Denise Myshko is your editorial contact for the Formulary Watch. She joined Formulary Watch as editor is June 2021 from Oncology Live. Prior to that, she was managing editor of PharmaVOICE, a trade publication in the pharmaceutical industry. Email: dmyshko@mjhlifesciences.com

 to an almost 4% increase in revenue for Cigna for 2022. In total, Cigna’s adjusted revenue for 2022 was $180.62 billion compared with $174.08 billion in 2012.

“2022 was a strong year of performance and growth for our company,” David Cordani, Cigna’s chief executive officer, said in an investor call. “With our Evernorth and Cigna platforms and our durable growth framework, we are well positioned to meet the needs of our customers, clients and partners in the future.”

Evernorth, which includes a group of businesses in pharmacy benefits and benefit solutions, is the largest segment of the company’s business. It contributed $140.34 billion in revenue in 2022 compared with $131.91 billion in 2021, a growth of 5%, which is in line with the company’s target. The division includes Express Scripts PBM, Express Scripts Pharmacy, Accredo (specialty pharmacy), eviCore Healthcare (medical benefits management), CuraScript SD (specialty and medical supplies), myMatrix (workers’ comp PBM), MDLive (a virtual care platform) and Freedom Fertility.

Within Evernorth, pharmacy revenue for 2022 increased 6% from $125.81 billion to $132.99 billion. 

, company executives said the pharmacy benefits services business will contribute to future growth, and the combined pharmacy benefits services, U.S. commercial and international business have contributed 60% of the company’s revenue. Last year’s results benefitted from pricing discipline and affordability initiatives, including clinical programs, executives said.

Related: Centene Selects Express Scripts to Administer Pharmacy Benefits

And while the number of pharmacy customers in 2022 and script volume decreased because of client attrition, going forward, the company indicated that its pharmacy benefit contract starting in January 2024 with Centene will drive growth. In October 2022, Centene announced that it was switching from CVS Caremark to Express Scripts, to administer pharmacy benefits for about 20 million Centene members. Centene provides healthcare through commercial plans and government-sponsored plans, including Medicaid and Medicare, TRICARE and the Health Insurance Marketplace.

Company executives also said biosimilars will help to lower costs for the company. Express Scripts will add Amgen’s biosimilar Amjevita (adalimumab-atto) to its national preferred formulary on parity with Humira, which treats patients with arthritis and anti-inflammatory conditions. Other Humira biosimilars will be evaluated as they come to market, the company said.

 in the past that it has advocated for the adoption of biosimilars. For example, Express Scripts added Viatris’ Semglee, the first FDA-approved interchangeable biosimilar basal insulin to improve glycemic control in adults and pediatric patients with type 1 diabetes and in adults with type 2 diabetes, to its national preferred formulary beginning in 2022. The company estimates this saved more than $20 million for plan sponsors in one year.

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Evernorth, Cigna’s pharmacy and benefits solutions division, contributed more than 75% of the company’s revenue last year.

Cigna’s Evernorth Division Contributed $140 million in 2022 Revenue

The presence of biosimilars in the market generally creates savings in the healthcare system, putting pressure on the prices of reference products and lowering prices overall. But when it comes to the latest biosimilar to enter the market, it’s complicated.

The recent launch of Amjevita (adalimumab-atto), Amgen’s biosimilar of AbbVie’s arthritis drug Humira has been highly anticipated. It is launching with a two-tier pricing program: the first is 5% below the current Humira price and the second is 55% below the current Humira list price. Humira’s 

 is $6,922 for a four-week supply — almost $90,000 annually.

The pricing model is meant to provide options for all payers, including commercial and government, as well as for private access to patients, said Renee Rayburg, RPh, vice president, specialty clinical consulting, Pharmaceutical Strategies Group (PSG). “The 5% model allows for PBMs to collect rebates that go to the payers and the 55% discount lowers the price and provides access for those in a high-deductible, consumer directed health plan,” she said in an interview with 

The 55% discount off Humira was surprising, Rayburg said. “Traditionally biosimilars have come to the market 10% to 30% lower than the list price of the reference product. This is probably one of the deepest discounted prices that we’ve seen.”

