Cameron Santoro is an associate editor for The Center for Biosimilars

Cameron Santoro

The Top 5 Biosimilar Articles for the Week of July 29

 with GoodRx to offer its unbranded adalimumab biosimilar to patients at an exclusive low price; a new ustekinumab biosimilar launches in Europe; and Mexican officials approve a bevacizumab biosimilar.

 on glycan profiling of monoclonal antibodies (Mabs) receives praise and recommendations from Sarfaraz K. Niazi, PhD.

 showed similar pharmacokinetic and safety profiles compared with the reference product Trulicity in healthy Chinese participants, according to a phase 1 analysis.

 that references Soliris (eculizumab), for the treatment of paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS).1

 were $452,611 over 3 years, driven by decreased drug acquisition costs and a utilization shift from reference to biosimilar natalizumab.

To read all of these articles and more, visit 

Videos

Here are the top 5 biosimilar articles for the week of July 29, 2024.

Ivo Abraham, PhD, RN. 

Ivo Abraham, PhD, RN, director of the Center for Health Outcomes and PharmacoEconomic Research at the University of Arizona Cancer Center acknowledged the responsibility of the FDA regarding safety and efficacy in drug approvals in an interview with The Center for Biosimilars

Abraham does not advocate for adopting the World Health Organization (WHO) guidelines entirely but sees promise in recent FDA movements on interchangeability since they propose the use of statistical modeling and shifting the clinical evidence burden to post-approval safety monitoring to expedite approval.

This transcript has been lightly edited for clarity. 

What specific regulatory roadblocks are hindering the rapid approval of biosimilars, and how can we collaborate with regulatory bodies to streamline the process? 

What we need to remember is that the FDA is the watchdog for everything that is related to drugs. It has an enormous responsibility and accountability, also to Congress, in terms of providing safe—in first instance—and then also effective drugs and that applies to biosimilars as well.

In a certain way, I expect the changes in terms of approval processes, and market entry, and post-approval monitoring will gradually, in an incremental way, stepwise, loosen up, for lack of a better word. So, biosimilar approval 2.0 will emerge at some point in time.

I'm not ready to be quoted saying that the FDA should adopt the WHO guidelines because the influence of the FDA and the European Medicines Agency (EMA) is global. Yes, we need to provide access to biosimilars in the rest of the world as well, but it needs to come from a very high level of standards related to quality and equivalence.

If you look, for instance, at issues—and that's an area where we see some movements within the FDA, and that has to do with interchangeability—there's a recent document that came out, and getting the interchangeability may, at some point in time, become a lot easier.

It can actually be done much easier because interchangeability can be modeled statistically. We have developed—while it's still in the prototype phase—a model that you could statistically create scenarios of interchangeability, take the data that are available, whether they're just pre-approval data, whether they're real-world clinical data, safety and effectiveness data, and model whether there is a risk and what that risk is of an adverse outcome related to interchangeable use of biosimilars.

It's also important then to shift the clinical evidence burden to safety post-approval. We can accelerate the process, for instance, as we do for some other drugs, and say, "Okay, we'll approve your biosimilar, but you are going to be watching yourself and reporting data to us based upon your biosimilars." In that process to develop—and I think that it is critical to develop channels for post-approval monitoring that go beyond voluntary reporting—make it required for the first 2 years on the market.

It doesn't mean that biosimilar companies would need to start sponsoring post-approval prospective studies or whatever because those are expensive. But you can do that to some extent with claims databases, electronic health records, to see what pops up in terms of safety signals as we use biosimilars.

Ivo Abraham, PhD, RN, University of Arizona Cancer Center, recognizes the importance of stringent safety measures for biosimilar approvals. However, he advocates for utilizing statistical models and placing emphasis on postmarket safety data collection.

Streamlining Biosimilar Approvals by Balancing Safety, Speed

The Top 5 Biosimilar Articles for the Week of July 22

 Samsung Bioepis’ Epysqli (eculizumab-aagh), marking the second US approval for a biosimilar referencing Soliris (eculizumab).

 or chronic inflammatory rheumatic disease treated with reference adalimumab who were switched to the 

 CT-P17 generally believed the switch was a treatment necessity. Higher satisfaction rates were observed among those who were convinced of the necessity compared with those with greater concerns about treatment.

 aim to save time and money for manufacturers in the Middle East and North Africa (MENA), but hesitancy among nations to adopt the guidelines is stifling market development of biosimilars.

challenges with pharmacy benefit managers

 (PBMs) that plague the biosimilar industry and new legislation that attempts to reform their practices and encourage biosimilar adoption.

