July 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
Michelle Booth, PharmD Director, Medical Pharmacy Strategy
Daphne Atria, PharmD, BCPS, CPE Strategic Clinical Pharmacist Consultant
Becky Borgert, PharmD, BCOP Director, Clinical Oncology Product Development
Glossary
Lara Frick, PharmD, BCPS, BCPP Drug Information Pharmacist Robert Greer, RPh, BCOP Senior Director, Clinical Strategy and Programs YuQian Liu, PharmD Director, Specialty Clinical Solutions 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. This quarterly publication offers clinical insights and competitive intelligence on anticipated drugs in development, so you are well-sourced on the drug pipeline. While select investigational agents for COVID-19 are profiled, given the rapidly evolving COVID-19 landscape, MRx created an exclusive report dedicated to drugs and vaccines in development for COVID-19. As cases surge in certain parts of the country and the globe, safe and effective vaccines and drugs are crucial to combat the pandemic. MRx Pipeline+ Bonus COVID-19 Edition centralizes relevant information on emerging COVID-19 therapeutics and vaccines. MRx Pipeline, 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 categories, eventual FDA-approved indications, populations within the plan, and other indices, the financial impact could vary by different lines of business. So far in 2020, a total of 29 novel drugs have received FDA approval. Last year at approximately the same timepoint, only 17 novel drugs had been approved. For the remainder of this year, 54 relevant drugs filed with the agency are profiled, each of which has an anticipated FDA decision in 2020. The progress of these agents is being actively monitored through MRx Pipeline. In the past few years, game changers, such as chimeric antigen receptor (CAR) T therapies, have transformed the pipeline by delivery of drug therapy directly to the site of action in the body. 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 highly-anticipated first gene therapy for hemophilia A, and the first treatment for genetic deficiency obesity. In the upcoming quarters, development of complex therapies, therapeutic options for rare hereditary diseases, oncology, immunology, neurology, and investigational agents will be monitored on the MRx radar. Moreover, sprouting products for cardiology, 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
81%
25% BIOSIMILAR
44%
BREAKTHROUGH THERAPY
31% ORPHAN DRUG
38%
pecialty drug names appear in ï‚« S magenta throughout the publication.
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ENDOCRINE
berotralstat oral Biocryst PROPOSED INDICATIONS
Hereditary angioedema (HAE) attack prevention
CLINICAL OVERVIEW
HAE is a rare genetic condition characterized by recurrent episodes of SC or submucosal edema of the GI tract, limbs, face, and upper respiratory tract. Patients with HAE types 1 and 2 have low levels of functional C1 esterase inhibitor (C1-INH), a protein that blocks plasma kallikrein. During HAE attacks, unregulated plasma kallikrein activity results in excessive production of the vasodilator bradykinin, leading to localized swelling and inflammation. Most HAE episodes are self-limiting and resolve in 3 to 5 days. However, abdominal edema may lead to nausea, vomiting, and severe pain. Life-threatening swelling of the throat or larynx can also occur. Frequency of attacks can vary greatly and can occur without any apparent trigger. Berotralstat is a second-generation, oral plasma kallikrein inhibitor. It was studied in 2 placebo-controlled phase 3 trials in 79 patients ≥ 12 years of age with type 1 or 2 HAE. The APeX-2 trial reported, from baseline to week 24, a 44.2% reduction in rate of HAE attacks (primary endpoint), a 49.2% reduction in HAE attacks requiring treatment, and a 53.6% reduction in on-demand medication use associated with once-daily oral berotralstat 150 mg compared to placebo (p<0.001 for all). The most common adverse effects reported were mild to moderate GI symptoms. ApeX-2 trial data at 48-weeks and the long-term (48-week) open-label Apex-S trial confirmed that berotralstat is generally well tolerated. Patients experienced sustained reductions in HAE attack frequency and improved QOL.
PLACE IN THERAPY
HAE affects 1 person in 10,000 to 50,000 in the US. Symptoms of HAE begin in early childhood and persist throughout life. Management consists of acute treatment of attacks, short-term prophylaxis during precipitating conditions, and long-term prophylaxis for frequent attacks. Agents approved in the US employ various mechanisms to manage HAE. Products that increase levels of C1-INH include danazol or replacement with plasma-derived C1-INH (Berinert®, Cinryze®, Haegarda®) and recombinant C1-INH (Ruconest®). The kallikrein inhibitors escallantide (Kalbitor®) and lanadelumab-flyo (Takhzyro®) and the bradykinin receptor antagonist icatibant (Firazyr®) are also available. Treatment options for acute attacks include Berinert (IV), Ruconest (IV), Firazyr (SC), and Kalibitor (IV). Danazol (oral) administered 3 times a day, Cinryze (IV) and Haegarda (SC) administered every 3 or 4 days, and Takhzyro (SC) administered every 2 or 4 weeks are used for routine prophylaxis of HAE attacks. Except for Kalbitor, all approved products can be self-administered. Berotralstat’s oral formulation and dosage frequency may be more convenient compared to the other prophylactic agents (danazol, Cinryze, Haegarda, Takhzyro). Furthermore, the safety profile for berotralstat is more favorable compared to oral danazol, which carries several contraindications and boxed warnings (e.g., thrombosis) due to androgen-like effects. Conversely, SC Takhzyro reported a much higher reduction in monthly attack rates compared to berotralstat (Takhzyro, 74% to 87%; berotralstat, 44.2%) in noncomparative trials. Notably, there are no patents pending to prevent approval of biosimilars to Cinzyre that could compete with berotralstat. While berotralstat has only been studied for prevention of HAE attacks in patients ≥ 12 years of age, over time, manufacturers of products within this class have sought approval in younger patients. In addition, a liquid formulation of berotralstat is being studied for acute HAE attacks.
FDA APPROVAL TIMELINE December 3, 2020 Fast Track
Orphan Drug
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$3
$29
$84
$142
$196
The forecast is a projection of total US sales per year.
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ONCOLOGY
idecabtagene vicleucel IV Bristol-Myers Squibb/Bluebird Bio PROPOSED INDICATIONS
Relapsed or refractory (R/R) multiple myeloma (MM)
CLINICAL OVERVIEW
Idecabtagene vicleucel (ide-cel) is a B cell maturation antigen (BCMA)-directed autologous chimeric antigen receptor (CAR) T cell therapy. It binds to BCMA on the surface of MM cells leading to CAR T cell proliferation, cytokine secretion, and subsequent cytolytic destruction of BCMA-expressing tumor cells. Ide-cel demonstrated clinical efficacy in the open-label, single-arm, phase 2 KarMMa trial among 128 patients with R/R MM who had received ≥ 3 prior regimens, including treatment with an immunomodulatory agent, proteasome inhibitor, and a CD38-directed antibody. In addition, 94% of patients received previous autologous SCT. A total of 128 patients received a single dose of ide-cel. A dose-dependent, clinically meaningful response was reported across all 3 doses studied (range, 150 x 106 to 450 x 106 cells). At a median follow-up of 11.3 months, responses observed with the highest dose were: ORR, 81%; complete response (CR), 35%; median DOR, 11.3 months; and median PFS, 11.3 months. Response rates were consistent among older individuals and difficult-to-treat patients (e.g., penta-refractory, high tumor burden, extramedullary disease). Median peak CAR+ T cell expansion was detected 11 days post dose. Cytokine release syndrome (CRS) was reported in 84% of patients in the overall population, including 7 cases of grade ≥ 3 severity. Neurotoxicity (NE) was reported in 18% of patients, including 4 cases of grade 3 severity. To manage CRS and NE adverse effects, tocilizumab was administered in 52% and 2% of patients, respectively, while corticosteroids were used in 15% and 8% of patients, respectively. Neutropenia and thrombocytopenia were observed in 91% and 63% of patients (mostly grade ≥ 3), respectively. Within 8 weeks of the dose, 5 deaths occurred; 2 of these deaths were due to disease progression and 3 were due to adverse events (CRS, aspergillus pneumonia, GI hemorrhage). One death occurred within 6 months of the dose due to cytomegalovirus pneumonia.
PLACE IN THERAPY
Over 32,270 new cases of MM and 12,830 deaths due to the condition are predicted in the US in 2020. While patients typically respond to initial therapy, eventual treatment-resistant relapse usually occurs. If approved, ide-cel will be the first CAR-T therapy for MM. Autologous CAR-T therapy reengineers T cells collected from the patient. After re-infusion back into the patient’s blood, the modified cells recognize and kill cancerous B cells. Ide-cel’s activity targets BCMA, which is found in 60% to 70% of MM patients. Ide-cel demonstrated a significant and durable response in heavily pretreated MM patients. The initial indication is expected to be as fourth-line treatment, an area where poor response to available therapy is observed. Single-dose ide-cel will likely compete with the CD38-directed cytolytic antibody isatuximab-irfc (Sarclisa®), histone deacetylase inhibitor panobinostat (Farydak®), thalidomide analogue pomalidomide (Pomalyst®), proteasome inhibitor ixazomib (Ninlaro®) as well as the investigational BCMA-targeting antibody drug conjugate belantamab mafodotin (anticipated approval, August 2020). 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 for all). Ide-cel is also being studied in earlier lines of treatment.
FDA APPROVAL TIMELINE March 31, 2021
Breakthrough Therapy
Orphan Drug
FINANCIAL FORECAST 2020
2021
2022
2023
2024
$11
$153
$343
$520
$715
The forecast is a projection of total US sales per year.
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ONCOLOGY
margetuximab IV Macrogenics PROPOSED INDICATIONS
Human epidermal growth factor receptor 2 (HER2)-positive breast cancer
CLINICAL OVERVIEW
Margetuximab is a monoclonal antibody that targets HER2 oncoprotein. It is engineered with a fragment crystallizable (Fc) domain to enhance the body’s immune response. The open-label, phase 3 SOPHIA trial compared margetuximab (n=266) with trastuzumab (n=270), each given in combination with chemotherapy (capecitabine, eribulin, gemcitabine, or vinorelbine), for the treatment of HER2-positive metastatic breast cancer after anti-HER2 therapy (trastuzumab-based therapy, pertuzumab). As of the September 2019 data cut-off, in the ITT population, margetuximab led to a slightly higher median OS compared to trastuzumab (median OS, 21.6 versus 19.8 months, respectively; p=0.326 [not significant]), and there was only a nominal increase in median PFS (5.7 versus 4.4 months, respectively; p=0.0006). Interestingly, response to margetuximab compared to trastuzumab was more pronounced in patients with CD16A genotypes containing 158F allele (median PFS, 6.9 versus 5.1 months, respectively; p=0.005; median OS, 23.7 versus 19.4 months, respectively; p=0.087). Overall, the ORR was 25.2% versus 13.7% in the margetuximab and trastuzumab groups, respectively (p=0.0006) and clinical benefit rates were 48.1% and 35.6%, respectively (p=0.0025). In general, safety profiles were similar among the agents, with the exception of infusion-related reactions (margetuximab, 13%; trastuzumab, 3%). The studied dose of margetuximab was 15 mg/kg via IV infusion on day 1 of each 21-day cycle, until progression or unacceptable toxicity occurred. It was administered over 120 minutes in cycle 1, then over 30 or 60 minutes during subsequent cycles.
