New Schizophrenia Drug Will Likely Have Familiar Coverage

by Leslie Small

Earlier this month, the FDA approved a drug that the manufacturer touts as "the first-and-only twice-yearly injectable for the treatment of schizophrenia in adults."

The drug is called Invega Hafyera (six-month paliperidone palmitate), a product produced by Janssen Pharmaceuticals, Inc., a Johnson & Johnson unit. Before they transition to the newly approved, twice-yearly injectable, however, patients must first be adequately treated by Invega Sustenna (one-month paliperidone palmitate) for at least four months or Invega Trinza (three-month paliperidone palmitate) for at least one three-month cycle. Both products are also manufactured by Janssen.

What drug benefits experts say?

• "Invega Hafyera will provide patients and providers another option for treating schizophrenia but will require monitoring of the tolerability and side effect profile due it being the first and only drug available dosed every six months," says Mesfin Tegenu, CEO and chairman of RxParadigm. The drug "would be a good alternative for patients who have previously been on extended-release paliperidone that would further benefit from a longer acting therapy," he adds.
• Robert Kinyua, Pharm.D., Prime Therapeutics' clinical program development director, says that coverage for Invega Hafyera "is expected to mirror that of existing long acting injectable (LAI) antipsychotics, especially Invega Sustenna and Invega Trinza." Those drugs are 63% covered or better and 48% covered or better, respectively, on commercial formularies, according to data from MMIT.
• "Second-generation oral antipsychotics" are currently the standard of care for treating schizophrenia, Tegenu says. Generics of those drugs are typically preferred, while branded versions "are preferred/non-preferred with prior authorization or step through requirements of trial and failure of generic alternatives first."

Emerging treatments:

• Biopharma is focused on developing new products "that target multiple symptoms in schizophrenia but most importantly, the negative and cognitive symptoms where the unmet need is most significant," Leerink analysts wrote in a Sept. 24 note about the recent virtual Psych Congress 2020. "Additionally, physicians still welcome safer products that provide better compliance and improved treatment outcomes, which is positive news for Alkermes' Aristada and ALKS-3831, Acadia's Nuplazid, as well as Intra-Cellular's Caplyta."

From RADAR on Drug Benefits