This would mean, she said, that Amgen is anticipating giving rebates of at least $40,000 — the difference between Humira’s list price and the 55% discount off that price. “PBMs may go the rebate route if they think the rebates could be higher,” she said. Humira has been a top cost driver in pharmacy spend for most plans. Generating competition in a category with significant financial impact for plans is promising.

There is also value for patients as well because Amgen is offering patient assistance through the Amjevita SupportPlus Co-Pay Program with $0 copays.

This may become even more important as AbbVie is now limiting its patient copay assistance for Humira if a PBM employs co-pay accumulator or maximizer programs, which do not count such assistance toward deductibles. AbbVie has a $14,000 per calendar year maximum on its assistance for Humira, but for patients with plans that have a maximizer program, the limit is now $4,000. The use of copay accumulator and maximizer programs — mechanisms used by PBMs to reduce their spending on specialty drugs — has grown from 14% of commercially-insured patients in 2019 to 33% in 2022, according to a 

But the real impact of Amjevita in terms of uptake and costs for treating patients with arthritis and inflammatory conditions may be minimal. “There’s been a lot of buzz, but I don't think one product alone is going to be enough to push the market to realize the full savings that biosimilars can offer,” Rayburg said.

The biggest impact financially will likely happen after July, when additional Humira biosimilars begin to reach the market. Being first may not help Amjevita become the dominant biosimilar for several reasons, Rayburg said. Not all of the Humira biosimilars are the same; they differ in terms of characteristics. Some reference an earlier version of Humira.

In 2018, AbbVie reformulated Humira and began offering a version that was higher concentration (which reduced volume), removed the citrate buffers (which reduced burning during injection) and uses a thinner needle. According to PSG estimates, 80% of Humira utilization is the citrate-free, high concentration formulation.

Amjevita, however, is a low-concentration version biosimilar. Amgen is developing a high-concentration version of Amjevita but that is not expected to reach the market until 2024. Rayburg said this may not be an issue with new starts, but patients currently on Humira may not want to switch.

In July 2023, Boehringer Ingelheim is expected to launch the low-concentration Cyltezo. It was approved with an interchangeable designation, which may help with uptake among physicians. Organon’s Hadlima in both a low- and high-concentration will likely have an interchangeable designation after its initial launch, and Pfizer’s application for Abrilada is under consideration for an interchangeable designation. Other Humira biosimilars expected to launch later this year include Fresenius Kabi’s Idacio, Coherus BioSciences’ Yusimry, Viatris’ Hulio, and Sandoz’ Hyrimoz but none of these are expected to have such a designation.

 of gastroenterologists, dermatologists and rheumatologists found that more than 60% would only feel comfortable prescribing an adalimumab biosimilar if it had an interchangeability designation. The survey also found that 93% of gastroenterologists said they are at least somewhat comfortable prescribing adalimumab biosimilars. Dermatologists also said they were also concerned about payers and PBM coverage.

Related: First Humira Biosimilar is Now Available

PBM coverage for Amjevita is not likely to have an impact for current Humira patients because there will likely not be much incentive for physicians to switch their patients, Rayburg said. Several PBMs — including Optum Rx and Express Scripts — have already indicated they will include some of these biosimilars as preferred products alongside Humira. Optum Rx has said they will include Amjevita and two other biosimilars on the Select and Premium formularies. An Optum Rx spokesperson said that beginning February 1, clients can include both Amjevita list price options on the commercial formulary.

A CVS Caremark spokesperson indicated that Humira will remain preferred and Amjevita will be placed on a non-preferred brand tier. Beginning Feb. 1, it will cover Amjevita on its commercial template formularies.


The real impact may not likely be seen until after July when additional biosimilars referencing Humira are launched.


 Will the Biosimilar Amjevita Lower Costs?

 Jesduvroq (daprodustat) for the once-a-day treatment of anemia due to chronic kidney disease (CKD) in adults on dialysis. Chronic kidney disease is characterized by progressive loss of kidney function and is a risk factor for cardiovascular disease. Anemia is a frequent complication of CKD and affects about 700 million patients worldwide, with an estimated one in seven patients also developing anemia. In the United States, about 810,000 patients have end-stage renal disease, of which 558,000 patients receive dialysis.

Developed by GSK, Jesduvroq is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI). It works to increase production of erythropoietin (EPO), which stimulates production of hemoglobin and red blood cells.