Economic evaluations of biosimilar disease-modifying antirheumatic drugs (DMARDs) suggest cost-effectiveness for patients with rheumatoid arthritis (RA) who did not respond well to methotrexate, potentially 

improving patient outcomes and health care affordability.

Here are the top 5 biosimilar articles for the week of July 22, 2024. 

The Top 5 Biosimilar Articles for the Week of July 15

, discusses how biosimilars can be part of a strategy for delivering high-quality care while achieving savings.

 Patients with HER2-positive breast cancer treated with the biosimilar 

 experienced similar adverse events and well-being as those treated with the originator drug (Herceptin), according to a study using a smartphone app to track symptoms.

biosimilar disease-modifying antirheumatic drugs (DMARDs)

 suggest cost-effectiveness for patients with rheumatoid arthritis (RA) who did not respond well to methotrexate, potentially improving patient outcomes and health care affordability.

 and the US sees another launch, Genentech’s ophthalmology biobetter returns to the market, and Samsung Bioepis shares data on switching to its denosumab biosimilar.

challenges with pharmacy benefit managers (PBMs)

 that plague the biosimilar industry and new legislation that attempts to reform their practices and encourage biosimilar adoption.

Here are the top 5 biosimilar articles for the week of July 15, 2024.

The cost-effectiveness demonstrated in the study can help health care stakeholders, rheumatologists, and patients better understand the benefits and financial feasibility of biosimilar DMARDs. | Image Credit: MicroOne - stock.adobe.com

For patients with rheumatoid arthritis (RA) who did not respond well to methotrexate, a study in 

 found that biosimilar drugs were both more beneficial and more cost-effective than leflunomide.

Current clinical guidelines for treating patients with RA typically recommend methotrexate monotherapy. However, over 50% of the patient population experiences failed treatment with methotrexate based on an inadequate response. If failed treatment occurs, it is recommended to use multiple conventional synthetic disease-modifying antirheumatic drugs (DMARDs), like leflunomide, combined with methotrexate. The next line of therapy combines biological DMARDs with methotrexate.

Expensive drug costs are the main reason biological DMARDs are not used as often in practice. A cross-sectional survey in Hong Kong found the high cost of biologics remains a major barrier to the first attempt of these drugs and long-term adherence to them.

 Even in countries when insurance covered up to 90% of biological DMARD costs, drug adherence was still not improved because of personal expenses and an increase in prescriptions.

More recent, Hong Kong has experienced price reductions ranging from 54% to 87% for CT-P13 (biosimilar infliximab) and ABP-501 (biosimilar adalimumab) compared with their reference products.

 The price reductions may help patients more easily access biological DMARDs after methotrexate failure.

The economic evaluation was initiated by the University of Hong Kong/Hospital Authority Hong Kong West Cluster. Data were recorded using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) reporting guideline. Disease activity was measured in quality-adjusted life-years (QALYs).

There were 25,099 patients with RA who participated in the study at an average age of 56 years old. More than half of the patient population identified as women (72.7%). Treatment with biosimilar DMARDs was cheaper and led to better outcomes (higher QALYs) than treatment with leflunomide.

The breakdown of the costs and QALYs were:

* Leflunomide: lifetime health care cost of $154,632 and 14.82 QALYs

* Biosimilar infliximab: $152,326 and 15.35 QALYs

* Biosimilar adalimumab: $145,419 and 15.55 QALYs

While biosimilar infliximab was slightly cheaper than leflunomide, biosimilar adalimumab was both cheaper and led to slightly better outcomes.

In the deterministic sensitivity analysis, the incremental cost-effectiveness ratio (ICER) (US$/QALY) was −$9088 to $10,238 when comparing biosimilar infliximab with leflunomide. Biosimilar adalimumab compared with leflunomide resulted in a range from −$15,797 to −$8615.

The probabilistic sensitivity analysis showed the probability of treatment sequences initiated with leflunomide, biosimilar infliximab, and biosmilar adalimumab being cost-effective out of 10,000 iterations was 0%, 9%, and 91%, respectively.