PLACE IN THERAPY
Breast cancer is the second leading cause of cancer death in women. In 2020, an estimated 279,100 new cases of breast cancer and 42,690 related deaths will occur. Approximately 15% of cases are HER2-positive. Trastuzumab-based therapy is the current SOC for HER2-positive breast cancer. However, only 25% to 30% of HER2-positive patients with metastatic disease will respond to SOC, leaving a large unmet need. Margetuximab contains an Fc domain engineered to provide increased CD16A 158F allele binding and decreased CD32B binding on immune cells; 85% of the population harbors the CD16A 158F allele which is associated with a diminished response to available therapeutic antibodies, including trastuzumab. As seen in the SOPHIA trial, while margetuximab demonstrated a similar response to trastuzumab in the ITT HER2positive population, it may provide an enhanced response in patients with the CD16A 158F allele. If approved, margetuximab in combination with chemotherapy will provide another option for the treatment of HER2-positive metastatic breast cancer. It remains to be seen if its modest clinical advantage over trastuzumab will allow it to compete with established therapies. These include trastuzumab-containing IV and SC administered products (including Herceptin® and its biosimilars, Herceptin Hylecta™, Enhertu®, and Kadcyla®), as well as oral regimens with kinase inhibitors lapatinib (Tykerb®), neratinib (Nerlynx®), and tucantinib (Tukysa™) that are used in combination with capecitabine (Xeloda®) in patients who have failed prior treatment with trastuzumab.
FDA APPROVAL TIMELINE December 18, 2020 Fast Track
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$12
$44
$83
$121
$159
The forecast is a projection of total US sales per year, including leukemia indications.
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HEMATOLOGY
roxadustat oral AstraZeneca PROPOSED INDICATIONS
Anemia of chronic kidney disease (CKD), including dialysis- and non-dialysis-dependent
CLINICAL OVERVIEW
Roxadustat is a hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI). HIF-PHIs stimulate erythropoietin production in the kidneys and liver, improve iron storage, and downregulate hepcidin–a key regulator of iron homeostasis. Phase 3 trials compared roxadustat to placebo in non-dialysis-dependent patients with CKD (n=4,277) and compared roxadustat to epoetin alfa in CKD patients on dialysis (n=3,880). Pooled analyses demonstrated a statistically significant mean increase from baseline in Hb levels (averaged over 28 to 52 weeks) with roxadustat versus both comparators. In non-dialysis-dependent patients, the difference from placebo was 1.72 g/dL (p<0.001), and in dialysis-dependent patients, the difference from epoetin alfa was 0.23 g/dL (p<0.0001). During the first year of treatment, fewer patients treated with roxadustat required RBC transfusions compared to those treated with placebo (5.2% versus 15.4%, respectively; p<0.001). This was also true for roxadustat compared to epoetin alfa (9.5% versus 12.8%, respectively; p=0.046). Risk of MACE and all-cause mortality with roxadustat was similar to placebo in non-dialysis-dependent patients. There was no increase in the risk of MACE or all-cause mortality with roxadustat compared to epoetin alfa in dialysis-dependent patients. Response to roxadustat was demonstrated regardless of baseline iron stores. The open-label, phase 3 DOLOMITE trial reported non-inferiority of roxadustat to darbepoetin alfa in 616 CKD patients not on dialysis. This was based on Hb response, defined as Hb ≥ 11 g/dL and an increase in Hb level by ≥ 1 g/dL in patients with baseline Hb > 8 g/dL or by ≥ 2 g/dL in those with baseline Hb ≤ 8 g/dL at week 24. Rate of response was 89.5% with roxadustat and 78% with darbepoetin alfa (p<0.05). Incidence of MACE was numerically lower with roxadustat, but the difference was not statistically significant. Roxadustat was administered orally 3 times per week in clinical trials.
PLACE IN THERAPY
An estimated 37 million people in the US have CKD. Anemia is prevalent in patients with CKD and worsens as disease progresses. Anemia can lead to arrhythmia, cardiomegaly, and heart failure as well as fatigue and decreased QOL. Treatment with iron, vitamin B12, and folic acid supplementation, erythropoietin stimulating agents (ESAs; epoetin alfa [Epoetin®, Procrit®], darbepoetin alfa [Aranesp®]), and RBC transfusions are used to manage anemia. However, transfusions can reduce the patient’s eligibility for kidney transplant and increase risk of infections, heart failure, and allergic reactions. Roxadustat is the first orally-administered small molecule HIF-PHI to be submitted to the FDA for treatment of CKD-related anemia. It has the potential to become the new SOC for anemia in CKD due to its convenient oral administration (ESAs are administered IV or SC), safety profile, and reduced need for iron supplements. Other HIF-PHIs in phase 3 clinical trials for this indication in the US include oral daprodustat and vadadustat. HIF pathways impact many biologic processes; therefore, there is potential concern about non-erythropoietic adverse effects, including increased risk of cancer, thrombosis, CVD, and diabetic retinopathy with this new therapeutic class.
FDA APPROVAL TIMELINE December 18, 2020
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$17
$190
$339
$460
$560
The forecast is a projection of total US sales per year.
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METABOLIC
setmelanotide SC Rhythm PROPOSED INDICATIONS
Pro-opiomelanocortin deficiency obesity (POMC-DO) and leptin receptor deficiency obesity (LEPR-DO)
CLINICAL OVERVIEW
Genetic factors play a role in the obesity cascade. POMC-DO and LEPR-DO are ultra-rare autosomal recessive single-gene disorders that impact the energy and appetite regulating leptin-melanocortin pathway. Both are characterized by lifelong persistent hunger and weight gain beginning in the first year of life as well as hormone deficiencies. Patients with POMC-DO lack hypothalamic melanocyte-stimulating hormones and tend to have red hair and pale skin. These individuals also exhibit low levels of adrenocorticotropic hormone (ACTH), which if left untreated, may lead to life-threatening hypoglycemia, seizures, hyperbilirubinemia, and cholestasis. It is unknown if patients with POMC-DO are at increased risk of CVD, cancer, or T2DM. Likewise, LEPR-DO is associated with hypogonadotropic hypogonadism and patients experience delayed or absent puberty. Aggressive food-seeking behavior and development of T2DM in early adulthood are also reported. POMC-DO and LEPR-DO involve gene abnormalities upstream of the melanocortin-4 receptor (MC4R) in the leptin-melanocortin pathway. Setmelanotide, a highly specific MC4R agonist, restores MC4R function. Two open-label, single-arm, phase 3 trials evaluated setmelanotide for the treatment of POMC-DO (n=10) and LEPR-DO (n=11) in patients ≥ 6 years of age. Setmelanotide was self- or caregiver-administered as once daily SC injections. At 52 weeks, 80% and 45.5% of patients in the POMC-DO and LEPR-DO cohorts, respectively, achieved the primary endpoint of ≥ 10% change in body weight from baseline. The mean reductions in body weight were 25.4% and 12.5%, respectively (p<0.0001 for both). Significant reductions from baseline in Most Hunger score were also reported (27.8% and 41.9%, respectively; p≤0.0004 for both). Among patients with POMC-DO, the mean change in BMI from baseline differed by age (≥ 19 years, -22.3% [p=0.056]; < 19 years, -49.2% [p=0.007]); smaller changes in each age group occurred in patients with LEPR-DO (-10.6% [p=0.01] and -13.4% [p=0.12], respectively). An ongoing long-term extension trial (POMC-DO, n=9; LEPR-DO, n=6) reported a durable weight loss for up to 155 weeks. The most common TEAEs reported were injection site reactions, nausea, vomiting, and hyperpigmentation. No significant changes in CV events, blood pressure, or heart rate were reported.
PLACE IN THERAPY
While approximately 50 cases of POMC deficiency obesity have been reported in literature, the prevalence of LEPR deficiency obesity is unknown. Rhythm Pharmaceuticals estimates that the US incidence of each are 100 to 500 and 500 to 2,000, respectively. Diagnoses for these disorders are confirmed using genetic testing. Individuals with either condition struggle with dramatic weight gain that does not respond to lifestyle changes or available therapeutic interventions. Patients also experience endocrine abnormalities that could be life-threatening if not treated (POMC-DO) or result in infertility (LEPR-DO). If approved, setmelanotide will be a first-in-class treatment for POMC-DO and LEPR-DO and could alter the disease course. Setmelanotide is also in clinical trials for obesity caused by other single-gene defects associated with hyperphagia and obesity, including Bardet-Biedl and Alström syndromes (phase 3) and Prader-Willi syndrome (phase 2). A once-weekly depot formulation is also in development.
FDA APPROVAL TIMELINE November 27, 2020
Breakthrough Therapy
Orphan Drug
Priority Review
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$5
$56
$166
$269
$405
The forecast is a projection of total US sales per year.
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Rare Pediatric Disease
ONCOLOGY
sodium thiosulfate IV Fennec PROPOSED INDICATIONS
Prevention of cisplatin-induced ototoxicity
CLINICAL OVERVIEW
Sodium thiosulfate (STS) is an antioxidant that may inactivate oxygen free-radicals and electrophilic platinum species and thereby preserve hearing. STS was studied in 2 open-label, phase 3 trials in pediatric patients who required cisplatin-based chemotherapy. The ACCL0431 trial included 104 evaluable patients 1 year to 18 years of age with various newly-diagnosed malignancies. The SIOPEL-6 trial enrolled 109 pediatric patients 1 month to 18 years of age with standard-risk localized hepatoblastoma. Both trials reported a nearly 50% lower incidence of hearing loss in patients treated with STS compared to patients who did not receive STS (observation control group) (ACCL0431: 28.6% versus 56.4%, respectively; SIOPEL-6: 33% versus 63%, respectively). In ACCL0431, there was also a greater between-group difference in incidence of hearing loss, favoring STS, in patients < 5 years of age (difference, 51.9%) compared to those ≥ 5 years (difference, 18.6%). In ACCL0431, durability of response was observed 1 year post therapy completion and response to STS was not impacted by CNS irradiation. Both studies reported no difference in OS or event-free survival (EFS) between the overall study populations at 3 years; however, in ACCL0431, these rates were lower in the STS group compared with the control group in patients with disseminated disease (OS, 42% versus 61%, respectively; EFS, 45% versus 84%, respectively). Across the 2 studies, 1 patient developed metabolic acidosis, which resolved after STS was stopped. Grade ≥ 3 hypophosphatemia and hypokalemia were reported more often in the STS group. STS was administered at a dose of 16 mg/m2 (SIOPEL-6) or 20 mg/m2 (ACCL0431) IV over 15 minutes 6 hours after each cisplatin dose.