A spokesperson for GSK said they are working to make Jesduvroq available as soon as possible. A wholesale acquisition cost has not yet been set for Jesduvroq. Because 87% of dialysis patients are on Medicare, GSK is in the process of submitting the required documentation with Centers for Medicare & Medicaid Services (CMS) to help ensure timely reimbursement and patient access to Jesduvroq. This is expected in the fourth quarter 2023/first quarter 2024 time frame.

“Anemia of CKD can be a debilitating condition that is challenging to manage. This news means that patients on dialysis who are living with anemia of CKD now have another treatment option to help manage their anemia,” LaVarne Burton, president and chief executive officer of the American Kidney Fund, said in a press release.

The approval is based on the results of the ASCEND-D trial, which were 

 in December 2021. The study compared Jesduvroq with Aranesp (darbepoetin alfa), and Jesduvroq demonstrated noninferiority based on mean change in hemoglobin. The label includes a boxed warning about the increased risk of death, myocardial infarction, stroke, venous thromboembolism, and thrombosis of vascular access. Jesduvroq increases the risk of thrombotic vascular events, including major adverse cardiovascular events (MACE).

In October 2022, the Cardiovascular and Renal Drugs Advisory Committee (CRDAC) 

 13 to 3 to support the use of Jesduvroq for adult dialysis patients with anemia of chronic kidney disease. But the committee did not support its use in non-dialysis patients. The ASCEND-ND trial of non-dialysis patients found that hazard ratio of time to first the major adverse cardiovascular event was 1.03. (A hazard ratio above 1 indicates increased risk of harm.) Committee members indicated they were uncertain about the possibility of increased cardiovascular risks in the non-dialysis patient population.

Jesduvroq is currently approved in Japan as Duvroq for patients with renal anemia. In 

, the European Medicines Agency validated the marketing authorization application (MAA) for daprodustat, which is currently under review.

Daprodustat, now with the brand name of Jesduvroq, is a new oral therapy but it carries a boxed warning about the risk of cardiovascular events.

FDA Approves Novel Therapy for CKD-Related Anemia

IBSA Pharma is voluntarily recalling 27 lots of Tirosint-SOL (levothyroxine sodium) Oral Solution, which is used to treat patients with hypothyroidism, as well as an adjunct to surgery and radioiodine therapy in the management of thyrotropin-dependent thyroid cancer.

This recall has been initiated because these lots may be subpotent. The company’s analyses show a slight decrease below 95.0% of its labeled amount in levothyroxine sodium (T4) for some lots.

Over- or under-treatment with Tirosint-SOL may have negative effects on growth and development, cardiovascular function, bone metabolism, reproductive function, cognitive function, emotional state, gastrointestinal function, and glucose and lipid metabolism. IBSA Pharma has not received any reports of adverse events that have been determined to be related to this recall.

The recall doesn’t apply to Tirosint capsules.

Tirosint-SOL is a clear solution supplied in a 1 mL white, non-transparent, unit-dose ampule. The dosage strength is identified on the box and the pouch. Each ampule bears a colored label with the dosage strength and the product name. Lot and NDC numbers associated with the recall can be found 

More than 12% of the U.S. population will develop a thyroid condition during their lifetime, and an estimated 20 million Americans have some form of thyroid disease, 

IBSA Pharma is recalling the hypothyroid medication because analyses showed lowered levels of levothyroxine in some lots.

Subpotency Leads to Recall of 27 Lots of Tirosint-SOL

 is now available for Daiichi Sankyo’s Turalio (pexidartinib) to treat adult patients with symptomatic tenosynovial giant cell tumor (TGCT). A new 125 mg capsule now available and the 200 mg capsule has been discontinued. The new recommended dose, which was approved by the FDA in October 2022, is 250 mg orally twice daily (taken as two 125 mg capsules) with a low-fat meal. The previous dose was 400 mg orally twice daily on an empty stomach.

Tenosynovial giant cell tumor is a rare, typically non-malignant tumor that affects small and large joints. The disease can cause debilitating symptoms, can be locally aggressive and can significantly impact everyday activities in a relatively young patient population.

“The new dose reflects study data that evaluated the impact of food on Turalio exposure should patients not follow the previous recommended dietary requirements when taking the medication,” Dan Switzer, head of U.S. Oncology Business, Daiichi Sankyo, said in a press release.

