A new oral GLP-1 therapy and the first preventive option for COVID-19 are among the pipeline drugs that payers and plan sponsors should be watching this spring, according to a new report.
The pipeline surveillance team at Optum Rx has released its latest report on notable drugs that are set for an imminent Food and Drug Administration review. The spring edition includes:
- Icotyde, or icotrokinra, an oral therapy for moderate-to-severe plaque psoriasis that secured FDA approval in March.
- Orforglipron, the second oral GLP-1 treatment, which is set for an April review.
- Ensitrelvir, or Xocova, a preventative therapy for COVID-19 exposure, with an FDA decision expected in June.
Icotyde and orforglipron both fit within high-priority areas for many insurers: psoriasis and obesity. In the latter case, it would follow an oral Wegovy to market, but orflorglipron is the first oral GLP-1 that does not have meal-time restrictions.
The drug’s review is being expedited through the FDA’s new National Priority Voucher program.
Sara Guidry, senior director of pipeline and drug surveillance at Optum Rx, told Fierce Healthcare in an interview that orforglipron has shown similar results in weight loss compared to oral Wegovy, though oral GLP-1s fall short in compared to injectable drug options.
She said that it’s hard to predict what the market impact of an additional oral GLP-1 could be, as the pills will appeal first to people who are unable or unwilling to take the injectable versions. But patients who are already taking an injectable drug may not be interested in switching.
That said, since the drug is anticipated to receive accelerated approval and will be released much closer to the oral formulation of Wegovy, new patients may choose to hold off to take orforglipron because it carries fewer restrictions around meals.
In addition, there are limited data so far on utilization trends for oral Wegovy, which secured FDA approval in late December, Guidry said.
“It hasn’t necessarily been available for long enough for us to have a lot of strong data to know how much new to treatment patients would be favoring orals versus injectables,” she said.
Icotyde, meanwhile, enters a crowded psoriasis market, where it compares favorably to other orals but showed lower response rates than some existing biologic injectables. Guidry said it makes for a strong option for patients that may favor an oral therapy, and payers can crunch the numbers to predict what share of their populations that may represent.
For example, plan sponsors can identify the rate at which new patients opt for orals, or how often patients switch from an oral therapy to an injectable one due to efficacy, she said, to help paint a picture of what demand could look like within their specific member base.
The third drug, ensitrelvir, would work as a preventive therapy for COVID-19, prescribed when an individual comes into contact with a known case of COVID-19, much like taking Tamiflu after flu exposure. The drug has also been used internationally as a treatment for COVID-19, which could be a path the drug takes in the U.S., too.
Beyond these three drugs, Guidry said that many of the trends that have defined the drug pipeline in the past several years hold and are likely to extend through much of 2026. For instance, Optum estimated that 70% of drugs approved in 2025 would be specialty drugs, and the final tally was 76%, she said.
About half of novel drug approvals are orphan drugs, which are developed to target specific rare diseases. Developments in oncology are also a major factor here, she said.
In addition, drugs that are already on the market are taking on approvals for new indications, a trend that extends into the GLP-1 space, she said.
“Not just novel drugs, but we are looking at new indications, new formulations, new strengths,” she said. “It’s almost like, at this point, we’re getting more specific.”
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