Soon after FDA approved semaglutide (Rybelsus, Novo Nordisk) tablets, the first and only glucagon-like peptide-1 (GLP-1) analog in pill form, to treat type 2 diabetes, one pharma executive is assuring formulary managers that the medication will be competitively priced.
Rybelsus, in 7 mg or 14 mg strengths, is intended for adults with type 2 diabetes who are not achieving their A1C goal with current antidiabetic treatment.
FormularyWatch spoke with Todd Hobbs, MD, vice president and chief medical officer at Novo Nordisk, to find out how the treatment is unique and how it will be priced compared to other GLP-1 medications.
FormularyWatch: What is the advantage of this GLP-1 analog versus other medications for type 2 diabetes?
Hobbs: Despite existing treatment options, many adults continue to have challenges managing their type 2 diabetes. About 50% of patients are still not achieving their target blood sugar levels.
Rybelsus is the first and only GLP-1 receptor agonist available in a pill and effectively lowers A1c in adults living with type 2 diabetes as demonstrated in head-to-head studies versus sitagliptin (Januvia, Merck), empagliflozin (Jardiance, Eli Lilly & Co.) and liraglutide (Victoza, Novo Nordisk) 1.8 mg.
FormularyWatch: What will the average wholesale acquisition cost be? How does that compare to other medications (including Novo Nordisk treatments) for type 2 diabetes?
Hobbs: Rybelsus will be competitively priced within the GLP-1 category. The WAC price for Rybelsus is $772.43 annually, while Ozempic is $772.43 annually, and Victoza is $614.52 annually.
Novo Nordisk is committed to working with health insurance companies and pharmacy benefit managers to ensure broad coverage and patient access for Rybelsus. In addition, a comprehensive Rybelsus savings card program will be available to reduce copays for eligible commercially-insured patients.
FormularyWatch: Do you expect physicians to prescribe it and insurers to cover it?
Hobbs: Although current treatment guidelines, such as the American Diabetes Association Standards of Medical Care in Diabetes, reinforce the importance of GLP-1 receptor agonist (RA) therapy for adults living with type 2 diabetes, utilization of these therapies is still low due to injection barriers along with HCP resistance. With Rybelsus, our hope is that PCPs will be more open to using this new oral GLP-1 RA treatment option for appropriate patients.
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FormularyWatch: What is important for formulary managers to know about the approval of Rybelsus?
Hobbs: Rybelsus is the first glucagon-like peptide-1 (GLP-1) receptor agonist (RA) in a pill approved as an adjunct to diet and exercise to improve blood sugar in adults with type 2 diabetes. This is important because patients who are not achieving their A1c goal with current antidiabetic treatment now have an effective GLP-1 RA treatment option available in a once-daily oral tablet that can help them meet their A1c goals.
FDA’s decision to grant marketing approval for Rybelsus marks a significant scientific achievement: we’ve found a way to produce and deliver a therapeutic protein for type 2 diabetes in a pill.
Oral delivery of large proteins has previously been a significant hurdle, as the body has natural barriers that digest and degrade proteins like GLP-1 receptor agonists. By pairing semaglutide with a carrier molecule, we were able to increase the bioavailability of the drug through the stomach to overcome this challenge and enable effective once-daily oral dosing. We are hopeful that providing semaglutide as a once-daily pill will encourage patients who were previously reluctant to take an injection to be able to add a GLP-1 RA in an oral formulation.
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