double-dummy, parallel-group ASCLEPIOS I and II trials compared ofatumumab with teriflunomide in adults with RMS. A total of 1,882 patients with EDSS 0 to 5.5 were treated for up to 30 months. Both studies reported a significantly lower annualized relapse rate (ARR) with ofatumumab than with teriflunomide (ARR, 0.11 versus 0.22 and 0.1 versus 0.25 for ASCLEPIOS I and II, respectively; RRR, 50.5% and 58.5%, respectively; p<0.001 for both studies). In ASCLEPIOS I and II, a significantly lower number of gadolinium-enhancing (Gd+) T1 lesions per scan and new or enlarging T2 lesions per year were also seen with ofatumumab compared to teriflunomide (T1 lesions: RRR, 97.5% and 93.8% for ASCLEPIOS I and II, respectively; p<0.001 for both studies; T2 lesions: RRR, 82% and 84.5% for ASCLEPIOS I and II, respectively; p<0.001 for both studies). Across both studies, the confirmed disability worsening (CDW) was significantly lower with ofatumumab than teriflunomide at 3 months (RRR, 34.4%; p=0.002) and 6 months (RRR, 32.5%; p=0.012). The safety profile of ofatumumab in the ASCLEPIOS trials was consistent with that reported in phase 2 trials. In the earlier phase 2 MIRROR study, the most common adverse event was injection-related reactions (52%), which were typically of mild to moderate severity and diminished with subsequent administrations. Ofatumumab was administered as 20 mg SC every 4 weeks, and teriflunomide was administered as 14 mg orally once daily. Corresponding matching placebo was used.
PLACE IN THERAPY
Nearly 1 million people in the US are living with MS, and the majority have relapsing forms of the condition. Disease-modifying therapies (DMT) indicated to treat RMS aim to decrease relapse rate and slow the accumulation of MRI-detected brain lesions. Once-monthly doses of ofatumumab, which may be selfadministered, demonstrated improved efficacy compared to daily oral teriflunomide (Aubagio®). If approved, ofatumumab will compete with Genentech’s CD20-directed cytolytic monoclonal antibody ocrelizumab (Ocrevus®) in the RMS space. Ofatumumab’s monthly self-administered SC dosing may be considered more convenient compared to ocrelizumab’s every 6-month IV maintenance regimen. Ocrelizumab is also FDA-approved for treatment of primary progressive MS (PPMS), an indication that ofatumumab is not currently seeking. Other agents used to treat relapsing forms of MS also carry risks. Natalizumab, dimethyl fumarate, fingolimod, alemtuzumab, and cladribine (oncology setting) have been associated with progressive multifocal leukoencephalopathy (PML), which can be fatal.
FDA APPROVAL TIMELINE June 2020
Priority Review
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$175
$546
$961
$1,387
$1,652
The forecast is a projection of total US sales per year.
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ONCOLOGY – RET-DIRECTED THERAPY BACKGROUND
Abnormalities in the rearranged during transfection (RET) kinase, including activating mutations and fusions, result in the upregulation and/or overactivation of RET tyrosine kinase activity leading to uncontrolled cell proliferation in various cancer cell type, including NSCLC and thyroid cancer. Selpercatinib and pralsetinib selectively block RET, inhibiting the activity of abnormal RET proteins.
selpercatinib oral Eli Lilly PROPOSED INDICATIONS
RET fusion-positive non-small cell lung cancer (NSCLC), RET-mutant medullary thyroid cancer (MTC), and RET fusion-positive thyroid cancer
CLINICAL OVERVIEW
The ongoing, open-label LIBRETTO-001 trial is evaluating oral selpercatinib monotherapy for the treatment of RET fusion-positive NSCLC. The phase 2 analysis for efficacy included patients (n=105) with prior platinumbased chemotherapy. Selpercatinib treatment resulted in a 68% ORR (95% CI, 58 to 76) regardless of prior therapy (e.g., anti-PD-1/PD-L1, multikinase inhibitor [MKI]). Notably, in patients with brain metastases (n=11), the CNS ORR was 91% (95% CI, 59 to 100), including 2 complete responses. At the data cut-off, the majority of patients were still responding to treatment, with a median DOR of 20.3 months (considered nonsignificant) and median PFS of 18.4 months. Selpercatinib was also studied in a subset of treatment-naïve patients (n=34) with RET fusion-positive NSCLC. In this population, selpercatinib resulted in an 85% ORR (95% CI, 69 to 95) and median DOR and PFS were not reached at data cut-off. The LIBRETTO-001 trial also included patients with RET fusion-positive thyroid cancer. Among those with RET-mutant MTC (n=55), selpercatinib led to an ORR of 56% (95% CI, 42 to 70) in patients who received prior cabozantinib and/or vandetanib and an ORR of 59% (95% CI, 47 to 70) in patients who were naïve to both agents (n=76). Calcitonin and carcinoembryonic antigen response, defined as a ≥ 50% decrease that lasted for ≥ 4 weeks, were observed in most patients. In addition, in heavily pretreated RET fusion-positive thyroid cancer patients (n=26), selpercatinib resulted in a 62% ORR (95% CI, 41 to 80). The DOR and PFS were not reached at data cut-off among any thyroid cancer patient group. In LIBRETTO-001, selpercatinib was generally well-tolerated, with an overall treatment discontinuation rate of 1.7%. An oral selpercatinib dose of 160 mg twice daily was determined as the phase 2 dose.
FDA APPROVAL TIMELINE July–August 2020
Breakthrough Therapy
Orphan Drug
Priority Review
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$17
$117
$319
$506
$658
The forecast is a projection of total US sales per year.
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pralsetinib oral Blueprint Medicines PROPOSED INDICATIONS
RET fusion-positive non-small cell lung cancer (NSCLC)
CLINICAL OVERVIEW
In the phase 2 portion of the ARROW trial, pralsetinib demonstrated a 61% ORR (95% CI, 50 to 72) in RET fusion-positive NSCLC patients (n=80) previously treated with platinum-based chemotherapy. At data cut-off, CR rate was 14%, and DOR was not reached. In treatment-naïve RET fusion-positive NSCLC patients (n=26), ORR was 73% (95% CI, 52 to 88) and CR was 12%. Pralsetinib was generally well tolerated with 4% of patients among the safety population (n=354) discontinuing treatment due to TEAEs. The study dosage of pralsetinib was 400 mg administered orally once daily.
FDA APPROVAL TIMELINE January–March 2021
Breakthrough Therapy
Orphan Drug
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$0
$43
$82
$119
$152
The forecast is a projection of total US sales per year.
PLACE IN THERAPY
It is estimated that 228,820 Americans will be diagnosed with lung cancer in 2020, of which 84% of cases will be NSCLC. In 2018, an estimated 53,900 cases of thyroid carcinoma (TC) were diagnosed in the US. It is estimated that 89.8% of TC cases are papillary carcinoma and 1.6% are MTC. Moreover, activating RET mutations or RET fusions are detected in up to 2% of all NSCLC cases, 10% to 20% of papillary thyroid cancers, and 60% of MTCs. Furthermore, RET mutations are predictive of aggressive tumor progression. Papillary carcinoma is usually caused by radiation therapy to the head and neck particularly when received during childhood. It is often asymptomatic, which leads to delayed diagnosis. Standard therapy is thyroidectomy followed by thyroxine supplementation in most patients and radioactive iodine ablation or external beam radiotherapy in select patients. Systemic therapies, such as lenvatinib or sorafenib, are used when tumors are not resectable, do not respond to radioactive iodine, are not amenable to localized beam radiation therapy, and have significant clinical disease progression. MTC is a neuroendocrine tumor of the thyroid gland and is characterized by the production of calcitonin. Most MTC cases (80%) are sporadic, but some are inheritable with germline RET mutations. The primary treatment for MTC is total thyroidectomy. For patients with progressive or symptomatic metastatic disease who are ineligible for surgery, systemic therapy may be considered. Chemotherapy shows little benefit in this setting; however, MKIs have provided longer-term response. Available systemic treatments for NSCLC and thyroid carcinomas discussed here include MKIs, such as cabozantinib and vandetanib. Currently there are no systemic therapies that selectively target RET, and MKIs are associated with toxicities, including a boxed warning for vandetanib regarding QT prolongation, torsades de pointes, and sudden death leading to its availability only through a REMS program. As selective RET agents, selpercatinib and pralsetinib demonstrate greater efficacy and more favorable safety profiles compared to the MKIs and could provide important options in the armamentarium for patients with RET fusions and mutations. While the application for pralsetinib covers only treatment for NSCLC, the ARROW study is also evaluating the drug for RET-mutant MTC in previously treated and treatment-naïve patients, as well as for RET fusion-positive thyroid cancer (ORR, 60%, 74%, and 89%, respectively, reported to date). Blueprint plans to submit a thyroid cancer application in 2Q 2020. 11 | magellanrx.com
ONCOLOGY
valoctocogene roxaparvovec IV Biomarin PROPOSED INDICATIONS
Hemophilia A treatment and prevention in adults
CLINICAL OVERVIEW
Individuals with hemophilia A lack or have low levels of clotting factor VIII (FVIII). Valoctocogene roxaparvovec (valrox) is an adeno-associated virus 5 (AAV5)-mediated gene therapy that delivers human B domain-deleted coagulation factor VIII (FVIII), resulting in an active variant of FVIII. A phase 1/2 study demonstrated efficacy and safety among 7 adult males with severe hemophilia A (FVIII ≤ 1 IU/dL) who received valrox 6x1013 vg/kg. A 96% reduction in mean annualized bleeding rate (ABR) from baseline was seen 3 years after the dose was administered. The mean FVIII expression declined by 43% during year 2 and by 10% during year 3 (mean FVIII levels of 64, 36, and 33 IU/dL at 1, 2, and 3 years, respectively). At year 3, complete or near complete elimination of prophylactic FVIII use was observed (mean, zero infusions). In addition, all patients experienced full resolution of bleeding in target joints at year 2. A transient elevation in ALT levels with no signs of ongoing liver damage was the most common adverse event reported. No development of FVIII inhibitors or other FVIII antibodies was identified. No patients withdrew from the study. Valrox is administered as a single IV infusion.
PLACE IN THERAPY
Hemophilia A is a congenital X-linked bleeding disorder that affects 1 in 5,000 male births. It is characterized by coagulation FVIII deficiency leading to chronic spontaneous bleeding into muscles and joints that can progress to debilitating arthropathy. For decades, the standard of care has been routine infusion of FVIII replacement products that are dosed 2 to 4 times per week. However, replacement therapy is complicated by the development of inhibitors (antibodies), which can reduce therapeutic efficacy. In November 2017, the monoclonal antibody emicizumab-kxwh (Hemlibra®) was approved for routine prophylaxis of bleeding events in hemophilia A in patients with or without inhibitors. It demonstrates substantially reduced incidence of bleeding with a dosing regimen as little as every 4 weeks. Valrox is poised to be the first gene therapy for hemophilia. If approved, a single IV infusion may provide a long-term option to dramatically reduce ABR and eliminate the need for prophylactic FVIII therapy. While FVIII expression plateaued at approximately 20% three years after valrox administration, data demonstrating long-tern efficacy beyond 3 years are not yet available. Several viral gene therapies are in clinical trials for hemophilia A. Phase 3 trials are ongoing by Pfizer/Sangamo and Spark, while therapies by Takeda and Ultragenyx are in phase 1/2 trials. The small interfering RNA (siRNA) product fitusiran by Sanofi/ Alnylam is also in late stage development. A number of agents are also being studied for hemophilia B. The FDA is also reviewing a valrox total antibody assay by ARUP as a companion diagnostic to identify patients most likely to respond to valrox. Biomarin estimates that about 80% of patients with hemophilia A in the US do not have preexisting immunity to AAV5 that would make them ineligible for valrox.
FDA APPROVAL TIMELINE August 21, 2020
Breakthrough Therapy
Orphan Drug
Priority Review
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$27
$126
$237
$427
$711
The forecast is a projection of total US sales per year.