As part of post-marketing requirements with FDA, Daiichi Sankyo conducted pharmacokinetic studies to evaluate the effects of food when taking Turalio. A high-fat meal (about 55 to 65 grams of total fat) was found to increase the concentration of drug in the body and may increase the risk of adverse reactions, including hepatotoxicity. These studies demonstrated that lowering the dose and taking it with a low-fat meal helps to minimize the potential for drug overexposure in the event a patient did not carefully follow the dietary recommendations when taking the 200 mg capsule.

Turalio is approved with a boxed warning for hepatotoxicity due to the risk of serious and potentially fatal liver injury and is only available through a Risk Evaluation and Mitigation Strategy (REMS) program. Across 768 patients who received Turalio in clinical trials, there were two irreversible cases of cholestatic liver injury, which is characterized by a build up of bile acids in serum and hepatocytes. One patient died with advanced cancer and ongoing liver toxicity and one patient required a liver transplant.

In addition, long-term efficacy data from the open-label extension part of the ENLIVEN phase 3 trial 

 to the label of Turalio. Patients who completed treatment in the double-blind, randomized part of the ENLIVEN trial were eligible to advance to an open-label extension. At the completion of the open-label extension, the objective response rate (ORR) was 61% in 61 patients originally randomized to the treatment arm.


Dosing has been lowered to reduce the risk of liver damage in patients taking Turalio, which is approved to treat patients with a rare tumor that affects the joints.


Daiichi Sankyo Makes Available New Dosing Regimen for Turalio

 the supplemental biologics license application (sBLA) for the expanded use of Takeda’s Takhyzro (lanadelumab-flyo) to prevent attacks of hereditary angioedema (HAE) in pediatric patients 2 to under 12 years old. HAE attacks can involve serious and debilitating swelling in the abdomen, face, feet, genitals, hands and throat, and potentially fatal upper airway angioedema has been reported in patients as young as 3 years of age.

Takhyzro is a fully human monoclonal antibody that specifically binds and decreases plasma kallikrein activity, which plays a critical role in HAE. It was originally approved in the United States in 2018 to prevent attacks of HAE in adult and pediatric patients 12 years and older.

Before this expanded indication, the only approved routine prophylaxis treatment options for children ages 6 to under 12 years old required dosing every three to four days, and children with HAE ages 2 to under 6 years old had no approved prophylaxis treatment. The expanded pediatric indication is a “long-awaited milestone for children and caregivers living with HAE in the United States, as this approval is for the first prophylaxis treatment for children with HAE 2 to <6 years of age,” Cheryl Schwartz, senior vice president of Takeda’s US Rare Disease Business Unit, told 

Takhyzro will continue to be priced at parity to its current pricing across the United States, Erin-Marie Beals, director of Rare Disease Communications for Takeda’s US Business Unit, told 

. According to Beals, the approximate cost of the 150 mg/1 mL pediatric dose of Takhyzro will be half that of the 2mL adult dose — which is $24,840, according to the company’s 

“We plan to publish our WAC pricing later this week,” Beals said. “Takeda believes that the cost of Takhyzra is commensurate with the value it offers for patients based on a number of factors, including its efficacy, safety and convenience of administration. Our goal is to ensure that all patients prescribed a Takeda therapy have access to it and the support they need.”

The approval was supported by extrapolation of efficacy data from the HELP Study, a phase 3 trial that included patients 12 to under 18 years of age, and additional pharmacokinetic analyses showing similar drug exposures between adults and pediatric patients.

It was also based on safety and pharmacodynamic data from the 

, an open-label phase 3 trial in 21 HAE patients 2 to under 12 years of age. Takhyzro reduced the rate of HAE attacks in pediatric patients by a mean of 94.8% compared with baseline, from 1.84 attacks per month to 0.08 attacks during the 52-week treatment period, according to Takeda. The majority of patients (76.2%) were attack-free with an average of 99.5% attack-free days.

The most common treatment-related treatment emergent adverse events in the study were injection site pain (29%), injection site erythema (14%), injection site swelling (5%), administration site pain (5%) and injection site reaction (5%).

Takhyzro is the first therapy to prevent attacks of hereditary angioedema (HAE) in children ages to 2 to under 6.

