13. Doptelet

FDA
(FDA)

Active ingredient: avatrombopag
Disease: thrombocytopenia in people with chronic liver disease
Peak sales: $648 million
Approved: May 21
Company: Dova Pharmaceuticals

The scoop: Doptelet, Dova’s first commercial product, is approved to boost platelet count in patients with chronic liver disease ahead of surgery so that they don’t have to undergo risky blood transfusions. Dova officially launched the drug at the wholesale acquisition cost for a five-day course of $9,000 for the 40 mg dose and $13,500 for the 60 mg dose, higher than the $6,000 some analysts had expected. Leerink’s Geoffrey Porges projected a slow ramp-up, noting that payers may save some money on the hospital costs for platelet transfusion but may end up spending more on Doptelet. “This saving for one side of the insurance plan (medical benefit), but an equal or greater cost for another part of the plan (pharmacy benefit) makes for a difficult sale, at least based on economics alone,” he recently wrote in an analysis. The drug soon encountered a competitor in the form of Shionogi’s Mulpleta. Because these drugs look alike regarding efficacy, safety and dosing schedule, the race will come down to market access and pricing strategy, Porges figured. And Shionogi has already launched its rival drug at about $8,500 for a seven-day course. — Angus Liu

13. Doptelet

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