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IMMUNOLOGY
viaskin peanut transdermal DBV Technologies PROPOSED INDICATIONS
Peanut allergy in children 4 to 11 years of age
CLINICAL OVERVIEW
Viaskin Peanut is an epicutaneous immunotherapy (EPIT) technology that delivers 250 mcg of peanut extract. The phase 3, randomized (2:1), double-blind, placebo-controlled PEPITES trial enrolled 356 peanut-allergic children 4 to 11 years of age. After 12 months, 35.3% of patients treated with viaskin peanut were able to consume ≥ 300 mg of peanut protein (equivalent to ~1 peanut) compared to 13.6% with placebo (p=0.00001). Although the difference was significant, the primary outcome of the trial was not met because a lower bound of the 95% CI of < 15% was not reached. The most common TEAE was local application site reaction (57.6% versus 27.1% with placebo), which was generally mild to moderate in severity and occurred during the first month of treatment. A total of 10 anaphylactic episodes (8 patients) were considered to be related to viaskin peanut. Epinephrine was used to treat 6 of the episodes. In the PEPITES study, the first viaskin peanut transdermal patch was applied for 3 hours under medical supervision. Subsequent patches were applied at home where the daily application duration time was increased gradually to 6 hours during week 1, 12 hours during week 2, and 24 (±4) hours thereafter.
PLACE IN THERAPY
Peanut allergy is a public health concern, placing a significant burden on patients and caregivers. Approximately 2.5% of children in the US suffer from peanut allergy, and this figure is rising. Reaction to peanut exposure varies from mild skin and/or GI symptoms to severe angioedema and anaphylaxis. The main approach to managing food allergy is avoidance of the precipitating allergen. When accidental peanut exposure occurs, antihistamines can manage mild to moderate reactions, but patients often carry an epinephrine auto-injector to treat severe reactions. If approved, viaskin peanut will be the first transdermal formulation to mitigate allergic reactions to accidental peanut exposure in individuals with confirmed peanut allergy. It follows the January 2020 approval of oral peanut allergen powder-dnfp (Palforzia™) that is mixed with food and consumed daily. Initial doses and dose escalations of Palforzia must be administered in a certified medical facility. While both products demonstrate desensitization compared to placebo, the Palforzia clinical trial enrolled patients who were sensitive to lower doses of peanut allergen. In addition, a higher response rate was reported with Palforzia (67% of patients tolerated ≥ 600 mg of peanut protein) compared to viaskin peanut (35% of patients tolerated ≥ 300 mg of peanut protein eliciting dose). The Palforzia indication also allows for start of therapy in the broader age range of 4 to 17 years compared to the study population for viaskin peanut of 4 to 11 years. Viaskin peanut and Palforzia provide consistent peanut allergen doses to increase a patient’s tolerance to accidental peanut exposure and reduce the risk of serious allergic reactions. Neither is a curative therapy, and both must be combined with a peanut avoidance diet. Therapy adherence will be key to continued desensitization. In clinical trials, proportionately fewer patients on viaskin peanut compared to those on Palforzia withdrew from the study (10.5% versus 21%). Ongoing trials are evaluating safety and efficacy of each product in patients 1 to 3 years of age in addition to their long-term (3 years) safety and tolerability.
FDA APPROVAL TIMELINE October 2, 2020
Breakthrough Therapy
Fast Track
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$13
$69
$160
$254
$335
The forecast is a projection of total US sales per year.
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Biosimilar Overview CLINICAL OVERVIEW
Biosimilars are very different from generic drugs in that they are not exact duplicates of their reference biologic product. The FDA approval process for biosimilars is designed to ensure that the biosimilar product is highly similar to the reference product without having any meaningful clinical differences. Many controversies surround biosimilars, and regulatory and litigation hurdles remain. The FDA has issued final and draft guidances. Select FDA biosimilar guidances are noted here. In January 2017, the agency issued final guidance on the nonproprietary naming of biologic products, which also applies to biosimilars. The biological products must bear a core name followed by a distinguishing 4-letter, lowercase, hyphenated suffix that is devoid of meaning. The FDA is still considering how to implement the nomenclature for previously approved biosimilar products. The international nonproprietary name (INN) impacts interchangeability as it affects pharmacists’ ability to substitute an interchangeable biosimilar for the reference product. The FDA withdrew the September 2017 draft industry guidance on determining similarity of a proposed biosimilar product to its reference product to allow for further consideration of the most current and relevant scientific methods in evaluating analytical data. The agency will focus on providing flexibility for efficient development of biosimilars while maintaining high scientific standards. In July 2018, the FDA finalized its guidance on labeling biosimilars. The guidance pertains to prescribing information (PI) but does not contain specific recommendations on interchangeability in the labeling. The labeling guidance provides recommendations on how to include, identify, and differentiate the biosimilar and the reference product in various sections of the PI. The basic premise remains that the originator product’s safety and effectiveness can be relied upon for HCPs to make prescribing decisions; therefore, a biosimilar should include relevant data from the originator in its PI. In May 2019, the agency released its final guidance on interchangeability. Several states had already enacted biosimilar substitution legislation. Biosimilars are expected to receive full extrapolation for the eligible indications of the reference products without requiring additional trials. Nevertheless, as each biosimilar comes to market, it will likely need to be considered individually. Insulins were historically regulated by the FDA as small molecules. However, effective March 23, 2020, drugs such as insulin and growth hormone are deemed biologics and transitioned from the drug pathway to the biologics pathway. Their licensure as biologics allows these agents to be considered in the biosimilar space and promotes competition and access.
PLACE IN THERAPY
The patents of several biologic drugs are set to expire in the next few years, opening the US market for biosimilar entry; however, patent litigation has resulted in significant launch delays of FDA-approved biosimilars. In June 2017, the US Supreme Court issued 2 landmark rulings: (1) allowing a biosimilar manufacturer to provide launch notice of commercial marketing to the originator manufacturer before or after FDA approval of the biosimilar product; and (2) eliminating any federal requirement for disclosure, also known as the “patent dance.” Some states, however, mandate disclosure. These decisions may bring biosimilars to the market sooner and potentially create price competition in the marketplace. In July 2018, the FDA unveiled its Biosimilar Action Plan (BAP), a series of 11 steps to encourage biosimilar market competition, some of which were previously announced or underway. The BAP contains 4 key strategies: (1) improving the biosimilar development and approval process; (2) maximizing scientific and regulatory clarity for sponsors; (3) effective communications for patients, clinicians, and payers; and (4) reducing unfair tactics that may delay market approval and entry. The BAP strives to promote access to biosimilar products and reduce healthcare costs.
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To date, a total of 26 biosimilars have received FDA approval. Of these, only 17 have entered the market. APPROVED BIOSIMILARS Brand Name (Nonproprietary name)
Manufacturer
Approval Date
Zarxio® (filgrastim-sndz)
Sandoz
March 2015
Inflectra® (infliximab-dyyb)
Pfizer/Celltrion
April 2016
Erelzi™ (etanercept-szzs)
Sandoz
August 2016
Amjevita™ (adalimumab-atto)
Amgen
September 2016
Renflexis® (infliximab-abda)
Samsung Bioepis/ Merck
May 2017
Cyltezo® (adalimumab-adbm)
Boehringer Ingelheim
August 2017
Mvasi™ (bevacizumab-awwb)
Amgen
September 2017
Ixifi™ (infliximab-qbtx)*
Pfizer
December 2017
Ogivri™ (trastuzumab-dkst)
Mylan
December 2017
Retacrit (epoetin alfa-epbx)
Pfizer/Hospira
May 2018
Fulphila® (pegfilgrastim-jmdb)
Mylan
June 2018
Nivestym® (filgrastim-aafi)
Pfizer
July 2018
Hyrimoz™ (adalimumab-adaz)
Sandoz
October 2018
Udenyca® (pegfilgrastim-cbqv)
Coherus
November 2018
Truxima® (rituximab-abbs)
Celltrion/Teva
November 2018
Herzuma® (trastuzumab-pkrb)
Celltrion/Teva
December 2018
Ontruzant® (trastuzumab-dttb)
Samsung Bioepis/ Merck
January 2019
Trazimera™ (trastuzumab-qyyp)
Pfizer
March 2019
Eticovo™ (etanercept-ykro)
Samsung Bioepis/ Merck
April 2019
Kanjinti™ (trastuzumab-anns)
Amgen
June 2019
Zirabev™ (bevacizumab-bvzr)
Pfizer
June 2019
Hadlima™ (adalimumab-bwwd)
Samsung Bioepis/ Merck
July 2019
Ruxience™ (rituximab-pvvr)
Pfizer
July 2019
Abrilada™ (adalimumab-afzb)
Pfizer
November 2019
Ziextenzo® (pegfilgrastim-bmez)
Novartis/Sandoz
November 2019
®
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Commercially Available
-
-
-
-
-
-
-
Originator Product (Manufacturer) Neupogen® (Amgen) Remicade® (Janssen) Enbrel® (Amgen) Humira® (Abbvie) Remicade (Janssen) Humira (Abbvie) Avastin® (Genentech) Remicade (Janssen) Herceptin® (Genentech) Epogen® (Amgen) Procrit® (Janssen) Neulasta® (Amgen) Neupogen (Amgen) Humira (Abbvie) Neulasta (Amgen) Rituxan® (Genentech) Herceptin (Genentech) Herceptin (Genentech) Herceptin (Genentech) Enbrel (Amgen) Herceptin (Genentech) Avastin (Genentech) Humira (Abbvie) Rituxan (Genentech) Humira (Abbvie) Neulasta (Amgen)
APPROVED BIOSIMILARS continued APPROVED BIOSIMILARS Brand Name (Nonproprietary name) Avsola™ (infliximab-axxq)
Manufacturer Amgen
Approval Date
Commercially Available
December 2019
-
Originator Product (Manufacturer) Remicade (Janssen)
* Pfizer already has Inflectra on the market and has not announced plans to launch Ixifi.
Also available are Eli Lilly’s Basaglar® insulin glargine, a biosimilar agent to Sanofi’s Lantus®, and Sanofi’s Admelog® insulin lispro, approved as a biosimilar product to Eli Lilly’s Humalog®. A host of factors will contribute to market acceptability and the potential success of biosimilars. Payers, pharmacies, prescribers, and patients each play a role in market adoption of biosimilars. While < 2% of Americans use biologics, they account for almost 40% of all prescription drug spending. Moreover, they comprised 70% of growth in drug spending from 2010 to 2015. Not surprisingly, there is a growing body of evidence on predicted biologic spend and potential biosimilar savings. The global biologic market is projected to exceed $390 billion by 2020. The global biosimilar market is expected to grow from $5.95 billion in 2018 to $23.63 billion in 2023. An IMS Health analysis expects biosimilars to save the US and Europe’s top 5 markets up to $110 billion by 2020. In the US, it is estimated that biosimilars will cost 15% to 35% less than the originator product. The potential cost savings, however, can vary based on the market segment where brand contracts can play a role. A 2017 report by the RAND Corporation estimates a $54 billion cost savings from biosimilars between 2017 and 2026. In July 2018, an FDA analysis reported that if Americans had access to FDA-approved biosimilars in 2017, it would have resulted in a $4.5 billion savings. A 2017 analysis by the Moran Company projects biosimilars could save the government an estimated $11.4 billion by 2027, but it would require the Centers for Medicare and Medicaid Services (CMS) to revise its reimbursement policy for biosimilars. Subsequently, in November 2017, the CMS revised its reimbursement policy. The CMS now issues a unique Healthcare Common Procedure Coding System (HCPCS) code to each individual biosimilar. Under this rule, Medicare Part B separately codes and pays for biosimilars and no longer groups them into a common payment code with originator agents. A June 2018 infliximab case study by the Pacific Research Institute forecasts annual savings of up to $465 million from increased use of biosimilars to replace a single biologic for commercial payers and Medicare. Biosimilars are paving the way for increased access to important biologic therapies that may increase survival and/ or QOL for many patients with difficult-to-treat diseases while also reducing costs.