FDA Okays Pediatric Indication for Takeda’s Takhyzro

 the new drug application (NDA) for zuranolone in to treat patients with major depressive disorder and postpartum depression. The application has been granted priority review and the FDA has assigned a Prescription Drug User Fee Act (PDUFA) action date of Aug. 5, 2023.

Developed by Sage Therapeutics and Biogen, zuranolone is a rapid-acting neuroactive steroid. In people with depression, it is thought to work by rapidly rebalancing dysregulated neuronal networks to help reset brain function. Zuranolone targets brain networks responsible for functions such as mood, arousal, behavior, and cognition.

It is estimated that more than 21 million adults in the United States experienced at least one major depressive episode in 2020, with nearly 14 million people diagnosed with major depressive disorder, and an estimated 500,000 cases of postpartum depression annually.

“Most current approved therapies may take weeks or months to work. We are committed to advancing treatments that could help physicians and patients by addressing depression symptoms quickly,” Laura Gault, M.D., Ph.D., chief medical officer at Sage said in a press release.

The zuranolone NDA includes data from the LANDSCAPE and NEST clinical development programs. The LANDSCAPE program includes five studies of zuranolone in adults with major depressive disorder (MDD-201B, MOUNTAIN, SHORELINE, WATERFALL, and CORAL). Data from the SHORELINE study were 

 in at the 2022 Psych Congress in New Orleans in September 2022. An analysis from the ongoing open-label study found the median time to the first repeat treatment course for those patients who responded to the initial 14-day treatment course was 135 days for the completed 30 mg cohort and 249 days for the ongoing 50 mg cohort

The NEST program includes two studies of zuranolone in adult women with postpartum depression (ROBIN and SKYLARK). Data from SKYLARK were 

 in October 2022 at the European College of Neuropsychopharmacology Congress. In the study, zuranolone met all primary and all key secondary endpoints, with study participants demonstrating rapid and significant improvements in depressive symptoms as early as day 3 that were sustained through day 45. Zuranolone was generally well-tolerated, with a safety profile consistent with previous clinical trials; most treatment-emergent adverse events (TEAEs) were mild or moderate in severity

Zuranolone is a rapid-acting neuroactive steroid that can take effect in 14 days to treat patients with major depressive disorder and postpartum depression. The FDA has assigned a PDUFA action date of Aug. 5, 2023.

FDA Accepts NDA for Zuranolone for Depression

The FDA is warning several companies that are illegally selling products claiming to cure, treat, mitigate, or prevent human monkeypox (mpox) infection. The products may be ineffective, unsafe and could prevent a person from seeking an appropriate diagnosis and treatment from a healthcare professional, the agency added.

There are no FDA-approved treatments for mpox. The products being flagged by the regulatory agency — which are often sold online — have not been reviewed by the FDA or proven to be safe and effective to treat mpox or other diseases or conditions, the FDA 

“We’ve seen criminals — both foreign and domestic — exploit new diseases as opportunities to defraud American patients; the emergence of monkeypox is no different. We hope the FDA can stop these harmful fake products from victimizing any more Americans,” Shabbir J. Imber Safdar, executive director of the Partnership for Safe Medicines, told 

Companies that received warning letters from the agency on January 30 include: monkeypox-treatment.com, Dr. Green Mom, Noble Elements, Old Tiles Wallpaper, and Organic Heirloom Plants.

The supplements — including colloidal silver and vitamin D — are misbranded as drugs “because they are intended for use in the cure, mitigation, treatment, or prevention of disease,” the FDA said in a 

 to Dr. Green Mom and the other companies.

Several of Dr. Green Mom’s claims for its vitamin products — Vitamin A, Vitamin D, Liquid Zinc, Immunity Boost, Mother’s Immunity, and Colloidal Silver — would indicate they are drugs that would require clinical trials to determine if they are safe and effective, the FDA said in its 

's claims such as “Monkeypox fever reducer” in its Advil, Aleve, and Amazon Children’s Ibuprofen product descriptions indicate that the products are intended to mitigate, prevent, treat, diagnose, or cure mpox in people, the FDA said in its 

 to the company. “We request that you cease the sale of any unapproved and unauthorized products for the mitigation, prevention, treatment, diagnosis, or cure of mpox,” The agency said.

The products may be ineffective, unsafe and could prevent a person from seeking an appropriate diagnosis.