PLACE IN THERAPY
Cisplatin, a standard component of chemotherapy regimens for pediatric malignancies, can cause damage to cochlear cells of the ear. Approximately 5,000 children in the US receive platinum-based chemotherapy each year, 40% to 60% of whom receive cisplatin and are at risk of irreversible bilateral hearing loss. This risk may be more pronounced by renal impairment, concomitant use of other ototoxic or renal toxic drugs, and radiation therapy. Ototoxicity typically occurs during or shortly after cisplatin treatment but can occur months to years after stopping therapy. Hearing loss emerging during childhood developmental years can have a profound effect on speech, language, and psychosocial development. STS demonstrated a significant reduction in the risk of ototoxicity associated with cisplatin therapy, particularly in patients < 5 years of age, who are most susceptible to cisplatin-induced hearing loss. If approved, STS will be the first and only drug indicated to prevent chemotherapy-induced ototoxicity, an area with no other drugs in late stage research. While STS appears to have no impact on survival in the overall study populations, the ACCL0431 study raised a concern of potential decreased survival when disseminated disease is present.
FDA APPROVAL TIMELINE August 10, 2020
Breakthrough Therapy
Fast Track
Orphan Drug
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$10
$30
$55
$73
$95
The forecast is a projection of total US sales per year.
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Priority Review
IMMUNOLOGY
sutimlimab IV Sanofi PROPOSED INDICATIONS Cold agglutinin disease
CLINICAL OVERVIEW
Cold agglutinin disease is a rare autoimmune disorder characterized by hemolytic anemia. Autoantibodies bind to RBCs causing them to agglutinate (clump). The RBCs hemolyze leading to anemia. Cause of cold agglutinin disease may be unknown (primary) or due to conditions such as infection, other autoimmune disease, or certain cancers (secondary). Common symptoms are related to anemia and can include fatigue, weakness, shortness of breath, dizziness, headache, chest pain, and arrhythmia. Patients may also experience Raynaud’s syndrome, splenomegaly, mottled skin, or thromboembolic events. Symptoms are often triggered by cold temperatures or viral infection. Sutimlimab is a humanized immunoglobulin G4 (IgG4) monoclonal antibody that inhibits activation of the classical complement pathway which is overactive in people with cold agglutinin disease. The 26-week, single-arm, phase 3 CARDINAL trial evaluated sutimlimab in 24 patients with cold agglutinin disease who received a blood transfusion in the previous 6 months. Improvement in Hb levels (≥ 1 g/dL increase) was seen within 1 week of starting sutimlimab therapy. Among patients treated, 62.5% achieved a Hb ≥ 12 g/dL or an increase of ≥ 2 g/dL. A mean Hb > 11 g/dL was maintained from week 3 to study end, and 71% of patients were transfusion-free after week 5. As early as week 1, clinically meaningful improvements in fatigue and bilirubin level were reported. An increase in FACIT-fatigue score from baseline (mean, 10.9 points) suggested improved QOL. Total bilirubin level normalized by week 3 and was maintained through week 26. No serious adverse effects reported were considered related to sutimlimab. Sutimlimab was administered as a weight-based dose (6.5 g or 7.5 g) via IV infusion on days 0 and 7, followed by once every other week through week 26.
PLACE IN THERAPY
The incidence of cold agglutinin disease is approximately 1 in 300,000. It is most often seen in middle aged or elderly adults. There are no approved treatments for the condition. Prognosis is generally good in mild to moderate cases with avoidance of cold temperature and in cases caused by viral infection. The prognosis is worse in individuals with underlying HIV infection or cancer. According to Sanofi, patients who suffer from cold agglutinin disease are at a 55% increased risk of thromboembolic events. Blood transfusions or plasmapheresis provide temporary support for severe hemolytic anemia. Rituximab (Rituxan®, biosimilars) is effective in the majority of chronic cases (≥ 60%) with duration of response of 1 to 2 years. Unfortunately, response to rituximab may diminish with repeated use. Increased response and duration have been reported with the addition of fludarabine or bendamustine; however, adverse effects may limit the use of these agents. Off-label uses of eculizumab (Soliris®) and ibrutinib (Imbruvica®) have also been reported in the literature. If approved, sutimlimab will be the first therapeutic treatment indicated for cold agglutinin disease. While sutimlimab demonstrated efficacy in patients who received recent blood transfusion, the ongoing phase 3 CADENZA study is also assessing it in patients with cold agglutinin disease without recent history (prior 6 months) of transfusion.
FDA APPROVAL TIMELINE November 13, 2020
Breakthrough Therapy
Orphan Drug
Priority Review
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$4
$35
$82
$121
$155
The forecast is a projection of total US sales per year, including cold agglutinin disease and ITP. 10 | magellanrx.com
ONCOLOGY
tafasitamab IV Morphosys PROPOSED INDICATIONS
Relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) in combination with lenalidomide
CLINICAL OVERVIEW
Tafasitamab is a humanized monoclonal antibody that contains a modified Fc domain. Tafasitamab targets CD19 expressed on B cells. The modified Fc domain enhances binding to the B cell, resulting in potent antibody-dependent cellular cytotoxicity (ADCC) and downregulation of B cell activation. Tafasitamab was studied in the phase 2, single-arm L-MIND clinical trial in combination with lenalidomide in 81 adults with R/R DLBCL. Patients had received 1 to 3 prior systemic therapies, including ≥ 1 anti-CD20 agent (e.g., rituximab). Patients had an ECOG score of 0 to 2 and were ineligible for high-dose chemotherapy and autologous SCT. After a median follow-up of 31.8 months (95% CI, 27.2 to 35.9), the study reported an ORR of 58.8% (primary endpoint), complete response (CR) of 41.3%, and median DOR of 34.6 months (95% CI, 26.1 to 34.6). The median OS was 31.6 months (95% CI, 18.3 to not reached [NR]) and PFS was 16.2 months (95% CI, 6.3 to NR). The most common grade ≥ 3 TEAEs reported with tafasitamab plus lenalidomide therapy (≥ 10%) were neutropenia, thrombocytopenia, and febrile neutropenia. In patients with R/R DBLCL, a significantly higher ORR was reported with tafasitamab plus lenalidomide in the L-MIND trial compared with lenalidomide monotherapy in the retrospective, observational (real-world), matched control cohort RE-MIND trial (n=490; ORR, 34.2%). In L-MIND, patients received 28-day cycles of tafasitamab and lenalidomide treatment. Tafasitamab 12 mg/kg was administered IV once weekly during cycles 1 through 3 (with a loading dose on day 4 of cycle 1), then every 2 weeks during cycles 4 through 12. Lenalidomide 25 mg was given orally on days 1 to 21 of cycles 1 through 12. After cycle 12, progression-free patients received tafasitamab every 2 weeks until disease progression.
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. An estimated 30% to 40% of cases relapse or progress after SOC therapy (R-CHOP). Few options remain for patients who are refractory to or relapse after chemotherapy or who are ineligible for SCT. Recently approved therapies target specific biomarkers on tumor cells and stimulate the body’s immune response against tumor cells. If approved, tafasitamab will provide an important option for treating R/R DLBCL in patients who are not suitable for autologous SCT or high-dose chemotherapy. It may compete with rituximab-containing regimens (Rituxan and its biosimilars), polatuzumab vedotin-piiq (Polivy™), and CAR-T therapies (Kymriah®, Yescarta®) in this oncology space. Moreover, tafasitamab has shown strong response rates and may be appropriate for patients whose clinical status is not amenable for CAR-T therapy or polatuzumab vedotin-piiq. The phase 3 B-MIND trial is studying tafasitamab in combination with bendamustine for R/R DLBCL; results are expected in 2022.
FDA APPROVAL TIMELINE August 28, 2020
Breakthrough Therapy
Fast Track
Orphan Drug
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$39
$166
$292
$408
$531
The forecast is a projection of total US sales per year.
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Priority Review
NEUROLOGY
viloxazine oral Supernus PROPOSED INDICATIONS
Attention deficit hyperactivity disorder (ADHD)
CLINICAL OVERVIEW
Viloxazine is a serotonin norepinephrine modulating agent. It demonstrates increased levels of serotonin (5-HT), norepinephrine (NE), and dopamine (DA) in the prefrontal cortex of the brain. Its use as a non-stimulant for the treatment of ADHD was evaluated across 4 double-blind, placebo-controlled, phase 3 clinical trials in children (ages 6 to 11 years; studies P301 and P303) and adolescents (ages 12 to 17 years; studies P302 and P304). A total of 902 patients received viloxazine. Dosages were 100 mg, 200 mg, and 400 mg in children, and 200 mg, 400 mg, and 600 mg in adolescents. The studies showed that viloxazine was effective in significantly reducing the symptoms of hyperactivity/impulsivity and inattention (based on the ADHD Rating Scale-5) compared to placebo at study end (weeks 6 to 8, depending on study) for all doses except 600 mg. Improvements were observed as early as week 1. Similarly, significant improvement in the Clinical Global Impression-Improvement (CGI-I) score was demonstrated with viloxazine (for all dosages except the 600 mg) at the study end. The most common TEAEs reported were somnolence, decreased appetite, headache, and fatigue. Across the trials, 3.5% of patients treated with viloxazine discontinued treatment due to TEAEs compared to 1.3% who received placebo. Viloxazine was studied as monotherapy administered orally once daily.