ONCOLOGY
bevacizumab IV MYL-1402O and SB8 are biosimilars to Genentech’s Avastin, a vascular endothelial growth (VEGF)-specific angiogenesis inhibitor indicated for the treatment of metastatic colorectal cancer, non-squamous non-small cell lung cancer (nsNSCLC), glioblastoma, metastatic renal cell carcinoma (RCC), and recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer.
FDA APPROVAL TIMELINE Merck/Samsung Bioepis (SB8) July–September 2020 Mylan/Biocon (MYL-1402O) December 25, 2020
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$2,078
$1,412
$1,143
$961
$808
The forecast is a projection of total US sales per year for the branded originator product.
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BIOSIMILAR OVERVIEW continued
BLOOD MODIFIER
filgrastim IV, SC Apotex and Kashiv are seeking biosimilars to Amgen’s Neupogen, a leukocyte growth factor indicated for use in patients with nonmyeloid malignancies who are receiving myelosuppressive anti-cancer drugs; following induction or consolidation chemotherapy for acute myeloid leukemia (AML); with nonmyeloid malignancies in patients who are undergoing myeloablative chemotherapy followed by bone marrow transplantation; to mobilize autologous hematopoietic progenitor cells for collection by leukapheresis; with symptomatic congenital neutropenia‚ cyclic neutropenia‚ or idiopathic neutropenia; and in patients who are acutely exposed to myelosuppressive doses of radiation (hematopoietic syndrome of acute radiation syndrome [HSARS]).
FDA APPROVAL TIMELINE Apotex (Grastofil) Pending Kashiv Pending
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$134
$113
$98
$89
$82
The forecast is a projection of total US sales per year for the branded originator product.
DIABETES
insulin glargine (Semglee) SC Mylan/Biocon Semglee is a biosimilar insulin to Sanofi’s Lantus, a long-acting insulin indicated for the treatment of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM).
FDA APPROVAL TIMELINE June 2020
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$948
$719
$538
$417
$344
The forecast is a projection of total US sales per year for the branded originator product.
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BIOSIMILAR OVERVIEW continued
BLOOD MODIFIER
pegfilgrastim SC Lapelga and PF-06881894 are biosimilars to Amgen’s Neulasta, a leukocyte growth factor indicated for use in patients with nonmyeloid malignancies who are receiving myelosuppressive anti-cancer drugs and in patients acutely exposed to myelosuppressive doses of radiation.
FDA APPROVAL TIMELINE Apotex (Lapelga) Pending
Pfizer/Hospira (PF-06881894) June 2020
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$1,889
$1,507
$1,237
$1,036
$895
The forecast is a projection of total US sales per year for the branded originator product.
ONCOLOGY
rituximab (ABP-798) Amgen/Allergan ABP-798 is an investigational biosimilar to Genentech’s Rituxan, a CD20-directed cytolytic antibody indicated for the treatment of non-Hodgkin’s lymphoma (NHL), chronic lymphocytic leukemia (CLL), rheumatoid arthritis (RA), and antineutrophil cytoplasmic antibodies-associated vasculitis.
FDA APPROVAL TIMELINE October 19, 2020
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$3,332
$2,225
$1,749
$1,464
$1,235
The forecast is a projection of total US sales per year for the branded originator product.
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KEEP ON YOUR RADAR Notable agents that are further from approval have been identified in this unique watch list. These are products with the potential for significant clinical and financial impact. Their development status is being tracked on the MRx Pipeline radar. These pipeline products, their respective class or proposed indication, as well as an estimated financial forecast for the year 2024, are displayed. The financials are projected total annual US sales, reported in millions. transcon pegylated growth hormone
aducanumab Neurology
$1,024
Endocrine
tafasitamab
$888
berotralstat Immunology
$193
Oncology
$492
betibeglogene autotemcel (Zynteglo)
roxadustat
Hematology/Gene therapy
Hematology
$343
$569
casimersen
risdiplam
Neurology/Gene therapy
Neurology
$293
$709 ripretinib
elivaldogene tavalentivec (Lenti-D)
$596
$35
Neurology/Gene therapy
Oncology
idecabtagene vicleucel
remestemcel-L Immunology
Oncology
$241
$1,040 inclisiran
relugolix
Women's health/ Oncology
$597
Cardiovascular
lenadogene nolparvovec (GS010)
$693
Ophthalmology/ Gene therapy
$15 pecialty drug names appear in ď&#x201A;Ť S magenta throughout the publication. 19 | magellanrx.com
PIPELINE DRUG LIST The pipeline drug list is an aerial outline of drugs with anticipated FDA approval through 2021. It is not intended to be a comprehensive inventory of all drugs in the pipeline; emphasis is placed on drugs in high-impact categories. Investigational drugs with a Complete Response Letter (CRL) and those that have been withdrawn from development are also noted. APPLICATION APPLICATION SUBMITTED SUBMITTED TO THE FDA
IN PHASE PHASE 33 TRIALS TRIALS
66% 34% 35% 27% 25% 6%
Specialty
65% 35% 35 % 13% 9%
Traditional
Priority Review
Orphan Drug
Breakthrough Therapy
Biosimilar
Specialty drug names appear in ï&#x201A;« magenta throughout the publication.
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PIPELINE DRUG LIST Specialty drug names appear in magenta throughout the publication. NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
dapagliflozin (Farxiga®)
AstraZeneca
T2DM-related CV risk reduction in patients with heart failure
Oral
Submitted – sNDA; Fast Track; Priority Review
May 2020
ramucirumab (Cyramza®)
Eli Lilly
NSCLC (1st-line, metastatic, EGFR+, in combination with erlotinib)
IV
Submitted – sBLA
May 2020
ixekizumab (Taltz®)
Eli Lilly
Axial spondyloarthritis (non-radiographic)
SC
Submitted – sBLA
May–Jun 2020
mannitol (dry powder)
Pharmaxis
CF (adults)
Inhaled
Submitted – NDA; Fast Track; Orphan Drug
May–Jun 2020
nadofaragene firadenovec
Fergene
Bladder cancer (highgrade, BCG-unresponsive, non-muscle invasive)
Intravesical
Submitted – BLA; Breakthrough Therapy; Fast Track; Priority Review
May–Jun 2020
olaparib (Lynparza®)
AstraZeneca
Ovarian cancer (maintenance, post 1st-line platinumbased chemotherapy & bevacizumab); Prostate cancer
Oral
Submitted – sNDA; Breakthrough Therapy; Orphan Drug; Priority Review
May–Jun 2020
ticagrelor (Brilinta®)
AstraZeneca
Coronary artery disease in patients with T2DM
Oral
Submitted – sNDA
May–Aug 2020
padeliporfin di-potassium
Steba Biotech
Prostate cancer
IV
Submitted – NDA
05/01/2020
avapritinib (Ayvakit )
Blueprint Medicines
GIST (4th-line)
Oral
Submitted – sNDA; Breakthrough Therapy; Fast Track; Orphan Drug
05/14/2020
dasotraline
Sumitomo Dainippon
Binge eating disorder
Oral
Submitted – NDA
05/14/2020
nivolumab (Opdivo®)
Bristol-Myers Squibb
NSCLC (metastatic, recurrent, EGFR-negative, ALK-negative)
IV
Submitted – sBLA; Fast Track; Priority Review
05/15/2020
rucaparib (Rubraca®)
Clovis Oncology
Prostate cancer
Oral
Submitted – sNDA; Breakthrough Therapy; Priority Review
05/15/2020
apomorphine
Sumitomo Dainippon
Parkinson’s disease (off episodes)
Oral transmucosal
Submitted – 505(b)(2) NDA; Fast Track
05/21/2020
artesunate
La Jolla
Malaria (severe)
Not specified
Submitted – NDA; Breakthrough Therapy; Orphan Drug
05/25/2020
dupilumab (Dupixent®)
Sanofi
Atopic dermatitis (ages 6 to 11 years)
SC
Submitted – sBLA; Breakthrough Therapy; Priority Review
05/26/2020
L-lactic acid/citric acid/ potassium bitartrate
Evofem
Contraception
Intravaginal
Submitted – NDA
05/26/2020
insulin glargine (biosimilar to Sanofi’s Lantus)
Mylan/Biocon
T1DM; T2DM
SC
Submitted – BLA
June 2020
®
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PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
ofatumumab (Arzerra)
Novartis
MS (relapsing)
SC
Submitted – sBLA; Priority Review
June 2020
pegfilgrastim (biosimilar to Amgen’s Neulasta)
Pfizer/Hospira
Neutropenia/leukopenia
SC
Submitted – BLA
June 2020
abicipar pegol
Allergan
Wet AMD
Intraocular
Submitted – BLA
Jun–Jul 2020
celecoxib oral solution
Dr. Reddy’s
Migraine treatment
Oral
Submitted – NDA
Jun–Jul 2020
inebilizumab
Viela Bio
Neuromyelitis optica (Devic’s syndrome)
IV
Submitted – BLA; Breakthrough Therapy; Orphan Drug
Jun–Jul 2020
minocycline 1.5% foam
Foamix
Rosacea
Topical
Submitted – 505(b)(2) NDA
06/02/2020
relebactam/imipenem/ cilastatin
Merck
HAP
IV
Submitted – NDA; Fast Track; Priority Review; QIDP
06/04/2020
elagolix (Orilissa®)
Abbvie
Uterine fibroids
Oral
Submitted – sNDA
06/05/2020
avelumab (Bavencio )
Merck
Bladder cancer (1st-line, maintenance, locally advanced or metastatic)
IV
Submitted – sBLA; Breakthrough Therapy; RTOR
06/09/2020
ketotifen
Bausch Health
Allergic conjunctivitis
Ophthalmic
Submitted – NDA
06/11/2020
pembrolizumab (Keytruda)
Merck
Solid tumors (monotherapy, unresectable or metastatic, tumor mutational burden-high ≥ 10 mutations/megabase, treatment-experienced)
IV
Submitted – sBLA; Priority Review
06/16/2020
burosumab-twza (Crysvita®)
Ultrenyx
Tumor-induced osteomalacia
SC
Submitted – sBLA; Priority Review