From a global perspective, 41 countries were identified with recorded sales of biosimilar infliximab in July 2022 from the IQVIA-MIDAS database. Research found 15 of the 28 high-income countries, similar to Hong Kong’s economic development, had lower unit prices of biosimilar infliximab.

In Australia, a study found etanercept experienced a 40% decrease in price for both the originator and biosimilar once the market listed the biosimilar.

 Prior to launch, etanercept was priced at US$1068 for a 50 mg/L 4 x 1 mL pen device but afterwards the drug was priced about US$641. Ultimately, Australia saw an average of $6 million in cost savings because of the biosimilar launch.

Study limitations included the treatment efficacies that were largely retrieved from independent randomized controlled trials with heterogeneity in patients’ demographic and clinical profiles.

 Additionally, participants were naive to biological DMARDs or had only experienced 1 biological DMARD prior to enrollment. Treatment efficacy may have been overestimated after applying Health Assessment Questionnaire Disability Index improvements to the cohort.

The cost-effectiveness demonstrated in the study can help health care stakeholders, rheumatologists, and patients better understand the benefits and financial feasibility of biosimilar DMARDs.

1. Peng K, Chan SCW, Wang Y, et al. Cost-effectiveness of biosimilars vs leflunomide in patients with rheumatoid arthritis. 

. 2024;7(6):e2418800. doi:10.1001/jamanetworkopen.2024.18800

2. Li Y, Lau LKW, Peng K, et al. Factors influencing choice of b/ts DMARDs in managing inflammatory arthritis from a patient perspective: a systematic review of global evidence and a patient-based survey from Hong Kong. 

. 2023;13(10):e069681. doi:10.1136/bmjopen-2022-069681

3. Santoro C. Biosimilar etanercept similar to Enbrel in persistence of treatment, cost savings for patients with RA. The Center for Biosimilars

. February 6, 2024. Accessed July 10, 2024. 

https://www.centerforbiosimilars.com/view/biosimilar-etanercept-similar-to-enbrel-in-persistence-of-treatment-cost-savings-for-patients-with-ra

Articles

Economic evaluations of biosimilar disease-modifying antirheumatic drugs (DMARDs) suggest cost-effectiveness for patients with rheumatoid arthritis (RA) who did not respond well to methotrexate, potentially improving patient outcomes and health care affordability.

Biosimilar DMARDs Offer Cost-Effective Option for Patients With RA After Failed Methotrexate Treatment

Jeffrey Casberg

Jeffrey Casberg, MS, RPh, senior vice president of pharmacy at 

, discussed the FDA approvals of new drugs and what these new launches could mean for drug pricing. He also spoke to the approach pharmacy and therapeutics committees take to reviewing new pipeline drugs.

What is your reaction to the FDA approval of the first denosumab biosimilars?

So denosumab biosimilars, there was 2 approved; 

Wyost [denosumab-bbdz] and Jubbonti [GP2411]

. The Jubbonti is for Prolia, the Wyost is for Xgeva. One is more oncology based, one is more osteoporosis based.

They were approved, but there's no announcement on when they're going to be launched. We're thinking they might even be delayed in launch till 2025. 

With only one manufacturer coming out, Sandoz, with both of those, we'll get some discount on the brand and reference drug but it's not going to be significant. It's not going to be like the 

Humira [adalimumab] situation with 9 or 10 biosimilars.

What are your thoughts on what the launch of the first tocilizumab biosimilar means for patients with autoimmune conditions?

 is actually IV [intravenous] and sub-q [subcutaneous]. I think that the 2 products launched, 

 is both IV and sub-q, and that's from Fresenius Kabi.

For the most part, Actemra is used in rheumatoid arthritis, a couple other conditions as well. Getting biosimilars in a different therapeutic area, including Actemra, that will be a big advancement. That's 2 biosimilars, so we will get a little competition there on pricing, but I don't know if I can predict what the discounts will be—maybe, 20% to 30% off.

How are pharmacy and therapeutics committees likely to approach new pipeline drugs, considering factors like efficacy, safety data, and potential cost compared to existing options?

P&T [pharmacy and therapeutic] committees are pretty standard in their approach on how they review drugs for formulary inclusion. It really comes down to safety, cost, and efficacy.