PLACE IN THERAPY
ADHD is the most common neurobehavioral childhood disorder, occurring in approximately 7% to 8% of children and youth. It is a chronic condition with core symptoms of inattention, hyperactivity, and difficulty controlling behavior. Medication in combination with behavioral therapy is recommended. Stimulants (e.g., amphetamine, methylphenidate) are the most frequently prescribed pharmacologic treatment for ADHD. While non-stimulant agents (e.g., atomoxetine [Strattera®], guanfacine ER [Intuniv®], and clonidine ER [Kapvay®]) are considered less effective, there is a niche for their use. Atomoxetine is recommended if there are concerns with using a controlled substance, if stimulant-induced weight loss is problematic, or for patients with anxiety, mood, tics, or substance abuse disorders. Extended-release formulations of guanfacine or clonidine may be helpful when used concurrently with a stimulant in patients who cannot tolerate usual stimulant doses, particularly in patients who experience tics. If approved, viloxazine will provide another non-stimulant treatment option for children and adolescents with ADHD. It could compete with the selective NE reuptake inhibitor atomoxetine (Strattera, generics) if it can differentiate itself based on its distinct mechanism of action, which affects 5-HT, NE, and DA, as well as its safety profile. Unlike atomoxetine, which is contraindicated in patients with severe CV disorders and has been associated with rare cases of liver injury, viloxazine has not demonstrated CV impairment and hepatotoxicity in clinical trials. Furthermore, viloxazine’s safety record based on its use as an antidepressant in Europe may provide physicians some confidence in prescribing the medication. Finally, clinically significant response to viloxazine was demonstrated at weeks 6 to 8 of the studies, and onset of action was seen as early as 1 week. Effect of atomoxetine on ADHD symptoms can also be seen within 1 to 2 weeks of starting therapy, with a gradual increase in response over 24 weeks. Viloxazine is also being studied in adults with ADHD.
FDA APPROVAL TIMELINE November 6, 2020
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$13
$55
$100
$141
$142
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 were 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 28 biosimilars have received FDA approval. Of these, only 18 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)
Manufacturer
Approval Date
Avsola™ (infliximab-axxq)
Amgen
December 2019
Nyvepria™ (pegfiltrastim-apgf)
Pfizer/Hospira
June 2020
Hulio® adalimumab-fkjp)
Mylan
July 2020
Commercially Available
-
Originator Product (Manufacturer) Remicade (Janssen) Neulasta (Amgen) Neulasta (Amgen)
* 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®. In June 2020, the FDA approved insulin glargine (Semglee™) by Mylan/Biocon under an abbreviated 505(b)(2) New Drug Application (NDA) pathway; the reference product was Lantus. Semglee is considered a biologic under section 351(a). 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.
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BIOSIMILAR OVERVIEW continued
ONCOLOGY
bevacizumab IV Merck/Samsung Bioepis Aybintio and Bmab-100 are biosimilars to Genentech’s Avastin, a vascular endothelial growth factor (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 (Aybintio) July–September 2020 Mylan/Biocon (Bmab-100) December 25, 2020
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$2,058
$1,496
$1,251
$1,078
$886
The forecast is a projection of total US sales per year for the branded originator product.
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
$152
$126
$108
$96
$88
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 MSB-11455 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 (HSARS).
FDA APPROVAL TIMELINE Apotex (Lapelga) Pending
Merck/Fresenius (MSB-11455) January–March 2021
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$1,918
$1,532
$1,255
$1,057
$915
The forecast is a projection of total US sales per year for the branded originator product.
ONCOLOGY
rituximab (ABP-798) IV 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 December 18, 2020
FINANCIAL FORECAST (reported in millions) 2020
2021
2022
2023
2024
$3,577
$2,498
$1,850
$1,481
$1,150
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. voclosporin
aducanumab
$649
$940
Immunology
Neurology
remdesivir COVID-19
betibeglogene autotemcel (Zynteglo) Hematology/Gene therapy
$1,190
$366
relugolix
casimersen
Women's health/ Oncology
Neurology/Gene therapy
$187
$578
efgartigimod
mRNA-1273 vaccine COVID-19
Immunosuppressants
$2,859
$727
lonapegsomatropin
elivaldogene tavalentivec (Lenti-D)
Endocrine
$589
Neurology/Gene therapy
$42
lenadogene nolparvovec (GS010) Ophthalmology/ Gene therapy
$39
inclisiran
Cardiovascular
ipatasertib
$693
Oncology
$510
pecialty drug names appear in ď&#x201A;Ť S magenta throughout the publication. 18 | 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
61% 39% 39% 24% 20% 6%
Specialty
68% 32% 35 % 14% 8%
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
Submitted (New Drugs) bevacizumab (biosimilar to Genentech’s Avastin)
Merck/Samsung Bioepis
Brain cancer; Cervical cancer; CRC; NSCLC; Ovarian cancer; RCC
IV
Submitted – BLA
viltolarsen
Nippon Shinyaku
DMD (exon 53 skipping)
IV
Submitted – NDA; Jul–Sep 2020 Fast Track; Orphan Drug; Priority Review; Rare Pediatric Disease
donepezil transdermal system
Corium
Alzheimer’s disease
Transdermal
Submitted – 505(b)(2) NDA
07/30/2020
viaskin peanut immunotherapy
DBV
Peanut allergy (ages 4 to 11 years)
Transdermal
Submitted – BLA; Breakthrough Therapy; Fast Track
08/05/2020
oliceridine
Trevena
Acute pain
IV
Submitted – NDA; Fast Track
08/07/2020
sodium thiosulfate
Fennec
Cisplatin-induced ototoxicity prevention
IV
Submitted – NDA; Breakthrough Therapy; Fast Track; Orphan Drug; Priority Review
08/10/2020
belantamab mafodotin
GlaxoSmithKline
Multiple myeloma (relapsed/refractory)
SC
Submitted – BLA; Breakthrough Therapy; Orphan Drug; Priority Review
08/14/2020
satralizumab
Genetech
Neuromyelitis optica (Devic’s syndrome)
SC
Submitted – BLA; Breakthrough Therapy; Orphan Drug
08/14/2020
filgotinib
Gilead
RA
Oral
Submitted – NDA; Priority Review
08/19/2020
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; Accelerated Approval
08/22/2020
risdiplam
Genetech
Spinal muscular atrophy (types 1, 2, 3)
Oral
Submitted – NDA; Breakthrough Therapy; Fast Track; Orphan Drug; Priority Review
08/24/2020
bupivacaine collagen sponge
Innocoll
Postsurgical pain
Surgical implant
Submitted – NDA
08/26/2020
clascoterone
Cassiopea
Acne
Topical
Submitted – NDA
08/27/2020
tafasitamab
Morphosys
DLBCL (relapsed/ refractory, in combination with lenalidomide)
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
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Jul–Sep 2020
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
HIV therapeutic vaccine
Immune Response
HIV-1 infection treatment (pediatrics)
IM
Submitted – BLA; Orphan Drug
Sep–Dec 2020
azacitidine
Bristol-Myers Squibb
AML
Oral
Submitted – NDA; Priority Review
09/03/2020
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; Priority Review
09/27/2020
hydrocortisone granule
Eton
Adrenal insufficiency (ages birth to < 17 years)
Oral
Submitted – 505(b)(2) NDA; Orphan Drug
09/29/2020
tramadol
Fortress
Pain (moderate to severe, medically supervised setting)
IV
Submitted – 505(b)(2) NDA
10/09/2020
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
REGN-EB3
Regeneron
Ebola virus infection treatment
IV
Submitted – BLA; Breakthrough Therapy; Orphan Drug; Priority Review
10/23/2020
loteprednol etabonate 0.25%
Kala
Dry eye disease
Ophthalmic
Submitted – 505(b)(2) NDA
10/30/2020
mannitol (dry powder)
Pharmaxis
CF (adults)
Inhaled
Submitted – NDA; Fast Track; Orphan Drug
10/30/2020
viloxazine
Supernus
ADHD
Oral
Submitted – NDA
11/06/2020
amphetamine sulfate IR (tamper resistant)
Arbor
ADHD (adults, pediatrics ages ≥ 3 years)
Oral
Submitted – NDA
11/13/2020
samidorphan/olanzapine
Alkermes
Bipolar disorder; Schizophrenia
Oral
Submitted – NDA
11/13/2020
sutimlimab
Sanofi
Cold agglutinin disease
IV
Submitted – BLA; Breakthrough Therapy; Orphan Drug; Priority Review
11/13/2020
naloxone single-dose prefilled syringe
US Worldmeds
Opioid overdose
IM
Submitted – 505(b)(2) NDA
11/15/2020
lisocabtagene maraleucel
Bristol-Myers Squibb
DLBCL (relapsed/ refractory)
IV
Submitted – BLA; 11/16/2020 Breakthrough Therapy; Orphan Drug; Priority Review; RMAT
lonafarnib
Eiger
Hutchinson–Gilford progeria syndrome
Oral
Submitted – NDA; 11/20/2020 Breakthrough Therapy; Orphan Drug; Priority Review; Rare Pediatric Disease