06/18/2020
tazemetostat (Tazverik™)
Epizyme
Follicular lymphoma (relapsed/refractory, 2+ prior therapies)
Oral
Submitted – sNDA; Accelerated Approval; Fast Track; Orphan Drug; Priority Review
06/18/2020
atezolizumab (Tecentriq®)
Genentech
NSCLC (1st-line, monotherapy, without EGFR or ALK mutations, high PD-L1 expression)
IV
Submitted – sBLA; Priority Review
06/19/2020
fosfomycin
Nabriva
UTI (complicated)
IV
Submitted – 505(b)(2) NDA; Fast Track; QIDP
06/19/2020
metoclopramide
Evoke
Diabetic gastroparesis (in women)
Intranasal
Submitted – 505(b)(2) NDA
06/19/2020
brigatinib (Alunbrig®)
Takeda
NSCLC (1st-line, ALK+, metastatic)
Oral
Submitted – sNDA; Breakthrough Therapy; Orphan Drug; Priority Review
06/23/2020
selinexor (Xpovio®)
Karyopharm
DLBCL (relapsed/ Oral refractory, post ≥ 2 multi-drug therapies, SCTineligible)
Submitted – sNDA; Accelerated Approval; Fast Track; Orphan Drug; Priority Review
06/23/2020
®
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PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
fenfluramine (low dose)
Zogenix
Dravet syndrome
Oral
Submitted – NDA; Fast Track; Orphan Drug; Priority Review
06/25/2020
bupivacaine/meloxicam ER
Heron
Postsurgical pain
Instillation
Submitted – NDA; Breakthrough Therapy; Fast Track
06/26/2020
obeticholic acid (Ocaliva®)
Intercept
NASH
Oral
Submitted – sNDA; Breakthrough Therapy; Priority Review
06/26/2020
octreotide
Chiasma
Acromegaly
Oral
Submitted – 505(b)(2) NDA; Orphan Drug
06/26/2020
pembrolizumab (Keytruda)
Merck
Cutaneous squamous cell carcinoma (recurrent/ metastatic, not curable with surgery/radiation)
IV
Submitted – sBLA
06/29/2020
cedazuridine/decitabine
Otsuka
Chronic myelomonocytic leukemia; Myelodysplastic syndrome
Oral
Submitted – NDA; Orphan Drug; Priority Review
Jul–Aug 2020
selpercatinib
Eli Lilly
NSCLC (RET-altered); Thyroid cancer (RETaltered)
Oral
Submitted – NDA; Breakthrough Therapy; Orphan Drug; Priority Review
Jul–Aug 2020
bevacizumab (biosimilar to Genentech’s Avastin)
Merck/Samsung Bioepis
CRC; Glioblastoma; NSCLC; Ovarian cancer; RCC
IV
Submitted – BLA
Jul–Sep 2020
omalizumab (Xolair®)
Genentech
Nasal polyposis
SC
Submitted – sBLA
Jul–Sep 2020
insulin lispro, ultra rapid
Eli Lilly
T1DM; T2DM
SC
Submitted – BLA
Jul–Oct 2020
remimazolam
Cosmo
Anesthesia
IV
Submitted – NDA
07/05/2020
dantrolene
Eagle
Heat stroke (exertional)
IV
Submitted – sNDA; Fast Track; Orphan Drug
07/08/2020
daratumumab (Darzalex®)
Janssen
Multiple myeloma
SC
Submitted – sBLA
07/10/2020
cantharidin 0.7% solution
Verrica
Molluscum contagiosum
Topical
Submitted – NDA
07/13/2020
guselkumab (Tremfya )
Janssen
PsA
SC
Submitted – sBLA
07/16/2020
oxymetazoline 0.1% solution
Osmotica
Acquired blepharoptosis
Topical
Submitted – NDA
07/16/2020
capsaicin (Qutenza®)
Grünenthal
Diabetic peripheral neuropathy
Topical
Submitted – sNDA
07/19/2020
calcipotriene/ betamethasone dipropionate
MC2
PSO
Topical
Submitted – 505(b)(2) NDA
07/20/2020
sodium oxybate (low dose)
Jazz
Narcolepsy
Oral
Submitted – NDA; Priority Review
07/21/2020
cortrophin (purified gel)
ANI
MS
IV
Submitted – sNDA
07/24/2020
atezolizumab (Tecentriq)
Genentech
HCC (1st-line, unresectable, in combination with bevacizumab)
IV
Submitted – sBLA; Breakthrough Therapy; RTOR
07/27/2020
®
23 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
bevacizumab (Avastin)
Genentech
HCC (1st-line, unresectable, in combination with atezolizumab)
IV
Submitted – sBLA; RTOR
07/27/2020
secukinumab (Cosentyx®)
Novartis
Axial spondyloarthritis (non-radiographic)
SC
Submitted – sBLA; Priority Review
07/29/2020
donepezil transdermal system
Corium
Alzheimer’s disease
Transdermal
Submitted – NDA
07/30/2020
cannabidiol (Epidiolex®)
GW
Tuberous sclerosis complex
Oral
Submitted – sNDA; Orphan Drug; Priority Review
07/31/2020
fluticasone furoate/ umeclidinium bromide/ vilanterol (Trelegy® Ellipta®)
GlaxoSmithKline
Asthma (adults)
Inhaled
Submitted – sNDA
07/31/2020
triheptanoin
Ultrenyx
Fatty acid oxidation disorders
Oral
Submitted – NDA; Fast Track; Orphan Drug
07/31/2020
esketamine (Spravato®)
Janssen
MDD (with suicidal ideation with intent)
Intranasal
Submitted – sNDA; Breakthrough Therapy; Fast Track
08/02/2020
viaskin peanut
DBV
Peanut allergy (ages 4 to 11 years)
Transdermal
Submitted – BLA; Breakthrough Therapy; Fast Track
08/05/2020
ipilimumab (Yervoy®)
Bristol-Myers Squibb
NSCLC (1st-line, metastatic or recurrent, EGFR- and ALK-negative, in combination with nivolumab and limited chemotherapy)
IV
Submitted – sBLA; Fast Track; Priority Review
08/06/2020
nivolumab (Opdivo)
Bristol-Myers Squibb
NSCLC (1st-line, metastatic or recurrent, EGFR- and ALK-negative, in combination with ipilimumab and limited chemotherapy)
IV
Submitted – sBLA; Fast Track; Priority Review
08/06/2020
oliceridine
Trevena
Acute pain
IV
Submitted – NDA; Fast Track
08/07/2020
ustekinumab (Stelara®)
Janssen
PSO (ages 6 to 11 years)
IV, SC
Submitted – sBLA
08/07/2020
KTE-X19
Gilead
Mantle cell lymphoma (relapsed/refractory)
IV
Submitted – BLA; Breakthrough Therapy; Orphan Drug; Priority Review
08/10/2020
capmatinib
Novartis
NSCLC
Oral
Submitted – NDA; Breakthrough Therapy; Orphan Drug; Priority Review
08/11/2020
sodium thiosulfate
Fennec
Chemotherapy-induced ototoxicity prevention
IV
Submitted – NDA; Breakthrough Therapy; Fast Track; Orphan Drug
08/11/2020
ripretinib
Deciphera
GIST (prior treatment with Oral imatinib, sunitinib, and regorafenib)
Submitted – NDA; Breakthrough Therapy; Fast Track; Orphan Drug; Priority Review; RTOR
08/13/2020
24 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
belantamab mafodotin
GlaxoSmithKline
Multiple myeloma (relapsed/refractory)
SC
Submitted – BLA; Breakthrough Therapy; Orphan Drug; Priority Review
08/14/2020
satralizumab
Genentech
Neuromyelitis optica (Devic’s syndrome)
SC
Submitted – BLA; Breakthrough Therapy; Orphan Drug
08/14/2020
dolutegravir/lamivudine (Dovato®)
Viiv
HIV-1 treatment (switch therapy)
Oral
Submitted – sNDA
08/16/2020
lurbinectidin
Mar
SCLC (relapsed)
IV
Submitted – NDA; Accelerated Approval; Orphan Drug; Priority Review
08/16/2020
lisocabtagene maraleucel
Bristol-Myers Squibb
DLBCL (relapsed/ refractory)
IV
Submitted – BLA; 08/17/2020 Breakthrough Therapy; Orphan Drug; Priority Review; RMAT
filgotinib
Gilead
RA
Oral
Submitted – NDA; Priority Review
margetuximab
Macrogenics
Breast cancer (HER2+, in combination with chemotherapy)
IV
Submitted – BLA; Fast 08/19/2020 Track
tucatinib
Seattle Genetics
Breast cancer (locally advanced unresectable, metastatic [including brain], HER2+, in combination with trastuzumab and capecitabine)
Oral
Submitted – NDA; Breakthrough Therapy; Fast Track; Orphan Drug; Priority Review
08/20/2020
valoctocogene roxaparvovec
Biomarin
Hemophilia A
IV
Submitted – BLA; Breakthrough Therapy; Orphan Drug; Priority Review
08/21/2020
veverimer
Tricida
CKD-related metabolic acidosis
Oral
Submitted – NDA
08/22/2020
risdiplam
Genentech
Spinal muscular atrophy (types 1, 2, 3)
Oral
Submitted – NDA; Breakthrough Therapy; Fast Track; Orphan Drug; Priority Review
08/24/2020
bupivacaine
Innocoll
Postsurgical pain
Surgical implantation
Submitted – NDA
08/26/2020
clascoterone
Cassiopea
Acne
Topical
Submitted – NDA
08/27/2020
tafasitamab
Morphosys
DLBCL (relapsed/ refractory, post lenalidomide monotherapy)
IV
Submitted – BLA; Breakthrough Therapy; Fast Track; Orphan Drug; Priority Review
08/28/2020
testosterone undecanoate
Lipocine
Hypogonadism
Oral
Submitted – 505(b)(2) NDA
08/28/2020
HIV vaccine (Remune)
Immune Response Bio
HIV-1 infection treatment (pediatrics)
IM
Submitted – BLA; Orphan Drug
Sep–Dec 2020
25 | magellanrx.com
08/19/2020
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
ibrutinib (Imbruvica®)
Abbvie
CLL/SLL (1st-line, ages < 70 years, in combination with rituximab)
Oral
Submitted – sNDA; Orphan Drug; RTOR
09/08/2020
terlipressin
Mallinckrodt
Hepatorenal syndrome type 1
IV
Submitted – NDA; Fast Track; Orphan Drug
09/12/2020
somapacitan
Novo Nordisk
Growth hormone deficiency (adults)
SC
Submitted – BLA
09/21/2020
diazepam film
Aquestive
Seizure clusters
Oral transmucosal
Submitted – 505(b)(2) NDA; Fast Track; Orphan Drug
09/27/2020
remestemcel-L
Mesoblast
GVHD (steroid-refractory, pediatric)
IV
Submitted – BLA; Fast 09/30/2020 Track; Orphan Drug; Priority Review
linaclotide acetate (Linzess®)
Ironwood
IBS (treatment of abdominal symptoms)
Oral
Submitted – sNDA
October 2020
fostemsavir
Viiv
HIV-1 infection (multidrug-resistant)
Oral
Submitted – NDA; Breakthrough Therapy; Fast Track
Oct–Dec 2020
viltolarsen
Nippon Shinyaku
DMD (exon 53 skipping)
IV
Submitted – NDA; Fast Track; Orphan Drug; Rare Pediatric Disease
Oct–Dec 2020
hydrocortisone granules
Diurnal
Adrenal insufficiency (ages birth to < 17 years)
Oral
Submitted – 505(b)(2) NDA; Orphan Drug
10/02/2020
tramadol
Fortress
Pain (moderate to severe, medically supervised setting)
IV
Submitted – 505(b)(2) NDA
10/09/2020
dolutegravir (Tivicay®) dispersible tablet
Viiv
HIV-1 treatment (pediatrics)
Oral
Submitted – sNDA
10/13/2020
trastuzumab/pertuzumab
Genentech
Breast cancer (HER2+, in combination with chemotherapy)
SC
Submitted – BLA
10/16/2020