I think in today's world, the only difference is that there's a lot of these new orphan drugs which don't have a lot of competitors, so the P&T committees have to look at a drug on its own or a small number of patients, so they really look at the efficacy opportunity—which patients should get the drug, and what the criteria can be.

It's a lot less managing 4 or 5 drugs in a therapeutic area and comparing the pros and cons of drugs that are very similar. Nowadays, we're comparing a million-dollar drug which has no competition and who the patient should be and what the criteria should be. So there is a little shift in reviewing drugs from multiple drugs in 1 therapeutic class to orphan drugs.

Jeffrey Casberg, MS, RPh, senior vice president of pharmacy at IPD Analytics, highlights new FDA approvals, the launch of the first tocilizumab biosimilar, and how pharmacy and therapeutics committees approach new pipeline drugs.

IPD Analytics' Jeffrey Casberg Discusses Recent Biosimilar Approvals

The Top 5 Biosimilar Articles for the Week of July 8

As the weather heats up for the US and Europe, so too did the 

, with clinical trial results from conferences and a study showcasing how to overcome economic and noneconomic barriers to oncology biosimilars.

 As Celltrion publishes phase 3 data on its tocilizumab biosimilar, other companies finalize partnerships, and Formycon 

 to receive approval for the American market. It was also approved with interchangeability.

FDA has approved Ahzantive (aflibercept-mrbb)

 as the third biosimilar referencing Eylea (aflibercept) for the treatment of eye conditions, including age-related macular degeneration.

 to remove switching study data for companies seeking to obtain an interchangeability designation for their biosimilars.

Here are the top 5 biosimilar articles for the week of July 8, 2024.

Recent data has utilized enhanced assessment of electronic patient-reported outcomes (ePROs) to identify undetected symptoms while improving symptom management for patients with various cancer subtypes. | Image Credit: Maksym - stock.adobe.com

Patients with HER2-positive breast cancer who were treated with biosimilar trastuzumab-dkst (Ogivri) experienced equivalent symptoms, adverse events (AEs), and well-being as patients treated with the originator trastuzumab (Herceptin), according to the results of a study published in 

Oncology care has benefitted significantly from biosimilars and their reference products, and these agents account for approximately 70% of the growth in costs of drugs from 2010 to 2015. Biosimilars are one way to reduce costs without affecting quality of care.

The study provided an enhanced assessment of electronic patient-reported outcomes (ePROs) that identified undetected symptoms while improving symptom management for patients with various cancer subtypes. The system has suggested improvements in well-being and awareness of AEs between outpatient visits.

The ePRO application collects patient-reported information in clinical trials, including symptoms, quality of life, treatment adherence, and treatment satisfaction. Data is accurately reported in real time and offers informed decisions when analyzing the efficacy and safety of medical interventions. The technological application allows patients to report their treatment results without the limitations of paper-based methods, with valuable insights delivered more efficiently and accurately.

There is limited research on the real-world outcomes, tolerability, and quality of life that has been performed using ePRO data collected from patients treated with anti-HER2 biosimilars.

An observational study was conducted to investigate the daily functional activity, symptoms, and therapy AEs recorded with medidux smartphone application in patients undergoing trastuzumab-dkst therapy.

In December 2017, trastuzumab-dkst was approved by the FDA as the first trastuzumab biosimilar for treatment of HER2-overexpressing breast or metastatic stomach cancer.

 Some patients experienced AEs such as fever, nausea, vomiting, infusion reactions, diarrhea, infections, increased cough, headache, fatigue, shortness of breath, rash, low white and red blood cell counts, and muscle pain.

Over a 20-month duration, a noninterventional, multicenter, prospective, observational study was held across 5 study sites in Switzerland.

The study enrolled patients who received an anti-HER2 treatment regimen. This regimen included an initial intravenous dose of trastuzumab-dkst at 8 mg/kg body weight, followed by maintenance doses of 6 mg/kg. The treatment could be given with or without pertuzumab, chemotherapy, and/or hormone therapy, depending on whether it was administered in a neoadjuvant (pre-surgery) or palliative (symptom management) setting.

The medidux app is a patient-centered, therapy assistance application that supports the structured, standardized, and dynamic documentation of symptoms and therapy AEs. Patients received the app and were instructed to record their symptoms, well-being, EQ-5D-5L questionnaires, cognitive capabilities, and vital parameters every day. Regular study visits were scheduled on days 1, 21, and 42 during 3 weekly chemotherapeutic interventions.