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PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
pralsetinib
Blueprint Medicines
NSCLC (RET-fusion+)
Oral
Submitted – NDA; Orphan Drug; Priority Review
11/23/2020
treprostinil dry powder
Liquidia
PAH
Inhaled
Submitted – 505(b)(2) NDA
11/24/2020
setmelanotide
Rhythm
Obesity (POMC and LEPR deficiency)
SC
Submitted – NDA; 11/27/2020 Breakthrough Therapy; Orphan Drug; Priority Review; Rare Pediatric Disease
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 (for secondary prevention in patients with ASCVD and FH)
SC
Submitted – NDA; Orphan Drug
December 2020
tanezumab
Pfizer
Osteoarthritis pain
IV
Submitted – BLA; Fast December Track 2020
berotralstat
Biocryst
Hereditary angioedema (attack prevention)
Oral
Submitted – NDA; Fast Track; Orphan Drug
lumasiran
Alnylam
Hyperoxaluria
SC
Submitted – NDA; 12/03/2020 Breakthrough Therapy; Orphan Drug; Priority Review; Rare Pediatric Disease
margetuximab
Macrogenics
Breast cancer (HER2+, in combination with chemotherapy)
IV
Submitted – BLA; Fast 12/18/2020 Track
rituximab (biosimilar to Genentech’s Rituxan)
Amgen/Allergan
RA; CLL/ SLL; NHL (indolent); ANCAassociated vasculitis
IV
Submitted – BLA
12/18/2020
roxadustat
AstraZeneca
Anemia due to CKD (dialysis-independent, dialysis-dependent)
Oral
Submitted – NDA
12/18/2020
relugolix
Myovant
Prostate cancer (advanced)
Oral
Submitted – NDA; Priority Review
12/20/2020
ansofaxine
Luye
MDD
Oral
Submitted – NDA
12/25/2020
bevacizumab (biosimilar to Genentech’s Avastin)
Mylan/Biocon
Brain cancer; Cervical cancer; CRC; NSCLC; Ovarian cancer; RCC
IV
Submitted – BLA
12/25/2020
vibegron
Urovant
Overactive bladder
Oral
Submitted – NDA
12/25/2020
arbaclofen ER
Osmotica
12/03/2020
MS-associated spasticity
Oral
Submitted – NDA
12/29/2020
furosemide wearable pump Scpharmaceuticals
Congestive heart failure
SC
Submitted – 505(b)(2) NDA
12/30/2020
tirbanibulin
Almirall
Actinic keratoses
Topical
Submitted – NDA
12/30/2020
pegfilgrastim (biosimilar to Amgen’s Neulasta)
Merck/Fresenius
Neutropenia/leukopenia
SC
Submitted – BLA
Jan–Mar 2021
22 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
vericiguat
Merck
Chronic heart failure
Oral
Submitted – NDA; Priority Review
01/21/2021
voclosporin
Aurinia
Lupus nephritis
Oral
Submitted – NDA; Fast Track; Priority Review
01/22/2021
ropeginterferon alfa-2b
Pharmaessentia
Polycythemia vera (in absence of symptomatic splenomegaly)
SC
Submitted – BLA; Orphan Drug
Mar–Apr 2021
serdexmethylphenidate
Kempharm
ADHD
Oral
Submitted – 505(b)(2) NDA
03/02/2021
ponesimod
Janssen
MS (relapsing)
Oral
Submitted – NDA
03/18/2021
dasiglucagon
Zealand
Hypoglycemia (diabetesrelated)
SC
Submitted – NDA; Orphan Drug
03/27/2021
idecabtagene vicleucel
Bristol-Myers Squibb/ Bluebird Bio
Multiple myeloma (relapsed/refractory)
IV
Submitted – BLA; Breakthrough Therapy; Orphan Drug
03/31/2021
tivozanib
AVEO
RCC (relapsed/refractory)
Oral
Submitted – NDA
03/31/2021
aducanumab
Biogen
Alzheimer’s disease
IV
Submitted – BLA; Fast Apr–Jun 2021 Track
eflornithine/sulindac
Mallinckrodt
Familial adenomatous polyposis
Oral
Submitted – 505(b)(2) NDA; Fast Track; Orphan Drug
Apr–Jun 2021
melflufen
Oncopeptides
Multiple myeloma (triple refractory)
IV
Submitted – NDA; Orphan Drug
Apr–Jun 2021
pegunigalsidase alfa
Chiesi
Fabry’s disease
IV
Submitted – BLA; Fast Apr–Jun 2021 Track
tralokinumab
AstraZeneca
Atopic dermatitis
SC
Submitted – BLA
Apr–Jun 2021
umbralisib
TG
Follicular lymphoma; Marginal zone lymphoma
Oral
Submitted – NDA; Breakthrough Therapy; Orphan Drug
Apr–Jun 2021
estetrol/drospirenone
Mayne
Contraception
Oral
Submitted – NDA
04/16/2021
relugolix/estradiol/ norethindrone
Myovant
Uterine fibroids-related Oral heavy menstrual bleeding
Submitted – NDA
06/01/2021
casimersen
Sarepta
DMD (amenable to exon 45 skipping)
IV
Submitted – NDA; Orphan Drug
06/25/2021
lonapegsomatropin
Ascendis
Growth hormone deficiency (pediatrics)
SC
Submitted – BLA; Orphan Drug
06/25/2021
pineapple proteolytic enzymes extract
Mediwound
Burn injury debridement
Topical
Submitted – BLA; Orphan Drug
06/30/2021
arimoclomol
Orphazyme
Niemann-Pick disease
Oral
Submitted – NDA; Breakthrough Therapy; Fast Track; Orphan Drug
Jul–Sep 2021
inolimomab
Elsalys
GVHD (acute, steroidrefractory)
IM
Submitted – BLA; Orphan Drug; RTOR
Jul–Sep 2021
pralsetinib
Blueprint Medicines
Thyroid cancer (RETfusion+)
Oral
Submitted – NDA; Breakthrough Therapy; RTOR
Jul–Sep 2021
taurolidine
Cormedix
Prevention of catheterrelated sepsis (hemodialysis patients)
IV
Submitted – NDA; Fast Track; QIDP
Jul–Sep 2021
23 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
avacopan
Chemocentryx
ANCA-associated vasculitis
Oral
Submitted – NDA; Orphan Drug
07/09/2021
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
Pending
pegfilgrastim (biosimilar to Amgen’s Neulasta)
Apotex
Neutropenia/leukopenia
SC
Submitted – BLA
Pending
Submitted (Supplementals) omalizumab (Xolair )
Genentech
Nasal polyps
SC
Submitted – sBLA
Jul–Sep 2020
cannabidiol (Epidiolex )
GW
Tuberous sclerosis complex-related seizures
Oral
Submitted – sNDA; Orphan Drug; Priority Review
07/31/2020
esketamine (Spravato®)
Janssen
MDD (with suicidal ideation with intent)
Intranasal
Submitted – sNDA; Breakthrough Therapy; Fast Track
07/31/2020
fluticasone furoate/ umeclidinium bromide/ vilanterol (Trelegy® Ellipta®)
GlaxoSmithKline
Asthma (adults)
Inhaled
Submitted – sNDA
07/31/2020
ustekinumab (Stelara®)
Janssen
PSO (ages 6 to 11 years)
IV, SC
Submitted – sBLA
08/07/2020
dantrolene (Ryanodex®)
Eagle
Heat stroke (exertional)
IV
Submitted – sNDA; Fast Track; Orphan Drug
08/08/2020
dolutegravir/lamivudine (Dovato®)
GlaxoSmithKline
HIV-1 treatment (switch therapy)
Oral
Submitted – sNDA
08/16/2020
ofatumumab (Arzerra®)
Novartis
MS (relapsing)
SC
Submitted – sBLA; Priority Review
September 2020
ibrutinib (Imbruvica)
Abbvie
CLL/SLL (1st-line, ages < 70 years, in combination with rituximab)
Oral
Submitted – sNDA; Orphan Drug; RTOR
09/08/2020
cefiderocol (Fetroja®)
Shionogi
HAP
IV
Submitted – sNDA; Fast Track; Priority Review; QIDP
09/27/2020
linaclotide acetate (Linzess®)
Ironwood
IBS (treatment of abdominal symptoms)
Oral
Submitted – sNDA
October 2020
ticagrelor (Brilinta®)
AstraZeneca
Ischemic stroke
Oral
Submitted – sNDA; Priority Review
Oct–Nov 2020
ravulizumab-cwvz (Ultomiris®) at-home, weekly SC formulation
Alexion
Paroxysmal nocturnal hemoglobinuria
SC
Submitted – sBLA; Orphan Drug
10/09/2020
dolutegravir (Tivicay®) dispersible tablet
Viiv
HIV-1 treatment (pediatrics)
Oral
Submitted – sNDA
10/13/2020
pembrolizumab (Keytruda®)
Merck
Hodgkin’s lymphoma (classical, relapsed/ refractory, monotherapy)
IV
Submitted – sBLA; Breakthrough Therapy; Priority Review
10/30/2020
alectinib (Alecensa®)
Genentech
NSCLC (1st-line, ALK+)
Oral
Submitted – sNDA
November 2020
®
®
24 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
carfilzomib (Kyprolis®)
Amgen
Multiple myeloma (relapsed/refractory, in combination with daratumumab)
IV
Submitted – sBLA; Orphan Drug
11/13/2020
estradiol/progesterone (Bijuva®) 0.5 mg/100 mg
TherapeuticsMD
Menopause (including hormone replacement therapy [HRT])
Oral
Submitted – sNDA
11/16/2020
baloxavir marboxil (Xofluza®) oral granules, tablets
Genentech
Influenza treatment (ages 1 to 12 years; postexposure prophylaxis ages 1 year to adults)
Oral
Submitted – sNDA
11/23/2020
daratumumab (Darzalex®)
Janssen
Multiple myeloma (relapsed/refractory, in combination with carfilzomib)
IV
Submitted – sBLA; Orphan Drug
12/10/2020
ocrelizumab (Ocrevus®) 2-hour twice-yearly infusion
Genentech
MS (relapsing and primary IV progressive)
Submitted – sBLA
12/14/2020
golimumab (Simponi Aria®)
Janssen
JIA; Juvenile psoriatic arthritis (jPsA)
IV
Submitted – sBLA
January 2021
mepolizumab (Nucala®)
GlaxoSmithKline
Hypereosinophilic syndrome (HES)
SC
Submitted – sBLA; Fast Track; Orphan Drug; Priority Review
January 2021
ivacaftor (Kalydeco®)
Vertex
CF (ages 4 to ≤ 6 months)
Oral
Submitted – sNDA; Breakthrough Therapy; Fast Track; Orphan Drug
February 2021
peginterferon beta-1a (Plegridy®)
Biogen
MS (relapsing/remitting, active secondary progressive)
IM
Submitted – sBLA
February 2021
sacubitril/valsartan (Entresto®)
Novartis
Heart failure with preserved ejection fraction (HFpEF)
Oral
Submitted – sNDA
02/26/2021
selinexor (Xpovio®)
Karyopharm
Multiple myeloma (≥ 1 prior therapy)
Oral
Submitted – sNDA; Fast Track; Orphan Drug
03/19/2021
Abbvie
PsA
Oral
Submitted – sNDA
04/01/2021
pimavanserin (Nuplazid )
Acadia
Dementia-related hallucinations and delusions
Oral
Submitted – sNDA; Breakthrough Therapy
04/03/2021
tenapanor (Ibsrela®)