rituximab (biosimilar to Genentech’s Rituxan)
Amgen/Allergan
RA; CLL/ SLL; NHL (indolent); Antineutrophil cytoplasmic antibodies associated vasculitis
IV
Submitted – BLA
10/19/2020
zolmitriptan (micro-needle patch)
Zosano
Migraine treatment
Transdermal
Submitted – 505(b)(2) NDA
10/20/2020
eflapegrastim
Spectrum
Neutropenia/leukopenia
SC
Submitted – BLA
10/23/2020
pembrolizumab (Keytruda) - 6-week dosing regimen
Merck
Melanoma; Classical NHL; DLBCL; Gastric cancer; HCC; Merkel cell carcinoma
IV
Submitted – sBLA; Breakthrough Therapy; Orphan Drug
10/23/2020
REGN-EB3
Regeneron
Ebola virus infection treatment
IV
Submitted – BLA; Breakthrough Therapy; Orphan Drug; Priority Review
10/23/2020
estradiol/progesterone
TherapeuticsMD
Menopause (including hormone replacement therapy [HRT])
Oral
Submitted – NDA
November 2020
26 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
niraparib (Zejula®)
GlaxoSmithKline
Ovarian cancer (1stline maintenance, post response to platinumbased chemotherapy)
Oral
Submitted – sNDA; Orphan Drug; RTOR
Nov–Dec 2020
viloxazine
Supernus
ADHD
Oral
Submitted – NDA
11/06/2020
samidorphan/olanzapine
Alkermes
Bipolar disorder; Schizophrenia
Oral
Submitted – NDA
11/13/2020
treprostinil dry powder
Liquidia
PAH
Inhaled
Submitted – 505(b)(2) NDA
11/24/2020
idecabtagene vicleucel
Bristol-Myers Squibb
Multiple myeloma (≥ 3 prior therapies)
IV
Submitted – BLA; Breakthrough Therapy; Orphan Drug
11/30/2020
naxitamab
Y-mAbs
Neuroblastoma (relapsed/ IV refractory, high-risk)
Submitted – BLA; Breakthrough Therapy; Orphan Drug; Priority Review
11/30/2020
nifurtimox
Bayer
Chagas disease
Oral
Submitted – NDA; Orphan Drug
11/30/2020
inclisiran
The Medicines Company
Dyslipidemia (in secondary prevention patients with ASCVD and familial hypercholesterolemia)
SC
Submitted – NDA; Orphan Drug
December 2020
ocrelizumab (Ocrevus®) 2-hour infusion
Genentech
MS (relapsing and primary IV progressive)
Submitted – sBLA
December 2020
tanezumab
Pfizer
Osteoarthritis pain
IV
Submitted – BLA; Fast December Track 2020
berotralstat
Biocryst
Hereditary angioedema
Oral
Submitted – NDA; Fast Track; Orphan Drug
12/03/2020
carfilzomib (Kyprolis®)
Amgen
Multiple myeloma (relapsed/refractory, in combination with daratumumab)
IV
Submitted – sBLA; Orphan Drug
12/10/2020
daratumumab (Darzalex)
Janssen
Multiple myeloma (relapsed/refractory, in combination with carfilzomib)
IV
Submitted – sBLA; Orphan Drug
12/10/2020
roxadustat
AstraZeneca
Anemia due to CKD (dialysis-independent; dialysis-dependent)
Oral
Submitted – NDA
12/20/2020
ansofaxine
Luye
MDD
Oral
Submitted – NDA
12/25/2020
bevacizumab (biosimilar to Genentech’s Avastin)
Mylan/Biocon
CRC; Glioblastoma; NSCLC; Ovarian cancer; RCC
IV
Submitted – BLA
12/25/2020
vibegron
Urovant
Overactive bladder
Oral
Submitted – NDA
12/25/2020
tirbanibulin
Almirall
Actinic keratoses
Topical
Submitted – NDA
12/30/2020
lonafarnib
Eiger Bio
Hutchinson – Gilford Progeria syndrome
Oral
Submitted – NDA; Breakthrough Therapy; Orphan Drug; Rare Pediatric Disease
Jan–Mar 2021
27 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
pralsetinib
Blueprint Medicines
NSCLC (RET-fusion+)
Oral
Submitted – NDA; Breakthrough Therapy; Orphan Drug
Jan–Mar 2021
setmelanotide
Rhythm
Obesity (proopiomelanocortin and leptin receptor deficiency)
SC
Submitted – NDA; Breakthrough Therapy; Orphan Drug
Jan–Mar 2021
peginterferon β-1a (Plegridy®)
Biogen
MS (relasping/remitting, active secondary progressive)
IM
Submitted – sBLA
February 2021
serdexmethylphenidate
Kempharm
ADHD
Oral
Submitted – 505(b)(2) NDA
March 2021
ponesimod
Janssen
MS (relapsing)
Oral
Submitted – NDA
03/18/2021
dasiglucagon
Zealand
Hyperinsulinemia/ hypoglycemia
SC
Submitted – NDA; Orphan Drug
03/31/2021
tivozanib hydrochloride monohydrate
AVEO
RCC (relapsed/refractory)
Oral
Submitted – NDA
03/31/2021
lumasiran
Alnylam
Hyperoxaluria
SC
Submitted – NDA; Breakthrough Therapy; Orphan Drug
Apr–Jun 2021
estetrol/drospirenone
Mayne
Contraception
Oral
Submitted – NDA
04/16/2021
relugolix
Myovant
Prostate cancer (advanced)
Oral
Submitted – NDA
04/21/2021
filgrastim (biosimilar to Amgen’s Neupogen)
Apotex
Neutropenia/leukopenia
IV, SC
Submitted – BLA
Pending
filgrastim (biosimilar to Amgen’s Neupogen)
Kashiv
Neutropenia/leukopenia
IV, SC
Submitted – BLA
Pending
oxycodone ER
Intellipharmaceutics
Chronic pain
Oral
Submitted – 505(b)(2) NDA; Fast Track
Pending
pegfilgrastim (biosimilar to Amgen’s Neulasta)
Apotex
Neutropenia/leukopenia
SC
Submitted – BLA
Pending
5-aminolevulinic acid (Ameluz®)
Biofrontera
Actinic keratoses (with conventional photodynamic therapy)
Topical
Phase 3 – sNDA
TBD
abaloparatide-TD
Radius
Osteoporosis/osteopenia
Transdermal
Phase 3 – NDA
TBD
abametapir
Dr. Reddy’s
Head lice (ages ≥ 6 months)
Topical
Phase 3 – NDA
TBD
abrocitinib
Pfizer
Atopic dermatitis
Oral
Phase 3 – NDA; Breakthrough Therapy
TBD
adalimumab (biosimilar to Abbvie’s Humira)
Coherus
RA; AS; PSO; PsA; JIA; CD; UC
SC
Phase 3 – BLA
TBD
adalimumab (biosimilar to Abbvie’s Humira)
Fresenius
RA; AS; PSO; PsA; JIA; CD; UC
SC
Phase 3 – BLA
TBD
adalimumab (biosimilar to Abbvie’s Humira)
Momenta
RA; AS; PSO; PsA; JIA; CD; UC
SC
Phase 3 – BLA
TBD
adalimumab (biosimilar to Abbvie’s Humira)
Mylan
RA; AS; PSO; PsA; JIA; CD; UC
SC
Phase 3 – BLA
TBD
28 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
ado-trastuzumab emtansine (Kadcyla®)
Genentech
Breast cancer (HER2+, adjuvant, with pertuzumab)
IV
Phase 3 – sBLA; Breakthrough Therapy
TBD
aducanumab
Biogen
Alzheimer’s disease
IV
Phase 3 – BLA; Fast Track
TBD
aflibercept (biosimilar to Regeneron’s Eylea®)
Mylan
Diabetic macular edema
Intraocular
Phase 3 – BLA
TBD
albuterol (ProAir® RespiClick®)
Teva
COPD
Inhaled
Phase 3 – sNDA
TBD
albutrepenonacog alfa (Idelvion®)
CSL
Hemophilia B (21-day dosing schedule)
IV
Phase 3 – sBLA; Orphan Drug
TBD
alicaforsen
Atlantic Healthcare
UC (pouchitis)
Rectal
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
alpha 1 proteinase inhibitor
Kamada
Emphysema
Inhaled
Phase 3 – BLA; Orphan Drug
TBD
andolast
Mylan
Asthma
Inhaled
Phase 3 – NDA
TBD
anifrolumab
AstraZeneca
SLE
IV
Phase 3 – BLA; Fast Track
TBD
antolimab
Allakos
Gastroenteritis (eosinophilic esophagitis)
IV
Phase 3 – BLA; Orphan Drug
TBD
apalutamide (Erleada®)
Janssen
Prostate cancer (metastatic, castrationresistant); Prostate cancer (localized)
Oral
Phase 3 – sNDA
TBD
APR-246
Aprea
Myelodysplastic IV syndrome (with susceptible TP5 mutation)
Phase 3 – NDA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
arimoclomol
Orphazyme
Niemann-Pick disease
Oral
Phase 3 – NDA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
asciminib
Novartis
Chronic myelogenous leukemia (CML)
Oral
Phase 3 – NDA; Orphan Drug
TBD
ataluren
PTC
DMD
Oral
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
atezolizumab (Tecentriq)
Genentech
CRC; RCC; Melanoma; Ovarian cancer; NSCLC (adjuvant); NSCLC (neoadjuvant); Bladder cancer (1st-line metastatic); Bladder cancer (adjuvant muscle-invasive); Breast cancer (TNBC, neoadjuvant, with nabpaclitaxel); Breast cancer (1st-line, TNBC, with paclitaxel)
IV
Phase 3 – sBLA; Breakthrough Therapy; Orphan Drug
TBD
autologous genetically modified human dermal fibroblasts
Castle Creek
Epidermolysis bullosa
Intradermal
Phase 3 – BLA; Fast Track; Orphan Drug; RMAT
TBD
avacopan
Chemocentryx
ANCA-associated vasculitis
Oral
Phase 3 – NDA; Orphan Drug
TBD
29 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
avalglucosidase alfa
Sanofi
Pompe disease
IV
Phase 3 – BLA
TBD
avatrombopag (Doptelet®)
Ararx
Thrombocytopenia (chemotherapy-induced)
Oral
Phase 3 – sNDA; Orphan Drug
TBD
azacitidine
Bristol-Myers Squibb
AML
Oral
Phase 3 – NDA
TBD
baclofen/naltrexone/ sorbitol
Pharnext
Charcot-Marie-Tooth disease
Oral
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
baricitinib (Olumiant®)
Eli Lilly
Atopic dermatitis; SLE; Alopecia; JIA; Uveitis
Oral
Phase 3 – sNDA; Breakthrough Therapy; Fast Track
TBD
bedaquiline (Sirturo®)
Janssen
Tuberculosis (ages 5 to 11 years, multidrugresistant)
Oral
Phase 3 – sNDA; Fast Track; Orphan Drug
TBD
belimumab (Benlysta®)
GlaxoSmithKline
Lupus nephritis
IV
Phase 3 – sBLA
TBD
benralizumab (Fasenra®)
AstraZeneca
Nasal polyposis
SC
Phase 3 – sBLA
TBD
betibeglogene autotemcel (Zynteglo)
Bluebird Bio
Thalassemia
IV
Phase 3 – BLA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
bevacizumab
Outlook
Wet AMD
Intraocular
Phase 3 – BLA
TBD
bevacizumab (biosimilar to Genentech’s Avastin)
Bio-Thera Solutions
CRC; Glioblastoma; NSCLC; Ovarian cancer; RCC
IV
Phase 3 – BLA
TBD
bevacizumab (biosimilar to Genentech’s Avastin)
Boehringer Ingelheim
CRC; Glioblastoma; NSCLC; Ovarian cancer; RCC
IV
Phase 3 – BLA
TBD
bevacizumab (biosimilar to Genentech’s Avastin)
Kyowa Kirin
CRC; Glioblastoma; NSCLC; Ovarian cancer; RCC
IV
Phase 3 – BLA
TBD
bexagliflozin
Theracos
T2DM
Oral
Phase 3 – NDA
TBD
bimekizumab
UCB
Axial spondyloarthritis; PsA; PSO
IV
Phase 3 – BLA
TBD
biotin (high dose)
Medday
MS
Oral
Phase 3 – NDA
TBD
brexpiprazole (Rexulti®)
Otsuka
Alzheimer’s diseaserelated agitation
Oral
Phase 3 – sNDA; Fast Track
TBD
budenoside
Calliditas
