Payers Are Likely to Manage New MS Drug Ponvory to Label

by Angela Maas

Although there are more than 20 FDA-approved disease-modifying therapies for multiple sclerosis (MS), companies continue to bring new products to market. Zitter Insights found that the majority of payers expect to manage the newest entrant, the Janssen Pharmaceutical Companies of Johnson & Johnson's Ponvory (ponesimod), to label.

On March 19, the FDA approved Ponvory to treat adults with relapsing forms of MS, including clinically isolated syndrome, relapsing-remitting disease and active secondary progressive disease.

The sphingosine 1-phosphate (S1P) receptor modulator joins other oral agents within that class: Gilenya (fingolimod) and Mayzent (siponimod), both from Novartis Pharmaceuticals Corp., and Bristol Myers Squibb's Zeposia (ozanimod).

For the Managed Care Biologics & Injectables Index: Q1 2021, between Feb. 25, 2021, and April 2, 2021, Zitter Insights polled 40 commercial payers with 128.6 million covered lives. Payers covering 82% of lives responded that they anticipate they will manage Ponvory to label following pharmacy and therapeutics committee review, which 70% of respondents expected to occur within three to four months of the drug's launch. Payers with 11% of lives said they are likely to manage the agent more restrictively than its label.

Zitter Insights also polled 50 neurologists during the same time frame. Almost two-thirds said they expect to prescribe Ponvory over certain MS therapies. More than half anticipated prescribing Ponvory interchangeably with all other MS agents, and only 30% said they are likely to transition current patients to the new drug.

Payers with 12% of lives expect that Ponvory and another pipeline agent, TG Therapeutics' ublituximab, will face barriers to entry because of their lack of differentiation from other drugs in the class and the difficulty in overcoming existing contracts for other treatments.

Payers generally place prior authorization, step therapy and dispensing limit requirements on the MS specialty agents, explains Nicole Kjesbo, Pharm.D., clinical program development director at Prime Therapeutics LLC.

"Johnson & Johnson's Ponvory is the fourth oral S1P modulator to be FDA approved for the treatment of relapsing forms of MS in the U.S. and is priced at a similar price point to other treatments," she notes. "While it is another option available to treat MS, we expect it may be difficult for Ponvory to pull market share from other therapies that have been available prior to its approval."

From RADAR on Specialty Pharmacy