Ardelyx
Hyperphosphatemia (in CKD dialysis-dependent patients)
Oral
Submitted – sNDA
06/30/2021
upadacitinib (Rinvoq™) ®
Phase 3 (New Drugs) abaloparatide-TD
Radius
Osteoporosis/osteopenia
Transdermal
Phase 3 – NDA
TBD
abametapir
Dr. Reddy’s
Head lice (aged ≥ 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
25 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
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)
Mylan/Biocon
RA; AS; PSO; PsA; JIA; CD; UC
SC
Phase 3 – BLA
TBD
aflibercept (biosimilar to Regeneron’s Eylea®)
Biogen/Samsung Bioepis
Diabetic macular edema
Intraocular
Phase 3 – BLA
TBD
aflibercept (biosimilar to Regeneron’s Eylea)
Mylan/Biocon
Diabetic macular edema
Intraocular
Phase 3 – BLA
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
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
autologous genetically modified human dermal fibroblasts
Castle Creek
Epidermolysis bullosa
Intradermal
Phase 3 – BLA; Fast Track; Orphan Drug; RMAT
TBD
avalglucosidase alfa
Sanofi
Pompe disease
IV
Phase 3 – BLA; Breakthrough Therapy; Fast Track
TBD
AZD-1222 vaccine (formerly ChAdOx1-S)
AstraZeneca/University of Oxford
COVID-19
IM
Phase 3 – BLA
TBD
baclofen/naltrexone/ sorbitol
Pharnext
Charcot-Marie-Tooth disease
Oral
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
balixafortide
Polyphor
Breast cancer
IV
Phase 3 – NDA; Fast Track
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
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/AstraZeneca
CRC; Glioblastoma; NSCLC; Ovarian cancer; RCC
IV
Phase 3 – BLA
TBD
bexagliflozin
Theracos
T2DM
Oral
Phase 3 – NDA
TBD
bimekizumab
UCB
Axial spondyloarthritis; Hidradenitis suppurativa; PsA; PSO
IV
Phase 3 – BLA
TBD
BNT162 vaccine (multiple variants)
Biontech/Pfizer
COVID-19
IM
Phase 3 – BLA
TBD
26 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
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
calmangafodipir
Pledpharma
Chemotherapy-induced peripheral neuropathy
IV
Phase 3 – NDA
TBD
cannabidiol gel
Zynerba
Fragile X syndrome
Transdermal
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
capsaicin
Centrexion
Osteoarthritis
Intraarticular
Phase 3 – NDA; Fast Track
TBD
carglumic acid
Recordati
Hyperammonaemia (autosomal disorderrelated)
Oral
Phase 3 – NDA; Orphan Drug
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
ceftobiprole medocaril
Basilea
ABSSSI; Bacteremia; CABP; IV HAP
Phase 3 – NDA; Fast Track; QIDP
TBD
cenicriviroc mesylate
Allergan
NASH
Oral
Phase 3 – NDA; Fast Track
TBD
ciltacabtagene autoleucel
Janssen
Multiple myeloma
IV
Phase 3 – BLA; Breakthrough Therapy; Orphan Drug
TBD
clindamycin phosphate gel
Daré
Bacterial vaginosis
Intravaginal
Phase 3 – NDA; QIDP
TBD
CM-AT
Curemark
Autism spectrum disorder
Oral
Phase 3 – BLA; Fast Track
TBD
conbercept
Chengdu Kanghong
Wet AMD
Intraocular
Phase 3 – BLA
TBD
coronavac vaccine
Sinovac
COVID-19
IM
Phase 3 – BLA
TBD
COVID-19 inactivated vaccine (Vero cell)
Sinopharm/Beijing Institute
COVID-19
IM
Phase 3 – BLA
TBD
COVID-19 inactivated vaccine (Vero cell)
Sinopharm/Wuhan Institute
COVID-19
IM
Phase 3 – BLA
TBD
crisantaspase (recombinant)
Jazz
ALL
IM, IV
Phase 3 – BLA; Fast Track
TBD
dactolisib
Restorbio
COVID-19
Oral
Phase 3 – NDA
TBD
dalcetrapib
Dalcor
Dyslipidemia/ hypercholesterolemia
Oral
Phase 3 – NDA
TBD
daprodustat
GlaxoSmithKline
Anemia due to CKD (dialysis-independent/ dependent)
Oral
Phase 3 – NDA
TBD
daridorexant
Idorsia
Insomnia
Oral
Phase 3 – NDA
TBD
darvadstrocel
Takeda
CD
IV
Phase 3 – BLA; Orphan Drug
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
27 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
dexmedetomidine
Bioxcel
Bipolar disorder; 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
dociparstat sodium
Chimerix
COVID-19
IV
Phase 3 – NDA
TBD
docosahexaenoic acid
Micelle
Sickle cell disease
Oral
Phase 3 – NDA; Orphan Drug
TBD
donaperminogene seltoplasmid
Helixmith
Diabetic foot ulcers; Diabetic peripheral neuropathy; Peripheral arterial disease
IM
Phase 3 – BLA; RMAT
TBD
dovitinib lactate
Oncology Venture
RCC
Oral
Phase 3 – NDA
TBD
dusquetide
Soligenix
Mucositis
IV
Phase 3 – NDA; Fast Track
TBD
dust mite immunotherapy
Stallergenes
Allergic rhinitis
SL/Oral transmucosal
Phase 3 – BLA
TBD
eculizumab (biosimilar to Alexion’s Soliris®)
Amgen
Paroxysmal nocturnal hemoglobinuria; Atypical hemolytic uremic syndrome
IV
Phase 3 – BLA
TBD
edasalonexent
Catabasis
DMD
Oral
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
efgartigimod
Argenx
ITP; Myasthenia gravis
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
elamipretide
Stealth Bio
Barth syndrome
IV, Oral, SC
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
elivaldogene tavalentivec (Lenti-D)
Bluebird Bio
Adrenomyeloneuropathy (adrenoleukodystrophy)
IV
Phase 3 – BLA; Breakthrough Therapy; Orphan Drug
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 therapeutic vaccine
OSE Immunotherapeutics
NSCLC
SC
Phase 3 – NDA; Orphan Drug
TBD
eprenetapopt
Aprea
Myelodysplastic syndrome (tumor protein p53 mutation)
IV
Phase 3 – NDA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
erdosteine
Alitair
COPD
Oral
Phase 3 – NDA
TBD
estetrol
Mithra
Menopausal vasomotor symptoms
Oral
Phase 3 – NDA
TBD
28 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
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; Orphan Drug
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
faricimab
Genentech
Diabetic macular edema; Wet AMD
Intraocular
Phase 3 – BLA
TBD
fasinumab
Regeneron
Osteoarthritis pain
SC
Phase 3 – BLA
TBD
fexapotide triflutate
Nymox
Benign prostatic hyperplasia
Intratumoral
Phase 3 – NDA
TBD
fezolinetant
Astellas
Menopausal vasomotor symptoms
Oral
Phase 3 – NDA
TBD
fidanacogene elaparvovec
Pfizer
Hemophilia B
IV
Phase 3 – BLA; Breakthrough Therapy; Orphan Drug
TBD
filgotinib
Gilead
PsA; CD; UC
Oral
Phase 3 – NDA
TBD
finerenone
Bayer
Diabetic nephropathy
Oral
Phase 3 – NDA
TBD
fitusiran
Sanofi
Hemophilia A and B (with and without inhibitors)
SC
Phase 3 – NDA; Orphan Drug
TBD
follitropin alfa (biosimilar to EMD Serono’s Gonal-F®)
Allergan
Female reproductive disorder
SC
Phase 3 – BLA
TBD
follitropin alfa (biosimilar to EMD Serono’s Gonal-F)
Finox
Female reproductive disorder
SC
Phase 3 – BLA
TBD
follitropin delta
Ferring
Female infertility
IV
Phase 3 – BLA
TBD
fosdenopterin
Bridgebio
Molybdenum cofactor deficiency (MoCD)
IV
Phase 3 – NDA; Breakthrough Therapy; Orphan Drug
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 – NDA
TBD
GLPG1690
Galapos
Idiopathic pulmonary fibrosis
Oral
Phase 3 – NDA; Orphan Drug
TBD
guadecitabine
Otsuka
Myelodysplastic syndrome
SC
Phase 3 – NDA
TBD
hydrocortisone granules
Diurnal
Congenital adrenal hyperplasia
Oral
Phase 3 – NDA; Orphan Drug
TBD
hypericin
Soligenix
Cutaneous T-cell lymphoma (CTCL)
Topical
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
29 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
ibrexafungerp
Scynexis
Fungal infections (systemic and nonsystemic)
IV, 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 Intrathecal (MPS II; Hunter syndrome)
Phase 3 – BLA; Fast Track; Orphan Drug
TBD
immunoglobulin IV 10%
Prometic Life Sciences
Primary immunodeficiencies
IV
Phase 3 – BLA
TBD
infigratinib
Bridgebio
Biliary tract cancer
Oral
Phase 3 – NDA; Fast Track
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/Biocon
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
L-citrulline
Asklepion
Acute lung injury
IV
Phase 3 – NDA; Orphan Drug
TBD
lebrikizumab
Dermira
Atopic dermatitis
SC
Phase 3 – BLA; Fast Track
TBD
lenadogene nolparvovec (GS010)
Gensight
Leber’s hereditary optic neuropathy
Intraocular
Phase 3 – BLA; Orphan Drug
TBD
lenzilumab
Humanigen
COVID-19
IV
Phase 3 – BLA
TBD
leriglitazone
Minoryx
Adrenomyeloneuropathy (adrenoleukodystrophy)
Oral
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
leronlimab
Cytodyn
COVID-19
IV, SC
Phase 3 – BLA
TBD
levodopa/carbidopa patch pump
Mitsubishi Tanabe
Parkinson’s disease
SC
Phase 3 – NDA
TBD
levoketoconazole
Strongbridge
Cushing’s syndrome
Oral
Phase 3 – NDA; Orphan Drug
TBD
ligelizumab
Novartis
Urticaria
SC
Phase 3 – BLA
TBD
linzagolix
Obseva
Endometriosis; Uterine fibroids
Oral
Phase 3 – NDA
TBD
lonafarnib
Eiger
Hepatitis D infection
Oral
Phase 3 – NDA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
lorecivivint
Samumed
Osteoarthritis (knee)
Intraarticular
Phase 3 – NDA
TBD
lutetium 177Lu-PSMA-617
Novartis
Prostate cancer
IV
Phase 3 – NDA
TBD
30 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
LYS-SAF302
Sarepta
Mucopolysaccharidosis IIIA (MPS 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 mesylate
AB Science