Immunoglobulin A (IgA) nephropathy (Berger’s disease)
Oral
Phase 3 – NDA; Orphan Drug
TBD
cabotegravir (long-acting)
Viiv
HIV-1 infection preexposure prevention (PrEP)
IM
Phase 3 – NDA
TBD
cabozantinib (Cabometyx®)
Exelixis
RCC (1st-line, with nivolumab)
Oral
Phase 3 – sNDA
TBD
calmangafodipir
Pledpharma
Chemotherapy-induced peripheral neuropathy
IV
Phase 3 – NDA
TBD
cannabidiol (Epidiolex)
GW
Rett syndrome
Oral
Phase 3 – sNDA
TBD
cannabidiol gel
Zynerba
Fragile X syndrome
Topical
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
capsaicin
Centrexion
Osteoarthritis
Intraarticular
Phase 3 – NDA; Fast Track
TBD
carglumic acid
Recordati
Hyperammonemia (genetic autosomal disorder-related)
Oral
Phase 3 – NDA; Orphan Drug
TBD
30 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
casimersen
Sarepta
DMD
IV
Phase 3 – NDA
TBD
CD24Fc
Oncoimmune
COVID-19
IV
Phase 3 – BLA
TBD
cedazuridine/decitabine
Otsuka
AML
Oral
Phase 3 – NDA
TBD
cediranib
AstraZeneca
Ovarian cancer
Oral
Phase 3 – NDA; Orphan Drug
TBD
cefiderocol (Fetroja®)
Shionogi
HAP
IV
Phase 3 – sNDA
TBD
ceftobiprole medocaril
Basilea
ABSSSI
IV
Phase 3 – NDA; Fast Track; QIDP
TBD
cenicriviroc mesylate
Allergan
NASH
Oral
Phase 3 – NDA; Fast Track
TBD
CM-AT
Curemark
Autism spectrum disorders
Oral
Phase 3 – BLA; Fast Track
TBD
conbercept
Chengdu Kanghong
Wet AMD
Intraocular
Phase 3 – BLA
TBD
crisantaspase (recombinant)
Jazz
ALL
IM, IV
Phase 3 – BLA; Fast Track
TBD
cyclic pyranopterin monophosphate
Bridgebio
Molybdenum cofactor deficiency (MoCD)
IV
Phase 3 – NDA; Breakthrough Therapy; Orphan Drug
TBD
dalcetrapib
Dalcor
Dyslipidemia/ hypercholesterolemia
Oral
Phase 3 – NDA
TBD
daprodustat
GlaxoSmithKline
Anemia due to CKD (dialysis-independent)
Oral
Phase 3 – NDA
TBD
daratumumab rHuPH20
Janssen
Amyloidosis
SC
Phase 3 – BLA
TBD
dehydrated human Mimedx amnion-chorion membrane
Achilles tendonitis; Plantar fasciitis
IV
Phase 3 – BLA
TBD
denosumab (biosimilar to Amgen’s Prolia®)
Novartis
Osteoporosis/osteopenia
SC
Phase 3 – BLA
TBD
deramanido
Otsuka
Tuberculosis
Oral
Phase 3 – NDA
TBD
dexmedetomidine
Bioxcel
Schizophrenia
SL/Oral transmucosal
Phase 3 – NDA; Fast Track
TBD
dianhydrogalactitol
Delmar
Brain cancer
IV
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
difelikefalin
Enteris
Pruritus (hemodialysisrelated)
IV
Phase 3 – NDA; Breakthrough Therapy
TBD
digoxin immune Fab
AMAG
Eclampsia/pre-eclampsia
IV
Phase 3 – BLA; Fast Track; Orphan Drug
TBD
docosahexaenoic acid
Micelle
Sickle cell disease
Oral
Phase 3 – NDA; Orphan Drug
TBD
donaperminogene seltoplasmid
Helixmith
Diabetic foot ulcers
IM
Phase 3 – BLA; RMAT
TBD
dovitinib lactate
Oncology Venture
RCC
Oral
Phase 3 – NDA
TBD
dupilumab (Dupixent)
Sanofi
COPD; Esophagitis
SC
Phase 3 – sBLA; Orphan Drug
TBD
durvalumab (Imfinzi®)
AstraZeneca
Bladder cancer (in combination with tremelimumab); NSCLC (1st-line, in combination with tremelimumab)
IV
Phase 3 – sBLA
TBD
31 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
dusquetide
Soligenix
Mucositis
IV
Phase 3 – NDA; Fast Track
TBD
dust mite immunotherapy
Stallergenes
Allergic rhinitis
SL/Oral transmucosal
Phase 3 – BLA
TBD
edasalonexent
Catabasis
DMD
Oral
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
efgartigimod
Argenx
Myasthenia gravis; Immune thrombocytopenic purpura
IV, SC
Phase 3 – BLA; Fast Track; Orphan Drug
TBD
efpeglenatide
Hanmi
T2DM
SC
Phase 3 – NDA
TBD
elafibranor
Genfit
NASH
Oral
Phase 3 – NDA; Fast Track
TBD
elivaldogene tavalentivec (Lenti-D)
Bluebird Bio
Adrenomyeloneuropathy (adrenoleukodystrophy)
IV
Phase 3 – BLA; Breakthrough Therapy; Orphan Drug
TBD
empagliflozin (Jardiance®)
Boehringer Ingelheim
Diabetic nephropathy
Oral
Phase 3 – sNDA
TBD
enmetazobactam
Allecra
UTI (complicated)
IV
Phase 3 – NDA; Fast Track; QIDP
TBD
entinostat
Syndax
Breast cancer
Oral
Phase 3 – NDA; Breakthrough Therapy
TBD
EP-2101 vaccine
OSE Immunotherapeutics
NSCLC
SC
Phase 3 – NDA; Orphan Drug
TBD
erdosteine
Alitair
COPD
Oral
Phase 3 – NDA
TBD
estetrol
Mithra
Menopausal vasomotor symptoms
Oral
Phase 3 – NDA
TBD
etanercept (biosimilar to Amgen’s Enbrel)
Coherus
RA; JIA; AS; PSO; PsA
SC
Phase 3 – BLA
TBD
etranacogene dezaparvovec
Uniqure
Hemophilia B
IV
Phase 3 – BLA; Breakthrough Therapy
TBD
etrasimod
Arena
UC
Oral
Phase 3 – NDA
TBD
etrolizumab
Genentech
CD; UC
SC
Phase 3 – BLA; Orphan Drug
TBD
evinacumab
Regeneron
Dyslipidemia/ hypercholesterolemia
SC
Phase 3 – BLA; Breakthrough Therapy
TBD
fasinumab
Regeneron
Osteoarthritis
SC
Phase 3 – BLA
TBD
fenfluramine (low dose)
Zogenix
Lennox-Gastaut syndrome
Oral
Phase 3 – NDA; Orphan Drug
TBD
fexapotide triflutate
Nymox
Benign prostatic hyperplasia
Intratumoral
Phase 3 – NDA
TBD
fezolinetant
Astellas
Menopause vasomotor symptoms
Oral
Phase 3 – NDA
TBD
filgotinib
Gilead
PsA; CD; UC
Oral
Phase 3 – NDA
TBD
fitusiran
Sanofi
Hemophilia A and B (with and without inhibitors)
SC
Phase 3 – NDA; Orphan Drug
TBD
fluocinolone (Iluvien®)
Alimera
Uveitis (chronic noninfectious)
Intraocular
Phase 3 – sNDA; Orphan Drug
TBD
32 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
follitropin alfa (biosimilar to EMD Serono’s Gonal-F®)
Allergan
Reproductive disorder
SC
Phase 3 – BLA
TBD
follitropin alfa (biosimilar to EMD Serono’s Gonal-F)
Finox
Reproductive disorder
SC
Phase 3 – BLA
TBD
follitropin delta
Ferring
Female infertility
IV
Phase 3 – BLA
TBD
fusidic acid
Arrevus
ABSSSI
Oral
Phase 3 – NDA; Orphan Drug; QIDP
TBD
gefapixant
Merck
Chronic cough
Oral
Phase 3 – NDA
TBD
gepotidacin
GlaxoSmithKline
UTI (uncomplicated)
Oral
Phase 3 – NDA; QIDP
TBD
givinostat
Italfarmaco
DMD
Oral
Phase 3 – NDA
TBD
glatiramer acetate depot
Mylan
MS
IM
Phase 3 – 505(b)(2) NDA
TBD
GLPG1690
Galapos
Idiopathic pulmonary fibrosis
Oral
Phase 3 – NDA; Orphan Drug
TBD
glycopyrronium bromide (Seebri Neohaler®)
Sumitomo Dainippon
Asthma
Inhaled
Phase 3 – sNDA
TBD
HLCM051
Athersys
COVID-19
IV
Phase 3 – BLA
TBD
hydrogen peroxide (Eskata®)
Aclaris
Warts
Topical
Phase 3 – sNDA
TBD
hydroxychloroquine
National Institutes of Health
COVID-19
Oral
Phase 3 – NDA
TBD
ibrexafungerp
Scynexis
Fungal infections (systemic and nonsystemic)
Oral
Phase 3 – NDA; Fast Track; Orphan Drug; QIDP
TBD
iclaprim
Motif Bio
ABSSSI; HAP
IV
Phase 3 – NDA; Fast Track; QIDP
TBD
idasanutlin
Genentech
AML
Oral
Phase 3 – NDA
TBD
idebenone
Santhera
DMD
Oral
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
idursulfase
Takeda
Mucopolysaccharidosis II (Hunter syndrome)
Intrathecal
Phase 3 – BLA; Fast Track; Orphan Drug
TBD
immunoglobulin IV 10%
Prometic Life Sciences
Primary immunodeficiencies
IV
Phase 3 – BLA
TBD
infliximab (biosimilar to Janssen’s Remicade)
Nichi-Iko
RA; AS; PSO; PsA; CD; UC
IV
Phase 3 – BLA
TBD
insulin aspart (biosimilar to Novo Nordisk’s Novolog®)
Mylan
T1DM; T2DM
SC
Phase 3 – BLA
TBD
insulin aspart (biosimilar to Novo Nordisk’s Novolog)
Sanofi
T1DM; T2DM
SC
Phase 3 – BLA
TBD
insulin glargine (biosimilar to Sanofi’s Lantus)
Gan & Lee
T1DM; T2DM
SC
Phase 3 – BLA
TBD
iodine I-131 monoclonal antibody
Actinium
Myeloablation (prior to allogeneic HSCT to treat AML)
IV
Phase 3 – BLA; Orphan Drug
TBD
ipatasertib
Genentech
Breast cancer; Prostate cancer
Oral
Phase 3 – NDA
TBD
lacosamide (Vimpat®)
UCB
Partial seizures
IV, Oral
Phase 3 – sNDA
TBD
L-citrulline
Asklepion
Acute lung injury
IV
Phase 3 – NDA; Orphan Drug
TBD
lebrikizumab
Dermira
Atopic dermatitis
SC
Phase 3 – BLA; Fast Track
TBD
33 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
lenadogene nolparvovec (GS010)
Gensight
Leber’s hereditary optic neuropathy
Intraocular
Phase 3 – BLA; Orphan Drug
TBD
leriglitazone
Minoryx
Adrenomyeloneuropathy (adrenoleukodystrophy)
Oral
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
leronlimab
Cytodyn
HIV-1 infection treatment; SC COVID-19
Phase 3 – BLA; Fast Track
TBD
levodopa/carbidopa (patch pump)
Mitsubishi Tanabe
Parkinson’s disease
SC
Phase 3 – 505(b)(2) NDA
TBD
levoketoconazole
Strongbridge
Cushing’s syndrome
Oral
Phase 3 – 505(b)(2) NDA; Orphan Drug
TBD
ligelizumab
Novartis
Urticaria
SC
Phase 3 – BLA
TBD
linzagolix
Obseva
Endometriosis; Uterine fibroids
Oral
Phase 3 – NDA
TBD
L-lactic acid/citric acid/ potassium bitartrate
Evofem
Urogenital chlamydia and gonorrhea prevention in women
Intravaginal
Phase 3 – NDA; Fast Track; QIDP
TBD
lonafarnib
Eiger
Hepatitis D infection
Oral
Phase 3 – NDA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
Samumed
Osteoarthritis (knee)
Intraarticular
Phase 3 – NDA
TBD
lumateperone (Caplyta )
Intra-Cellular Therapies
Bipolar disorder
Oral
Phase 3 – sNDA
TBD
lutetium 177Lu-PSMA-617
Novartis
Prostate cancer
IV
Phase 3 – NDA
TBD
LYS-SAF302
Sarepta
Mucopolysaccharidosis IIIA (Sanfilippo A syndrome)
Intracerebral
Phase 3 – BLA; Fast Track; Orphan Drug
TBD
maribavir
Takeda
Cytomegalovirus infection treatment
Oral
Phase 3 – NDA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
marstacimab
Pfizer
Hemophilia A and B
SC
Phase 3 – BLA; Orphan Drug
TBD
masitinib
AB Science
Asthma (eosinophilic); Alzheimer’s disease; MS (primary progressive, non-active secondary); Pancreatic cancer; Prostate cancer
Oral
Phase 3 – NDA; Orphan Drug
TBD
mavacamten
Myokardia
Obstructive hypertrophic cardiomyopathy
