As specialty products, therapies for ulcerative colitis (UC) can be expensive, and formulary positioning is paramount to product uptake. Payers are settled in vital contracts that lead them to prioritize broad immunology drugs Humira and Remicade. This has posed a high barrier for newer entrants to the market, which cannot compete in volume and rebates. Biosimilar and generic competition will further undermine the likely premium pricing of newer and pipeline products. 

The UC pipeline holds multiple novel prospects in terms of distinct mechanisms of action and biologics with more convenient formulations. The market will welcome interleukin-23 (IL-23) modulators Omvoh (mirikizumab) and guselkumab. There has been a positive response to Xeljanz as the first oral drug competing with biologics for UC, and other companies have recognized this opportunity to provide greater ease of administration, for example with oral Velsipity and Rinvoq. These products will provide more options for UC patients beyond the established non-oral anti-TNF class that is currently the mainstay of treatment. It is likely that these novel products will initially compete at later lines of therapy after the anti-TNF inhibitors, given the latter’s enduring stronghold at the first line of biologic therapy. 

This Datamonitor Healthcare report contains a Disease Analysis module.