FDA Warns Companies Claiming to Treat Monkeypox

 Gilead Sciences’ Trodelvy (sacituzumab govitecan-hziy) to treat patients with locally advanced or metastatic breast cancer. It is indicated for patients who are HR+/HER2-, the most common type of breast cancer. It accounts for about 70% of all new cases. Five-year relative survival rate for these patients is 30%.

Trodelvy has also been recommended as a preferred treatment for metastatic HR+/HER2- breast cancer by the National Comprehensive Cancer Network.The drug has a 

 of $2,419 per vial. Gilead Sciences offers patients 

 with $0 out of pocket for up to $25,000 annually.

“Despite decades of advances, people living with pre-treated HR+/HER2- metastatic breast cancer need new treatment options,” principal investigator Hope S. Rugo, M.D., professor of Medicine and director, Breast Oncology and Clinical Trials Education at the UCSF Helen Diller Family Comprehensive Cancer Center, said in a press release. “Nearly all people with this type of breast cancer will eventually develop resistance to endocrine-based therapies and progress on available chemotherapies. This approval is significant for the breast cancer community. We have had limited options to offer patients after endocrine-based therapy and chemotherapy, and to see a clinically meaningful survival benefit of more than three months with a quality of life benefit for these women is exceptional.”

The approval is based on progression-free survival and overall survival data from the 

. Trodelvy demonstrated a statistically significant and clinically meaningful overall survival (OS) benefit of 3.2 months compared with the treatment of physician’s choice. Trodelvy also demonstrated a 34% reduction in risk of disease progression or death. Three times as many people treated with Trodelvy were progression free at one year versus those treated with chemotherapy.

The safety profile for Trodelvy was consistent with prior studies, with no new safety signals identified in this patient population.

Trodelvy is approved in more than 40 countries to treat adult patients with metastatic triple-negative breast cancer, and has been granted accelerated approval in the United States to treat patients with metastatic urothelial cancer

Trodelvy has been recommended as a preferred treatment for metastatic HR+/HER2- breast cancer by the National Comprehensive Cancer Network.

FDA Approves Trodelvy for HR+/HER2- Breast Cancer

 Tezspire (tezepelumab-ekko) in a pre-filled, single-use pen for patients aged 12 years and older with severe asthma. First approved by the FDA in December 2021, Tezspire is a first-in-class biologic for severe asthma. It targets thymic stromal lymphopoietin (TSLP), which plays a role in the inflammation associated with asthma.

Developed by Amgen and AstraZeneca, the original Tezspire delivered via a single-use syringe has a 

 of $3,847.35 per 210 mg/mL, which is given every four weeks. A spokesperson for the companies indicated that the pricing of the pre-filled will be made available when it launches.

The spokesperson said the Tezspire Together Fast Start program helps eligible commercially insured patients start therapy quickly should they face a delay in coverage. Eligible patients may receive up to 12 no-cost doses and may start therapy before the Prior Authorization is submitted. Once coverage is secured, the Tezspire Together Co-pay program can help eligible commercially insured patients reduce their out-of-pocket costs for medication and in-office administration. Patients pay as little as $0 per dose and there are no income restrictions.

“Severe asthma continues to be a very complex condition to manage, so we welcome the Tezspire pre-filled pen as an option that will empower patients and healthcare providers with increased choice,” Kenneth Mendez, president and chief executive officer of the Asthma and Allergy Foundation of America, said in a press release. “We believe self-administration alternatives can play an important role in patients' lives and address unmet needs for those living with severe asthma.”

The approval was based on results from the PATHFINDER clinical trial program, which included results from the PATH-BRIDGE phase 1 trial and the PATH-HOME trial phase 3 trial. The majority (92%) of healthcare providers, patients and caregivers were able to successfully administer Tezspire both in the clinic and at home. The improvements in asthma control and the safety profile observed in the PATH-HOME trial were consistent with previous clinical trials. The most common adverse reactions were pharyngitis, arthralgia, and back pain.

Tezspire is a biologic that specifically targets the inflammation associated with asthma.

FDA Okays Pediatric Indication for Takeda’s Takhyzro

FDA Accepts NDA for Zuranolone for Depression

FDA Warns Companies Claiming to Treat Monkeypox

FDA Approves Trodelvy for HR+/HER2- Breast Cancer

FDA Approves Tezspire in Pre-Filled Pen