Asthma (eosinophilic); Alzheimer’s disease; Amyotrophic lateral sclerosis; Mastocytosis; MS (primary progressive, non-active secondary)
Oral
Phase 3 – NDA; Orphan Drug
TBD
mavacamten
Myokardia
Obstructive hypertrophic cardiomyopathy
Oral
Phase 3 – NDA; Breakthrough Therapy; Orphan Drug
TBD
meloxicam/rizatriptan
Axsome
Migraine treatment
Oral
Phase 3 – NDA
TBD
metachromatic leukodystrophy gene therapy
Orchard
Metachromatic leukodystrophy
IV
Phase 3 – BLA; Orphan Drug
TBD
microbiota suspension
Ferring
C. 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
mitapivat
Agios
Pyruvate kinase deficiency
Oral
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
molgramostim
Savara
Pulmonary alveolar proteinosis
Inhaled
Phase 3 – BLA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
mRNA-1273 vaccine
Moderna/NIAID
COVID-19
IM
Phase 3 – BLA; Fast Track
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
nemolizumab
Galderma
Atopic dermatitis
SC
Phase 3 – BLA
TBD
nirsevimab
AstraZeneca
RSV infection prevention
N/A
Phase 3 – BLA; Breakthrough Therapy; Fast Track
TBD
31 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
olipudase alfa
Sanofi
Niemann-Pick disease
IV
Phase 3 – BLA; Breakthrough Therapy; Orphan Drug
TBD
omega-3 phospholipid (krill oil)
Akcea
Hypertriglyceridemia (severe)
N/A
Phase 3 – NDA
TBD
ondansetron ER once-daily
Redhill
Gastroenteritis
Oral
Phase 3 – NDA
TBD
oportuzumab monatox
Sesen Bio
Bladder cancer (BCGunresponsive, nonmuscle invasive)
Intravesical
Phase 3 – BLA; Fast Track
TBD
OTL-103
Orchard
Wiskott-Aldrich syndrome IV
Phase 3 – BLA; Orphan Drug; RMAT
TBD
oxalobacter formigenes
Oxthera
Hyperoxaluria
Oral
Phase 3 – BLA; Orphan Drug
TBD
palovarotene
Ipsen
Fibrodysplasia ossificans progressiva
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
Intraocular
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
pegzilarginase
Aeglea
Arginase 1 deficiency
IV
Phase 3 – BLA; Breakthrough Therapy
TBD
pimecrolimus
Bausch Health
Atopic dermatitis
Topical
Phase 3 – NDA
TBD
pimodivir
Janssen
Influenza treatment
Oral
Phase 3 – NDA; Fast Track
TBD
plasminogen (human)
Liminal
Hypoplasminogenemia
IV
Phase 3 – BLA; Fast Track; Orphan Drug
TBD
plinabulin
BeyondSpring
Neutropenia/leukopenia; NSCLC
IV
Phase 3 – NDA
TBD
pollinex quattro grass
Allergy Therapeutics
Allergic rhinitis
SC
Phase 3 – BLA
TBD
ranibizumab (biosimilar to Genentech’s Lucentis®)
Biogen/Samsung Bioepis
Wet AMD
Intraocular
Phase 3 – BLA
TBD
ranibizumab (biosimilar to Genentech’s Lucentis)
Coherus/Santo
Wet AMD
Intraocular
Phase 3 – BLA
TBD
ranibizumab (biosimilar to Genentech’s Lucentis)
STADA Arzneimittel/ Bausch Health
Wet AMD
Intraocular
Phase 3 – BLA
TBD
REGN-COV2
Regeneron
COVID-19
N/A
Phase 3 – BLA
TBD
relacorilant
Corcept
Cushing’s syndrome
Oral
Phase 3 – NDA; Orphan Drug
TBD
reltecimod
Atox
Necrotizing soft tissue infection
IV
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
relugolix (± estradiol/ norethindrone)
Myovant
Endometriosis
Oral
Phase 3 – NDA
TBD
remdesivir
Gilead
COVID-19
Inhaled, IV
Phase 3 – NDA
TBD
reproxalap
Aldeyra
Congenital ichthyosis
Topical
Phase 3 – NDA; Orphan Drug
TBD
resmetirom
Madrigal
NASH
Oral
Phase 3 – NDA; Fast Track
TBD
32 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
ridinilazole
Summit
C. difficile-associated diarrhea
Oral
Phase 3 – NDA; Fast Track; QIDP
TBD
rigosertib
Onconova
Myelodysplastic syndrome
IV
Phase 3 – NDA; Orphan Drug
TBD
rituximab (biosimilar to Genentech’s Rituxan)
Archigen
RA; CLL/ SLL; NHL (indolent); ANCAassociated vasculitis
IV
Phase 3 – BLA
TBD
rivoceranib
LSK Biopartners
Gastric cancer
Oral
Phase 3 – NDA; Orphan Drug
TBD
rozanolixizumab
UCB
ITP; Myasthenia gravis
SC
Phase 3 – BLA
TBD
RSV nanoparticle vaccine
Novavax
RSV infection prevention
IM
Phase 3 – BLA; Fast Track
TBD
ruxolitinib cream
Incyte
Atopic dermatitis; Vitiligo
Topical
Phase 3 – sNDA
TBD
savolitinib
AstraZeneca
RCC
Oral
Phase 3 – NDA
TBD
seladelpar
Cymabay
Primary biliary cholangitis/hepatic fibrosis
Oral
Phase 3 – NDA; Breakthrough Therapy; Orphan Drug
TBD
sepofarsen
Proqr
Leber’s congenital amaurosis
Intraocular
Phase 3 – NDA; Fast Track; Orphan Drug
TBD
setmelanotide
Rhythm
Alström syndrome; Bardet-Biedl syndrome
SC
Phase 3 – NDA; 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; CVD
Oral
Phase 3 – NDA
TBD
sparsentan
Retrophin
Focal segmental glomerulosclerosis; Immunoglobulin A nephropathy (Berger’s disease)
Oral
Phase 3 – NDA; Orphan Drug
TBD
spartalizumab
Novartis
Melanoma
IV
Phase 3 – BLA
TBD
sulopenem etzadroxil
Iterum
Intra-abdominal infections; UTI (uncomplicated)
IV, Oral
Phase 3 – NDA; Fast Track; QIDP
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
tapinarof
Roivant
PSO
Topical
Phase 3 – NDA
TBD
tecarfarin
Espero
Anticoagulation
Oral
Phase 3 – NDA
TBD
teplizumab
Provention Bio
T1DM (prevention or delay)
IV
Phase 3 – BLA; Breakthrough Therapy; Orphan Drug
TBD
33 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
teprasiran
Quark
Delayed graft function; Kidney injury prevention following cardiac surgery
IV
Phase 3 – NDA
TBD
tezepelumab
AstraZeneca
Asthma (severe, uncontrolled)
SC
Phase 3 – BLA; Breakthrough Therapy
TBD
timbetasin
Regenerx
Dry eye syndrome; Neurotrophic keratitis
Topical
Phase 3 – BLA; Orphan Drug
TBD
timrepigene emparvovec
Biogen
Choroideremia
Intraocular
Phase 3 – BLA; Orphan Drug; RMAT
TBD
tirzepatide
Eli Lilly
T1DM
SC
Phase 3 – NDA
TBD
tivanisiran
Sylentis
Dry eye syndrome
Topical
Phase 3 – NDA
TBD
tofersen
Biogen
Amyotrophic lateral sclerosis
Intrathecal
Phase 3 – NDA; Orphan Drug
TBD
tominersen
Genentech
Huntington’s disease
Intrathecal
Phase 3 – NDA; Orphan Drug
TBD
tonogenchoncel-L
Kolon Tissuegene
Osteoarthritis
Intraarticular
Phase 3 – BLA
TBD
trabedersen
Autotelic
Brain cancer (malignant glioma; glioblastoma)
IV, Intratumoral
Phase 3 – NDA; Orphan Drug
TBD
tradipitant
Vanda
Atopic dermatitis; COVID-19; Gastroparesis; Pruritus
Oral
Phase 3 – NDA
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
trastuzumab duocarmazine
Synthon Bio
Breast cancer
IV
Phase 3 – BLA; Fast Track
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 (HBV) 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; Mantle cell lymphoma
Oral
Phase 3 – NDA; Orphan Drug
TBD
vadadustat
Akebia
Anemia due to CKD (dialysis-independent/ dependent)
Oral
Phase 3 – NDA
TBD
vazegepant
Biohaven
Migraine treatment; COVID-19
Intranasal, Oral
Phase 3 – NDA
TBD
veliparib
Abbvie
Breast cancer; Ovarian cancer
Oral
Phase 3 – NDA
TBD
VGX-3100
Inovio
Cervical dysplasia
IM
Phase 3 – BLA
TBD
vilanterol trifenatate
GlaxoSmithKline
Asthma; COPD
Inhaled
Phase 3 – NDA
TBD
34 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
vocimagene amiretrorepvec
Tocen
Brain cancer (malignant glioma; glioblastoma)
Intratumoral
Phase 3 – BLA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
vonoprazan fumarate
Phathom
H. pylori infection; Esophagitis
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); Transthyretin amyloidosis polyneuropathy
SC
Phase 3 – NDA; 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
Phase 3 (Supplementals) ado-trastuzumab emtansine (Kadcyla)
Genentech
Breast cancer (HER2+, adjuvant, with pertuzumab)
IV
Phase 3 – sBLA; Breakthrough Therapy
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
anakinra (Kineret®)
Swedish Orphan Biovitrum
COVID-19
SC
Phase 3 – sBLA
TBD
apalutamide (Erleada®)
Janssen
Prostate cancer (localized)
Oral
Phase 3 – sNDA
TBD
atezolizumab (Tecentriq®)
Genentech
Bladder cancer (1st-line metastatic); Bladder cancer (adjuvant, muscleinvasive); Breast cancer (TNBC, neoadjuvant, with nabpaclitaxel); Breast cancer (1st-line, TNBC, with paclitaxel); Melanoma; Ovarian cancer
IV
Phase 3 – sBLA; Breakthrough Therapy; Orphan Drug
TBD
avatrombopag (Doptelet®)
Ararx
Thrombocytopenia (chemotherapy-induced)
Oral
Phase 3 – sNDA; Orphan Drug
TBD
baricitinib (Olumiant®)
Eli Lilly
Alopecia areata; Atopic dermatitis; COVID-19; JIA; SLE; Uveitis
Oral
Phase 3 – sNDA; Breakthrough Therapy; Fast Track
TBD
bacille Calmette-Guérin (BCG) (TICE® strain) vaccine
Merck
COVID-19
Intradermal
Phase 3 – sBLA
TBD
belimumab (Benlysta®)
GlaxoSmithKline
ANCA-associated IV vasculitis; Lupus nephritis
Phase 3 – sBLA; Breakthrough Therapy
TBD
benralizumab (Fasenra®)
AstraZeneca
Nasal polyps
SC
Phase 3 – sBLA
TBD
brexpiprazole (Rexulti )
Otsuka
Alzheimer’s diseaserelated agitation; Bipolar disorder; PTSD
Oral
Phase 3 – sNDA; Fast Track
TBD
®
35 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
cabozantinib (Cabometyx®)
Exelixis
RCC (1st-line, with nivoluab)
Oral
Phase 3 – sNDA
TBD
canakinumab (Ilaris®)
Novartis
COVID-19
IV
Phase 3 – sBLA
TBD
cannabidiol (Epidiolex)
GW
Rett syndrome
Oral