Each patient had an observational period that lasted 6 weeks and at the end, patients decided whether to continue therapy with trastuzumab-dkst or the originator trastuzumab.

The study had a primary objective to evaluate ePRO data received in the medidux app by patients with HER2-positive breast cancer treated with trastuzumab-dkst while comparing the data with ePRO findings obtained from a historical cohort treated with trastuzumab in 2 previous studies (

The well-being of patients in both cohorts and the electronically reported symptoms was considered the secondary objective.

A total of 53 patients who identify as female were enrolled in the study with an average age of 57 years in the prospective cohort and 51 in the historical cohort. Around 38.9% of patients had tumor stage 2 with fewer patients (22.2%) had palliative treatment than neoadjuvant or adjuvant treatment. Over half of the population received dual anti-HER2 blockade with trastuzumab and pertuzumab (59.3%).

Patients in the prospective cohort experienced 84 of the 92 available different symptoms entered in the app, with the average being more than 4 symptoms a day, that resulted in a total of 9680 symptoms.

There were 54 of the 82 different symptoms found in the historical cohort, with the average being more than 3 symptoms a day, that resulted in 6904 symptom entries.

Common symptoms included fatigue, taste disorder, nausea, diarrhea, dry mucosa, joint discomfort, tingling, sleep disorder, headache, and appetite loss. Most patients in the trastuzumab-dkst cohort experienced minimal (grade 0) and mild (grade 1) toxicities, followed by grade 2, 3, and 4 toxicities.

Common Terminology Criteria for Adverse Events (CTCAE) Score

The primary end point was evaluated among 50 patients who received trastuzumab-dkst and 38 patients treated with the originator trastuzumab.

The average CTCAE scores could be compared between the 2 cohorts with an estimated difference of –1.27 (95% CI, –7.24 to 4.70; 

 = .68). Notably, the adjusted average of CTCAE scores were not altered between cohorts either (2.51; 95% CI, –3.27 to 8.29).

Secondary end points were analyzed in 52 patients who received trastuzumab-dkst and 38 patients as part of the historical cohort. On average, the difference in well-being patients treated with trastuzumab-dkst and originator trastuzumab was 4.45 (95% CI, –3.53 to 12.44; 

 = .28). There were no major differences between the adjusted well-being scores (3.78; 95% CI, –4.64 to 12.19) of both groups.

Cognitive Abilities in the Prospective Cohort

Data from 37 patients (70%) who performed at least 1 cognitive test were involved in the analysis, with 767 cognitive tests entered overall. The average execution time was 42.9 seconds. However, the small sample size and limited number of cognitive tests recorded were not correlated to the cognitive abilities and treatment performed.

The study design limited the results because it neglected a prospective control group and could not be randomized. Additionally, the app was not skilled to perform questionnaires to patients and cognitive abilities were not available for the historical cohort.

Future studies are necessary to analyze data through a randomized design with real-world functions in patients with HER2-positive breast cancer who were treated with anti-HER2 biosimilars.

Ultimately, treatments of both trastuzumab-dkst and the originator expressed equal symptoms, AEs, and well-being as reported by ePRO. Results highlighted the integration of an ePRO tool into research and clinical practice can provide reliable information when investigating tolerability and safety outcomes of similar therapeutic compounds.

1. Trojan A, Roth S, Atassi Z, et al. Comparison of the real-world reporting of symptoms and well-being for the HER2-directed trastuzumab biosimilar ogivri with registry data for herceptin in the treatment of breast cancer: Prospective observational study (OGIPRO) of electronic patient-reported outcomes. 

2. The ultimate guide to ePRO: Everything you need to know. Lindus Health. Accessed July 1, 2024. 

https://www.lindushealth.com/blog/the-ultimate-guide-to-epro#:~:text=Defining%20ePRO%3A%20What%20It%20Is%20and%20Its%20Importance&text=In%20simple%20terms%2C%20ePRO%20involves

3. FDA approves Ogivri as a biosimilar to Herceptin. News release. FDA. December 1, 2017. Accessed July 2, 2024. 

https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-ogivri-biosimilar-herceptin#:~:text=On%20December%201%2C%202017%2C%20the,gastric%20or%20gastroesophageal%20junction%20adenocarcinoma).

