23. Mulpleta

red blood cells
(Arek Socha)

Active ingredient: lusutrombopag
Disease: boosts platelet count in chronic liver disease patients before surgery
Sales estimate: $38 million in 2024
Approved: July 31
Company: Shionogi

The scoop: Mulpleta’s approval was the second thrombopoietin receptor agonist in 2018, trailing Dova Pharmaceutical’s nod for Doptelet by two months. The suddenly hot market has analysts comparing and contrasting the drugs, which are not substantially different when it comes to efficacy and safety. That means looking at other issues like price, convenience, promotion and access. Mulpleta’s main advantage? A lower price tag, with a list price of $8,500 for a seven-day course of treatment versus Doptelet’s cost of $9,000 for a five-day course of treatment with the 40-mg form and $13,500 for the 60-mg form. Another notch in Mulpleta’s belt is experience—the treatment has been approved for use in Japan since 2015, while Doptelet is Dova’s first product ever. While that might also seem to give Mulpleta a marketing edge, Dova struck a deal with Salix for its GI sales reps already working in liver disease to add Doptelet to their portfolio in October. Shionogi has not announced its sales plans, but it may already be playing catch-up. — Beth Snyder Bulik

23. Mulpleta
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