Phase 3 – sNDA
TBD
dapagliflozin (Farxiga®)
AstraZeneca
COVID-19; CKD; Diabetic nephropathy; Post MI
Oral
Phase 3 – sNDA; Fast Track
TBD
daratumumab-rHuPH20 (Darzalex Faspro™)
Janssen
Amyloidosis
SC
Phase 3 – sBLA
TBD
dupilumab (Dupixent®)
Sanofi
Atopic dermatitis (ages 6 months to 5 years); Bullous pemphigoid; COPD; Esophagitis; Pruritus; Urticaria
SC
Phase 3 – sBLA; Breakthrough Therapy; Orphan Drug
TBD
durvalumab (Imfinzi®)
AstraZeneca
Bladder cancer (with tremelimumab); NSCLC (1st-line, with tremelimumab); NSCLC (neoadjuvant)
IV
Phase 3 – sBLA; Breakthrough Therapy; Fast Track
TBD
empagliflozin (Jardiance®)
Boehringer Ingelheim
Chronic heart failure; Diabetic nephropathy
Oral
Phase 3 – sNDA; Fast Track
TBD
fenfluramine (Fintepla®)
Zogenix
Lennox-Gastaut syndrome
Oral
Phase 3 – sNDA; Orphan Drug
TBD
hydrogen peroxide (Eskata®)
Aclaris
Warts
Topical
Phase 3 – sNDA
TBD
immunoglobulin 5% (Octagam®)
Octapharma
COVID-19
IV
Phase 3 – sBLA
TBD
lacosamide (Vimpat®)
UCB
Primary generalized tonic-clonic seizures (adjunctive treatment)
IV, Oral
Phase 3 – sNDA
TBD
lumateperone (Caplyta®)
Intra-Cellular Therapies
Bipolar disorder
Oral
Phase 3 – sNDA
TBD
mepolizumab (Nucala)
GlaxoSmithKline
COPD; Nasal polyps
SC
Phase 3 – sBLA
TBD
meropenem/vaborbactam (Vabomere®)
Melinta
Bacteremia; HAP
IV
Phase 3 – sNDA; QIDP TBD
niraparib (Zejula®)
GlaxoSmithKline
Ovarian cancer (in combination with dostarlimab)
Oral
Phase 3 – sNDA; Orphan Drug
TBD
nitazoxanide (Alinia®)
Lupin
COVID-19
Oral
Phase 3 – sNDA
TBD
olaparib (Lynparza )
AstraZeneca
Breast cancer (metastatic, adjuvant treatment); Ovarian cancer (gBRCAm, 3rd-line); Ovarian cancer (2nd-line, in combination with cediranib)
Oral
Phase 3 – sNDA; Fast Track; Orphan Drug
TBD
omalizumab (Xolair)
Genentech
Food allergies
SC
Phase 3 – sBLA; Breakthrough Therapy
TBD
onasemnogene abeparvovac-xioi (Zolgensma®)
Novartis
Spinal muscular atrophy (type 2, 3)
IV, Intrathecal
Phase 3 – sBLA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
ozanimod (Zeposia®)
Celgene
CD; UC
Oral
Phase 3 – sNDA
TBD
®
36 | magellanrx.com
PIPELINE DRUG LIST continued NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
paliperidone (Invega Sustenna®) 6-month injectable
Janssen
Schizophrenia
IM
Phase 3 – sNDA
TBD
patisiran (Onpattro®)
Alnylam
Transthyretin amyloid cardiomyopathy (wild type or hereditary)
IV
Phase 3 – sNDA
TBD
pertuzumab (Perjeta®)
Genentech
Breast cancer (HER2+, adjuvant, with adotrastuzumab)
IV
Phase 3 – sBLA
TBD
pirfenidone (Esbriet®)
Genentech
Idiopathic pulmonary fibrosis (unclassifiable interstitial lung disease [uILD])
Oral
Phase 3 – sNDA; Breakthrough Therapy; Fast Track; Orphan Drug
TBD
polatuzumab vedotin-piiq (Polivy)
Genentech
DLBLC (1st-line)
IV
Phase 3 – sBLA; Breakthrough Therapy; Orphan Drug
TBD
prasterone (Intrarosa®)
AMAG
Female sexual arousal disorder
Intravaginal
Phase 3 – sNDA
TBD
ravulizumab-cwvz (Ultomiris)
Alexion
COVID-19
IV
Phase 3 – sBLA
TBD
rilonacept (Arcalyst®)
Regeneron
Recurrent pericarditis
SC
Phase 3 – sBLA; Breakthrough Therapy; Orphan Drug
TBD
risankizumab-rzaa (Skyrizi®)
Abbvie
PsA; CD; UC
SC
Phase 3 – sBLA; Orphan Drug
TBD
ruxolitinib (Jakafi®)
Incyte
COVID-19
Oral
Phase 3 – sNDA
TBD
sacubitril/valsartan (Entresto)
Novartis
Post-acute MI
Oral
Phase 3 – sNDA; Fast Track
TBD
Sanofi
COVID-19
SC
Phase 3 – sBLA
TBD
secnidazole (Solosec )
Lupin
Trichomoniasis
Oral
Phase 3 – sNDA
TBD
selinexor (Xpovio)
Karyopharm
Liposarcoma
Oral
Phase 3 – sNDA; Orphan Drug
TBD
semaglutide (Ozempic®)
Novo Nordisk
Diabetic nephropathy; Diabetic retinopathy; Obesity
SC
Phase 3 – sNDA
TBD
tecovirimat (Tpoxx®)
SIGA
Smallpox
IV
Phase 3 – sNDA; Fast Track; Orphan Drug
TBD
teriflunomide (Aubagio®)
Sanofi
MS (pediatrics)
Oral
Phase 3 – sNDA
TBD
ticagrelor (Brilinta)
AstraZeneca
Sickle cell disease
Oral
Phase 3 – sNDA
TBD
tisagenlecleucel-t (Kymriah)
Novartis
DLBCL (1st relapse)
IV
Phase 3 – sBLA; Breakthrough Therapy; Orphan Drug
TBD
tocilizumab (Actemra®)
Genentech
COVID-19
IV
Phase 3 – sBLA
TBD
upadacitinib (Rinvoq)
Abbvie
Atopic dermatitis; Axial spondyloarthritis; CD; UC; Giant cell arteritis
Oral
Phase 3 – sNDA; Breakthrough Therapy
TBD
Janssen
SLE
IV, SC
Phase 3 – sBLA
TBD
Beigene
Waldenstrom macroglobulinemia
Oral
Phase 3 – sNDA; Fast Track; Orphan Drug
TBD
sarilumab (Kevzara®) ®
ustekinumab (Stelara) zanubrutinib (Brukinsa ) ®
37 | magellanrx.com
PIPELINE DRUG LIST continued
Complete Response Letter (CRL)/Withdrawn Drugs NAME
MANUFACTURER
DOSAGE FORM
CLINICAL USE
APPROVAL STATUS
FDA APPROVAL
abicipar pegol
Allergan
Wet AMD
Intraocular
CRL
TDB
avapritinib (Ayvakit®)
Blueprint Medicines
GIST (4th-line)
Oral
CRL
TDB
bupivacaine/meloxicam
Heron
Postsurgical pain
Instillation
CRL
TDB
cantharidin 0.7% drugdevice
Verrica
Molluscum contagiosum
Topical
CRL
TDB
dasotraline
Sumitomo Dainippon
Binge eating disorder
Oral
Withdrawn
N/A
fosfomycin
Nabriva
UTI (complicated)
IV
CRL
TDB
lenvatinib (Lenvima )
Eisai
HCC (1st-line, unresectable, in combination with pembrolizumab)
Oral
CRL
TDB
nadofaragene firadenovec
FKD
Bladder cancer (highgrade, BCG-unresponsive, non-muscle invasive)
Intravesical
CRL
TDB
obeticholic acid (Ocaliva®)
Intercept
NASH
Oral
CRL
TDB
oxycodegol
Nektar
Chronic low back pain
Oral
Withdrawn
N/A
pembrolizumab (Keytruda)
Merck
HCC (1st-line, unresectable, in combination with lenvatinib)
IV
CRL
TDB
rimegepant tablet
Biohaven
Migraine treatment
Oral
Withdrawn
N/A
treprostinil disposible patch pump
United Therapeutics
PAH
SC
CRL
TDB
®
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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 BMI Body Mass Index
CI Confidence Interval 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 ECOG Eastern Cooperative Oncology Group EDSS Expanded Disability Status Scale EGFR Epidermal Growth Factor Receptor ER Extended-Release
BCVA Best Corrected Visual Acuity
FACIT Functional Assessment of Chronic Illness Therapy
CABP Community Acquired Bacterial Pneumonia
FDA Food and Drug Administration
CAP Community Acquired Pneumonia
FH Familial Hypercholesterolemia
CD Crohn's Disease
FLT3 FMS-Like Tyrosine Kinase-3
CDC Centers for Disease Control and Prevention
GI Gastrointestinal
CF Cystic Fibrosis
GIST Gastrointestinal Stromal Tumor
CHF Congestive Heart Failure
GLP-1RA Glucagon-Like Peptide-1 Receptor Agonist
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GLOSSARY continued GVHD Graft Versus Host Disease
MRI Magnetic Resonance Imaging
H Half
MRSA Methicillin-Resistant Staphylococcus Aureus
HAM-D Hamilton Depression Rating Scale
MS Multiple Sclerosis
HAP Healthcare-Associated Pneumonia
N/A Not Applicable
Hb Hemoglobin
NASH Non-Alcoholic Steatohepatitis
HbA1c Hemoglobin A1c
NDA New Drug Application
HCC Hepatocellular Carcinoma
NHL Non-Hodgkin Lymphoma
HCP Healthcare Professional
NIAID National Institute of Allergy and Infectious Diseases
HCV Hepatitis C Virus
NSAID Non-Steroidal Anti-Inflammatory Drug
HER Human Epidermal Growth Factor Receptor
NSCLC Non-Small Cell Lung Cancer
HER2 Human Epidermal Growth Factor Receptor 2
ODT Orally Disintegrating Tablet
HFA Hydrofluoroalkane
ORR Overall/Objective Response Rate
HIT Heparin Induced Thrombocytopenia
OR Odds Ratio
HIV Human Immunodeficiency Virus
OS Overall Survival
HIV-1 Human Immunodeficiency Virus-1
PAH Pulmonary Arterial Hypertension
HR Hazard Ratio
PARP Poly (ADP-ribose) polymerase
HSCT Hematopoietic Stem Cell Transplant
PASI 50 Psoriasis Area and Severity Index ≥ 50%
HTN Hypertension
PASI 70 Psoriasis Area and Severity Index ≥ 70%
IBS Irritable Bowel Syndrome
PASI 90 Psoriasis Area and Severity Index ≥ 90%
IBS-C Irritable Bowel Syndrome, Constipation Predominant
PCI Percutaneous Coronary Intervention
IM Intramuscular ITP Immune Thrombocytopenic Purpura ITT Intent-To-Treat 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
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PD-1 Programmed Death Protein 1 PD-L1 Programmed Death-Ligand 1 PDUFA Prescription Drug User Fee Application PFS Progression-Free Survival 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
GLOSSARY continued QOL Quality of Life
TBD To Be Determined
R-CHOP Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisone
TEAE Treatment-Emergent Adverse Events
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 sBLA supplemental Biologics License Application SC Subcutaneous SCCHN Squamous Cell Cancer of the Head and Neck 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
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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 WBC White Blood Cell WHO World Health Organization XR Extended-Release
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