People being treated for advanced prostate cancer now have a new oral option. On Dec. 18, the FDA approved Myovant Sciences GmbH’s Orgovyx (relugolix), a gonadotropin-releasing hormone (GnRH) receptor antagonist, to treat adults with advanced prostate cancer, AIS Health reported. Dosing for the drug is a loading dose of 360 mg on the first day of treatment and then 120 mg of the tablet once daily.
Treatment of advanced prostate cancer usually involves androgen deprivation therapy (ADT), and the current standard of care is luteinizing hormone-releasing hormone (LHRH) receptor agonists, such as leuprolide acetate, which is administered by a health care provider as an injection or implant. It is available as AbbVie Inc.’s Lupron Depot and Eligard from Tolmar Pharmaceuticals, Inc. to treat prostate cancer.
During the same time frame, Zitter surveyed 100 oncologists, and 77% said they were likely to prescribe Orgovyx, with 62% saying they were likely to prescribe the new drug over leuprolide acetate. Almost half of respondents indicated they are likely to transition patients on leuprolide acetate to Orgovyx.
Winston Wong, Pharm.D., president of W-Squared Group, says that he expects Orgovyx to have "significant uptake for several reasons. Even though it is taken daily, it is easier for the patient to be treated when compared to the patient having to travel to the physician office to receive their injection."
He says he expects prescriptions to drop for Lupron and Eligard. "Possibly the remaining niche for either of these injectable drugs would be for the traditional Medicare patient who does not have a prescription plan through Part D or a Medicare Advantage plan."
For payers, Orgovyx, he says, "is approximately 25% less expensive from a drug cost standpoint, charges for office visits and administration are avoided, and utilization of the oral product is more easily monitored being covered under the prescription benefit."
According to Bill Sullivan, a longtime industry expert, "since it is an oral tablet, there would be a preference [among payers] to cover it, as it would go through the PBM, opening the door for rebates to flow to them vs. the physicians."