Oral
Phase 3 – NDA; Orphan Drug
TBD
melflufen
Oncopeptides
Multiple myeloma
IV
Phase 3 – NDA; Orphan Drug
TBD
meloxicam/rizatriptan
Axsome
Migraine treatment
Oral
Phase 3 – 505(b)(2) NDA
TBD
mepolizumab (Nucala®)
GlaxoSmithKline
COPD
SC
Phase 3 – sBLA
TBD
meropenem/vaborbactam (Vabomere®)
Melinta
HAP; Bacteremia
IV
Phase 3 – sNDA; QIDP TBD
metachromatic leukodystrophy gene therapy
Orchard
Metachromatic leukodystrophy
IV
Phase 3 – BLA; Orphan Drug
lorecivivint ®
34 | magellanrx.com
TBD
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
microbiota suspension
Ferring
Clostridium difficile infection (recurrent)
Rectal
Phase 3 – BLA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
mirikizumab
Eli Lilly
PSO; CD; UC
IV, SC
Phase 3 – BLA
TBD
mirvetuximab soravtansine
Immunogen
Ovarian cancer
IV
Phase 3 – BLA; Fast Track; Orphan Drug
TBD
molgramostim
Savara
Pulmonary alveolar proteinosis
Inhaled
Phase 3 – BLA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
nadofaragene firadenovec
Trizell
Mesothelioma
Percutaneous catheter/ Injection
Phase 3 – BLA
TBD
nalbuphine ER
Trevi
Pruritus
Oral
Phase 3 – NDA
TBD
napabucasin
Sumitomo Dainippon
CRC
Oral
Phase 3 – NDA
TBD
narsoplimab
Omeros
HSCT-associated thrombotic microangiopathy
SC
Phase 3 – BLA; Breakthrough Therapy; Orphan Drug
TBD
natalizumab (biosimilar to Biogen’s Tysabri®)
Novartis
MS
IV
Phase 3 – BLA
TBD
niraparib (Zejula®)
GlaxoSmithKline
Ovarian cancer (in combination with dostarlimab)
Oral
Phase 3 – sNDA
TBD
nirsevimab
AstraZeneca
RSV infection prevention
IM, IV
Phase 3 – BLA; Breakthrough Therapy; Fast Track
TBD
nitric oxide
Mallinckrodt
Bronchopulmonary dysplasia
Inhaled
Phase 3 – NDA
TBD
nitric oxide
Novan
Molluscum contagiosum
Topical
Phase 3 – NDA
TBD
olaparib (Lynparza)
AstraZeneca
Ovarian cancer (adjuvant); Oral Ovarian cancer (BRCA mutated)
Phase 3 – sNDA; Orphan Drug
TBD
olipudase alfa
Sanofi
Niemann-Pick disease
IV
Phase 3 – BLA; Breakthrough Therapy; Orphan Drug
TBD
omalizumab (Xolair)
Genentech
Peanut allergy
SC
Phase 3 – sBLA; Breakthrough Therapy
TBD
omidubicel
Gamida Cell
Hematologic cancer
IV
Phase 3 – BLA; Breakthrough Therapy; Orphan Drug
TBD
onasemnogene abeparvovac-xioi (Zolgensma®)
Novartis
Spinal muscular atrophy (type 2, 3)
IV, Intrathecal
Phase 3 – sBLA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
ondansetron ER (oncedaily)
Redhill
Gastroenteritis
Oral
Phase 3 – 505(b)(2) NDA
TBD
oportuzumab monatox
Sesen Bio
Bladder cancer (BCGunresponsive, nonmuscle invasive)
Intravesical
Phase 3 – BLA; Fast Track
TBD
35 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
OTL-103
Orchard
Thrombocytopenia
IV
Phase 3 – BLA; Orphan Drug; RMAT
TBD
oxalobacter formigenes
Oxthera
Hyperoxaluria
Oral
Phase 3 – BLA; Orphan Drug
TBD
ozanimod
Celgene
CD; UC
Oral
Phase 3 – NDA
TBD
paliperidone (6-month injectable)
Janssen
Schizophrenia
IM
Phase 3 – NDA
TBD
palovarotene
Ipsen
Fibrodysplasia ossificans progressive
Oral
Phase 3 – NDA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
pamrevlumab
Fibrogen
Idiopathic pulmonary fibrosis
IV
Phase 3 – BLA; Fast Track; Orphan Drug
TBD
pegcetacoplan
Apellis
Paroxysmal nocturnal hemoglobinuria
SC
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
pegunigalsidase alfa
Chiesi
Fabry’s disease
IV
Phase 3 – BLA; Fast Track
TBD
pegzilarginase
Aeglea
Arginase 1 deficiency
IV
Phase 3 – BLA; Breakthrough Therapy
TBD
pertuzumab (Perjeta®)
Genentech
Breast cancer (HER2+, adjuvant, with adotrastuzumab)
IV
Phase 3 – sBLA
TBD
PF-06651600
Pfizer
Alopecia areata
Oral
Phase 3 – NDA; Breakthrough Therapy
TBD
pimecrolimus lotion
Bausch
Atopic dermatitis
Topical
Phase 3 – NDA
TBD
pimodivir
Janssen
Influenza treatment
Oral
Phase 3 – NDA; Fast Track
TBD
pineapple proteolytic enzymes extract
Mediwound
Burn injury
Topical
Phase 3 – BLA; Orphan Drug
TBD
pirfenidone (Esbriet®)
Genentech
Idiopathic pulmonary fibrosis (adults with unclassifiable interstitial lung disease [uILD])
Oral
Phase 3 – sNDA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
plinabulin
Beyondspring
Neutropenia/leukopenia; NSCLC
IV
Phase 3 – NDA
TBD
pneumococcal 15-valent conjugate vaccine
Merck
Invasive pneumococcal disease prevention
IM
Phase 3 – BLA; Breakthrough Therapy
TBD
polatuzumab vedotin-piiq (Polivy®)
Genentech
DLBLC (1st-line)
IV
Phase 3 – sBLA; Orphan Drug
TBD
pollinex quattro grass
Allergy Therapeutics
Allergic rhinitis
SC
Phase 3 – BLA
TBD
prasterone (Intrarosa )
AMAG
Female sexual arousal disorder
Intravaginal
Phase 3 – sNDA
TBD
ranibizumab (biosimilar to Genentech’s Lucentis®)
Samsung Bioepis
Wet AMD
Intraocular
Phase 3 – BLA
TBD
ranibizumab (biosimilar to Genentech’s Lucentis)
Santo
Wet AMD
Intraocular
Phase 3 – BLA
TBD
ranibizumab (biosimilar to Genentech’s Lucentis)
STADA Arzneimittel
Wet AMD
Intraocular
Phase 3 – BLA
TBD
®
36 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
ravulizumab-cwvz (athome, weekly dose) (Ultomiris®)
Alexion
Paroxysmal nocturnal hemoglobinuria
SC
Phase 3 – sBLA; Orphan Drug
TBD
reltecimod
Atox
Necrotizing soft tissue infection
IV
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
relugolix
Myovant
Endometriosis; Uterine fibroids
Oral
Phase 3 – NDA
TBD
remdesivir
Gilead
COVID-19
IV
Phase 3 – NDA
TBD
remestemcel-L
Mesoblast
CD; COVID-19
IV
Phase 3 – BLA; Fast Track
TBD
reproxalap
Aldeyra
Congenital ichthyosis
Topical
Phase 3 – NDA; Orphan Drug
TBD
resmetirom
Madrigal
NASH
Oral
Phase 3 – NDA; Fast Track
TBD
ridinilazole
Summit
C. difficile-associated diarrhea
Oral
Phase 3 – NDA; Fast Track; QIDP
TBD
risankizumab-rzaa (Skyrizi®)
Abbvie
PsA; CD; UC
SC
Phase 3 – sBLA; Orphan Drug
TBD
rituximab (biosimilar to Genentech’s Rituxan)
Archigen
RA; CLL/SLL; NHL (indolent); Antineutrophil cytoplasmic antibodies associated vasculitis
IV
Phase 3 – BLA
TBD
rituximab (biosimilar to Genentech’s Rituxan)
Teva
RA; CLL/SLL; NHL (indolent); Antineutrophil cytoplasmic antibodies associated vasculitis
IV
Phase 3 – BLA
TBD
rivoceranib
LSK Biopartners
Gastric cancer
Oral
Phase 3 – NDA; Orphan Drug
TBD
ropeginterferon alfa-2b
Essentia
Polycythemia vera
SC
Phase 3 – BLA; Orphan Drug
TBD
roxadustat
AstraZeneca
Anemia due to oncology treatment
Oral
Phase 3 – NDA
TBD
rozanolixizumab
UCB
Myasthenia gravis
SC
Phase 3 – BLA
TBD
RSV nanoparticle vaccine
Novavax
RSV infection prevention
IM
Phase 3 – BLA; Fast Track
TBD
ruxolitinib (Jakafi®)
Incyte
COVID-19
Oral
Phase 3 – sNDA
TBD
ruxolitinib cream
Incyte
Atopic dermatitis; Vitiligo
Topical
Phase 3 – NDA
TBD
sacubitril/valsartan (Entresto®)
Novartis
Heart failure with preserved ejection fraction (HFpEF); Postacute myocardial infarction
Oral
Phase 3 – sNDA; Fast Track
TBD
sarilumab (Kevzara®)
Sanofi
COVID-19
SC
Phase 3 – sBLA
TBD
seladelpar
Cymabay
Primary biliary cholangitis/hepatic fibrosis
Oral
Phase 3 – NDA; Breakthrough Therapy; Orphan Drug
TBD
selinexor (Xpovio®)
Karyopharm
Multiple myeloma (with bortezomib and dexamethasone)
Oral
Phase 3 – sNDA; Orphan Drug
TBD
semaglutide (Ozempic®)
Novo Nordisk
Obesity
SC
Phase 3 – sNDA
TBD
37 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
sepofarsen
Proqr
Leber’s congenital amaurosis
Intraocular
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
sodium hyaluronate/ triamcinolone hexacetonide
Anika
Osteoarthritis (knee)
Intraarticular
Phase 3 – NDA
TBD
sodium oxybate (oncenightly dosing)
Avadel
Narcolepsy
Oral
Phase 3 – 505(b)(2) NDA; Orphan Drug
TBD
sofpironium bromide
Brickell
Axillary hyperhidrosis
Topical
Phase 3 – NDA
TBD
somatrogon
Opko
Growth hormone deficiency (pediatric)
SC
Phase 3 – BLA; Orphan Drug
TBD
sotagliflozin
Lexicon
T2DM
Oral
Phase 3 – NDA
TBD
sparsentan
Retrophin
Focal segmental glomerulosclerosis
Oral
Phase 3 – NDA; Orphan Drug
TBD
spartalizumab
Novartis
Melanoma
IV
Phase 3 – BLA
TBD
sulopenem
Iterum
UTI (uncomplicated)
IV, Oral
Phase 3 – NDA; Fast Track; QIDP
TBD
sutimlimab
Sanofi
Cold agglutinin disease
IV
Phase 3 – BLA; Breakthrough Therapy; Orphan Drug
TBD
suvodirsen
Wave Life Sciences
DMD
IV
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
tabelecleucel
Atara
Epstein-Barr virus-associated post-transplant lymphoproliferative disease
IV
Phase 3 – BLA; Breakthrough Therapy; Orphan Drug
TBD
tanezumab
Pfizer
Cancer pain; Chronic low back pain
SC
Phase 3 – BLA; Fast Track
TBD
Roivant
PSO
Topical
Phase 3 – NDA
TBD
tasimelteon (Hetlioz )
Vanda
Smith-Magenis syndrome
Oral
Phase 3 – sNDA; Orphan Drug
TBD
taurolidine
Cormedix
Prevention of catheterrelated bloodstream infection in hemodialysis patients
IV
Phase 3 – NDA; Fast Track; QIDP
TBD
Espero
Anticoagulation
Oral
Phase 3 – NDA
TBD
tecovirimat (Tpoxx )
SIGA
Smallpox
IV
Phase 3 – sNDA; Fast Track; Orphan Drug
TBD
tenapanor (Ibsrela®)
Ardelyx
Hyperphosphatemia (in CKD patients on dialysis)
Oral
Phase 3 – sNDA
TBD
teplizumab
Provention Bio
T1DM (prevention or delay)
IV
Phase 3 – BLA; Breakthrough Therapy
TBD
teprasiran
Quark
Delayed graft function; Kidney injury prevention following cardiac surgery
IV
Phase 3 – NDA; Orphan Drug
TBD
teriflunomide
Sanofi
MS (pediatrics)
Oral
Phase 3 – NDA
TBD
tezepelumab
AstraZeneca
Asthma
SC
Phase 3 – BLA; Breakthrough Therapy
TBD
ticagrelor (Brilinta)