4. OGIVRI (trastuzumab-dkst). Ogivri. Accessed July 2, 2024. 

Patients with HER2-positive breast cancer treated with the biosimilar trastuzumab-dkst experienced similar adverse events and well-being as those treated with the originator drug (Herceptin), according to a study using a smartphone app to track symptoms.

Trastuzumab-dkst Matches Herceptin's Safety, Well-Being for HER2-Positive Breast Cancer

Here are the top 5 biosimilar articles for the week of July 1, 2024. 

The Top 5 Biosimilar Articles for the Week of July 1

 for the treatment of inflammatory conditions, including plaque psoriasis and ulcerative colitis.

, 1 in Crohn disease (CD), and 1 in ulcerative colitis (UC), found 

 in patients treated with the subcutaneous formulation of infliximab biosimilar CT-P13 (Remsima, Inflectra; Celltrion) compared with placebo as maintenance therapy following an induction phase of intravenous CT-P13.

Key findings showed that there continues to be a lack of understanding and/or confidence in biosimilars 

, leading to diminished provider willingness to prescribe biosimilars and patient perceptions about the safety of switching to a biosimilar.

Here are the top 5 biosimilar articles for the week of July 1, 2024.

Jeffrey Casberg Q3

Jeffrey Casberg, RPh, MS, senior vice president of pharmacy at 

, considers the top 3 promising biosimilars currently coming down the pipeline. He addresses the significance  of each and the specific areas of health they treat.

He also touches on the FDA Advisory Committee and speaks about the obstacles that have delayed approvals for these medications.

This transcript has been lightly edited for clarity.

In your view, what are the top 3 promising specialty drugs currently coming down the pipeline and why should stakeholders be keeping an eye on them?

The first one I'll talk about is donanemab for Alzheimer's disease by 

; it's an amyloid-β inhibitor for early Alzheimer's disease. It would be a little bit different than 

 from Biogen, which was fully approved more recently.

Donanemab was originally going to be approved beginning of 2023, so over a year ago, but it has had a little bit of a storied pathway to approval. We were watching for an approval here any day during this last month or so, then out of the blue, there was an announcement that the FDA has requested an 

If I'm a manufacturer, not really happy about that; you never really want extra scrutiny on your drug. I'm sure they're going to talk about the dosing regimen, the potential for shorter duration of therapy compared to Leqembi probably the ARIA [amyloid-related imaging abnormalities] side effect profile. They haven't given us a date for that FDA Advisory Committee meeting. I would anticipate a date being announced any day and I still think there's opportunity for approval before the end of 2024.

I think one of the other products that is exciting is resmetirom, or Rezdiffra. for NASH [nonalcoholic steatohepatitis]. First product approved for NASH. Again, a therapeutic area we've been waiting for therapies now for maybe 10 years. Finally we do have an approval. Congratulations to 

 on that, getting their product over the finish line.

A once daily, oral product. It showed signs of efficacy and NASH resolution and fibrosis improvement. Prescribing information did not include discussion of the need for biopsy in diagnosis. So, to diagnose NASH, now called MASH [metabolic dysfunction-associated steatohepatitis], the gold standard is liver biopsy, but that's pretty invasive. You can also use noninvasive therapy testing to get diagnosis of staging of NASH in the liver. They did not have that, which was a plus for Madrigal.

It would be interesting to see how the payers set up their criteria for approval. There's a whole lot of population out there that could be treated with this, so that's another big approval that just occurred. 

I'll just mention one other recent approval. It's called 

 for pulmonary arterial hypertension, sotatercept, by Merck. Winrevair is the brand name.

It's a new product for PAH, pulmonary arterial hypertension. It's a new mechanism of action, and has the potential to be more disease modifying—the other therapies out there are more symptomatic treatments—and probably early on will be used as add-on or [in the] second or third line. But I think as physicians get used to it, they could move it up in therapy.

It is pretty expensive: $240,000 for most patients, could be $480,000 for some patients. It's a weight-based dosing, so 1 vial or 2 vials. I think it's subcutaneous every 3 weeks, and it can be self-administered or professionally administered.

In an interview with Jeffrey Casberg, MS, RPh, he discusses 3 promising specialty drugs coming through the pipeline. Casberg explains these drugs offer new treatment options for major diseases and stakeholders should watch for their potential impact on the market.