Optum: Why payers should be watching flurry of drug development activity around eczema

In a busy drug pipeline, there’s been a flurry of development activity around atopic dermatitis, according to a new analysis from OptumRx.

Atopic dermatitis, or eczema, is a common condition that affects some 32 million Americans, according to the report. Nearly 10 million report moderate to severe symptoms, and the condition is responsible for an estimated $5 billion economic burden each year.

Bill Dreitlein, senior director of pipeline and drug surveillance at OptumRx, told Fierce Healthcare payers should be thinking about the interest in developing drugs for eczema on two fronts: one, these drugs do operate differently and can treat different severities of the disease. Two, it means the market will be a more competitive one, which allows plans and pharmacy benefit managers more flexibility to negotiate and plan for the costs.

“There’s clearly been a surge of emphasis in that area,” Dreitlein said. “That creates a very different dynamic.”

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Optum’s analysts are tracking a number of drugs coming through the pipeline that fall into two “buckets” in terms of how they target the disease. One category, biologic interleukin inhibitors, is dominated by the drug Dupixent. The other bucket of therapies is small-molecule JAK inhibitors.

Optum said there are currently three biologic interleukin inhibitors in the development pipeline that could challenge Dupixent. One such product, tralokinumab, is highlighted in the report, with the Food and Drug Administration (FDA) set to weigh in soon.

The report says the drug could be a notable competitor to several therapies on the market, but there are little data on how it fares head-to-head with other atopic dermatitis drugs.

Optum added that four JAK inhibitor drugs are likely to be evaluated by the FDA this year, with four more products in the pipeline for the FDA to look at in the next five years. There are notable safety concerns about this class of drugs, according to the report, such as off-target effects.

As all of this development continues, Optum expects the atopic dermatitis market’s growth to outpace that of other dermatological conditions like psoriasis or psoriatic arthritis, according to the report, ballooning by 130% to $11 billion by 2029.

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Dupixent has also been approved by the FDA to treat asthma, and Dreitlein said other drugs coming to market for eczema could also pursue approvals for multiple indications.

“I think we could see that with some of the drugs in the atopic dermatitis space,” he said. “It clearly bears watching.”

In addition to the significant development in atopic dermatitis, the Optum report also spotlights aducanumab, an antibody therapy for patients with Alzheimer’s disease. If approved, the drug would be the first disease-modifying therapy for the condition, and about 1.4 million people would be eligible to take it.

The drug has been in development for some time and has faced delays in its approval process, but an FDA decision is expected in early July.

Dreitlein said either way the FDA lands, it “will be newsworthy” for the industry. If approved, it becomes the first drug of its kind for a very common condition, he said, and if it isn’t, drugmakers will have to take a step back and reevaluate how to get an Alzheimer’s drug like this over the finish line.

“It’s an important disease and it’s very difficult to develop drugs in that space,” Dreitlein said.