AstraZeneca
Sickle cell disease
Oral
Phase 3 – sNDA
TBD
tapinarof ®
tecarfarin ®
38 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
timbetasin
Regenerx
Dry eye syndrome
Ophthalmic
Phase 3 – NDA
TBD
timrepigene emparvovec
Biogen
Choroideremia
Intraocular
Phase 3 – BLA; Orphan Drug; RMAT
TBD
tirzepatide
Eli Lilly
T1DM
SC
Phase 3 – NDA
TBD
tisagenlecleucel-t (Kymriah™)
Novartis
DLBCL (relapsed/ refractory in 1st relapse)
IV
Phase 3 – sBLA; Breakthrough Therapy; Orphan Drug
TBD
tofersen
Biogen
Amyotrophic lateral sclerosis
Intrathecal
Phase 3 – NDA; Orphan Drug
TBD
tonogenchoncel-L
Kolon Tissuegene
Osteoarthritis
Intraarticular
Phase 3 – BLA
TBD
tradipitant
Vanda
Atopic dermatitis; Gastroparesis; Pruritus; COVID-19
Oral
Phase 3 – NDA
TBD
tralokinumab
AstraZeneca
Atopic dermatitis
SC
Phase 3 – BLA
TBD
transcon PEG growth hormone
Ascendis
Growth hormone deficiency
SC
Phase 3 – BLA
TBD
trastuzumab (biosimilar to Genentech’s Herceptin)
Novartis
Breast cancer; Gastric/ gastroesophageal cancer
IV
Phase 3 – BLA
TBD
trastuzumab (biosimilar to Genentech’s Herceptin)
Tanvex
Breast cancer; Gastric/ gastroesophageal cancer
IV
Phase 3 – BLA
TBD
tripotassium citrate monohydrate/potassium hydrogen carbonate microtablet
Advicenne
Renal tubular acidosis
Oral
Phase 3 – NDA
TBD
trivalent hepatitis B vaccine
VBI Vaccines
Hepatitis B prevention
IM
Phase 3 – BLA
TBD
trofinetide
Acadia
Rett syndrome
Oral
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
ublituximab
TG
CLL/SLL; MS
IV
Phase 3 – BLA; Orphan Drug
TBD
udenafil
Allergan
Congenital single ventricle heart disease (adolescents)
Oral
Phase 3 – NDA; Orphan Drug
TBD
umbralisib
TG
CLL/SLL; DLBCL; Indolent NHL; Marginal zone lymphoma
Oral
Phase 3 – NDA; Breakthrough Therapy; Orphan Drug
TBD
upadacitinib (Rinvoq™)
Abbvie
Atopic dermatitis; Axial spondyloarthritis; PsA; CD; UC; Giant cell arteritis
Oral
Phase 3 – sNDA; Breakthrough Therapy
TBD
ustekinumab (Stelara)
Janssen
SLE
IV, SC
Phase 3 – sBLA
TBD
vadadustat
Akebia
Anemia due to CKD (dialysis-independent)
Oral
Phase 3 – NDA
TBD
vazegepant
Biohaven
Migraine treatment; COVID-19
Intranasal
Phase 3 – NDA
TBD
veliparib
Abbvie
Breast cancer
Oral
Phase 3 – NDA
TBD
vilanterol trifenatate
GlaxoSmithKline
Asthma; COPD
Inhaled
Phase 3 – NDA
TBD
visomitin
Mitotech
Dry eye syndrome
Ophthalmic
Phase 3 – NDA
TBD
vocimagene amiretrorepvec
Tocen
Brain cancer (malignant glioma; glioblastoma)
Intratumoral
Phase 3 – BLA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
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PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
voclosporin
Aurinia
Lupus nephritis
Oral
Phase 3 – NDA; Fast Track
TBD
volanesorsen
Akcea
Familial chylomicronemia syndrome
SC
Phase 3 – NDA; Orphan Drug
TBD
vonoprazan
Phathom
Helicobacter pylori infection
Oral
Phase 3 – NDA; QIDP
TBD
vosoritide
Biomarin
Achondroplasia
SC
Phase 3 – NDA; Orphan Drug
TBD
vutrisiran
Alnylam
Transthyretin amyloid cardiomyopathy (ATTR-CM, wild-type or hereditary)
SC
Phase 3 – NDA; Orphan Drug
TBD
zanubrutinib (Brukinsa®)
Beigene
Waldenstrom macroglobulinemia
Oral
Phase 3 – sNDA; Fast Track; Orphan Drug
TBD
zilucoplan
Ra
Myasthenia gravis
SC
Phase 3 – NDA; Orphan Drug
TBD
zoliflodacin
Entasis
Gonorrhea
Oral
Phase 3 – NDA; Fast Track; QIDP
TBD
Complete Response Letter (CRL)/Withdrawn Drugs NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
empagliflozin (Jardiance)
Boehringer Ingelheim
T1DM
Oral
CRL
TBD
exenatide SC pump
Intarcia
T2DM
SC
CRL
TBD
lamotrigine oral liquid
Eton
Partial seizures; Primary generalized tonic-clonic seizures; Lennox-Gastaut syndrome
Oral
CRL
TBD
paclitaxel injection concentrate for suspension
Sun Advanced Research
Breast cancer
IV
CRL
TBD
ranibizumab (biosimilar to Genentech’s Lucentis)
Santo
Wet AMD
Intraocular
Withdrawn
N/A
rizatriptan film
Gensco
Migraine treatment
Oral transmucosal
CRL
TBD
40 | magellanrx.com
GLOSSARY ABSSSI Acute Bacterial Skin and Skin Structure Infection ACR20 American College of Rheumatology 20% Improvement ACR50 American College of Rheumatology 50% Improvement ACR70 American College of Rheumatology 70% Improvement ADHD Attention Deficit Hyperactivity Disorder ADL Activities of Daily Living AED Anti-Epileptic Drug ALK Anaplastic Lymphoma Kinase ALL Acute Lymphoblastic Leukemia ALT Alanine Transaminase AMD Age-Related Macular Degeneration AML Acute Myeloid Leukemia ANCA Antineutrophil Cytoplasmic Antibodies ANDA Abbreviated New Drug Application ART Antiretroviral Therapy ARV Antiretroviral AS Ankylosing Spondylitis ASCVD Atherosclerotic Cardiovascular Disease AST Aspartate Aminotransferase BLA Biologics License Application BsUFA Biosimilar User Fee Act BCVA Best Corrected Visual Acuity CABP Community Acquired Bacterial Pneumonia CAP Community Acquired Pneumonia CD Crohn's Disease CDC Centers for Disease Control and Prevention CF Cystic Fibrosis CHF Congestive Heart Failure CI Confidence Interval
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CKD Chronic Kidney Disease CLL Chronic Lymphocytic Leukemia CNS Central Nervous System COPD Chronic Obstructive Pulmonary Disease COVID-19 Coronavirus Disease 2019 CRC Colorectal Cancer CRL Complete Response Letter CV Cardiovascular CVD Cardiovascular Disease DAS28-CRP Disease Activity Score-28 with C Reactive Protein DEA Drug Enforcement Administration DLBCL Diffuse Large B Cell Lymphoma DMD Duchenne Muscular Dystrophy DMARD Disease Modifying Antirheumatic Drug DNA Deoxyribonucleic Acid DOR Duration of Response DPP-4 Dipeptidyl Peptidase 4 DR Delayed-Release EDSS Expanded Disability Status Scale EGFR Epidermal Growth Factor Receptor ER Extended-Release FDA Food and Drug Administration FLT3 FMS-Like Tyrosine Kinase-3 GI Gastrointestinal GIST Gastrointestinal Stromal Tumor GLP-1RA Glucagon-Like Peptide-1 Receptor Agonist GVHD Graft Versus Host Disease H Half HAM-D Hamilton Depression Rating Scale HAP Healthcare-Associated Pneumonia HbA1c Hemoglobin A1c
GLOSSARY continued HCC Hepatocellular Carcinoma
NSCLC Non-Small Cell Lung Cancer
HCP Healthcare Professional
ODT Orally Disintegrating Tablet
HCV Hepatitis C Virus
ORR Overall/Objective Response Rate
HER Human Epidermal Growth Factor Receptor
OS Overall Survival
HER2 Human Epidermal Growth Factor Receptor 2
PAH Pulmonary Arterial Hypertension
HFA Hydrofluoroalkane
PARP Poly(ADP-ribose) polymerase
HIT Heparin Induced Thrombocytopenia
PASI 50 Psoriasis Area and Severity Index ≥ 50%
HIV Human Immunodeficiency Virus
PASI 70 Psoriasis Area and Severity Index ≥ 70%
HIV-1 Human Immunodeficiency Virus-1
PASI 90 Psoriasis Area and Severity Index ≥ 90%
HR Hazard Ratio
PCI Percutaneous Coronary Intervention
HSCT Hematopoietic Stem Cell Transplant
PD-1 Programmed Death Protein 1
HTN Hypertension
PD-L1 Programmed Death-Ligand 1
IBS Irritable Bowel Syndrome
PDUFA Prescription Drug User Fee Application
IBS-C Irritable Bowel Syndrome, Constipation Predominant
PFS Progression-Free Survival
IM Intramuscular IV Intravenous JIA Juvenile Idiopathic Arthritis LDL-C Low-Density Lipoprotein Cholesterol MACE Major Adverse Cardiovascular Events MADRS Montgomery – Åsberg Depression Rating Scale MAOI Monoamine Oxidase Inhibitor MDD Major Depressive Disorder MDI Metered Dose Inhaler MRI Magnetic Resonance Imaging MRSA Methicillin-Resistant Staphylococcus Aureus MS Multiple Sclerosis N/A Not Applicable NASH Non-Alcoholic Steatohepatitis NDA New Drug Application NHL Non-Hodgkin Lymphoma NSAID Non-Steroidal Anti-Inflammatory Drug
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PGA Physician Global Assessment PsA Psoriatic Arthritis PSO Plaque Psoriasis PTCA Percutaneous Transluminal Coronary Angioplasty PTSD Post-Traumatic Stress Disorder Q Quarter QIDP Qualified Infectious Diseases Product QOL Quality of Life RA Rheumatoid Arthritis RBC Red Blood Cell RCC Renal Cell Carcinoma REMS Risk Evaluation and Mitigation Strategy RMAT Regenerative Medicine Advanced Therapy RNA Ribonucleic Acid RRR Relative Risk Reduction RSV Respiratory Syncytial Virus RTOR Real-Time Oncology Review
GLOSSARY continued sBLA supplemental Biologics License Application
WBC White Blood Cell
SC Subcutaneous
WHO World Health Organization
SCCHN Squamous Cell Cancer of the Head and Neck
XR Extended-Release
SCLC Small Cell Lung Cancer SCT Stem Cell Transplant SGLT Sodium-Glucose Co-Transporter SL Sublingual SLE Systemic Lupus Erythematosus SLL Small Lymphocytic Lymphoma sNDA supplemental New Drug Application SOC Standard of Care sPGA Static Physician Global Assessment SR Sustained-Release SNRI Serotonin and Norepinephrine Reuptake Inhibitor SSRI Selective Serotonin Reuptake Inhibitor SSSI Skin and Skin Structure Infection T1DM Type 1 Diabetes Mellitus T2DM Type 2 Diabetes Mellitus TBD To Be Determined TEAE Treatment-Emergent Adverse Events TNBC Triple Negative Breast Cancer TNF Tumor Necrosis Factor TNFα Tumor Necrosis Factor-alpha UA Unstable Angina UC Ulcerative Colitis US United States UTI Urinary Tract Infection VAS Visual Analog Scale VEGF Vascular Endothelial Growth Factor VTE Venous Thromboembolism
43 | magellanrx.com
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