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Drug Pipeline Monthly Update

Critical updates in an ever changing environment

June 2019

New drug information

●● Slynd™ (drospirenone): Exeltis’ Slynd, an oral only pill (POP) for pregnancy prevention, has been approved by the U.S. Food and Drug Administration (FDA). Slynd is the only POP for pregnancy prevention with 24 active and 4 inactive tablets with a 24-hour missed pill window allowed. Combined oral contraceptives (i.e., contain estrogen and a progestin) are contraindicated in women with thromboembolic disorders. Slynd is not contraindicated in women with thromboembolic disorders as there was not an increase in thromboembolic events in women taking Slynd in clinical trials. Launch is anticipated in the fall of 2019.1

●● Ortikos™ (): Sun Pharma received FDA approval for Ortikos for the treatment of mild to moderate active Crohn’s disease; as well as maintenance of clinical remission of mild to moderate Crohn’s disease. Launch plans are pending. Generic drug information

●● Faslodex® (fulvestrant injection): Sandoz launched their generic version of AstraZeneca’s Faslodex for the treatment of certain forms of breast cancer. Other manufacturers are set to launch their generic versions of Faslodex in 2021. Faslodex had $533 million in annual U.S. sales in 2018.

●● Revatio®+ (sildenafil oral suspension 10mg/ml): Novitium launched their generic version of Pfizer’s Revatio for the treatment of pulmonary arterial hypertension. Novitium will lose exclusivity in November 2019. Revatio oral suspension had $187 million in annual U.S. sales in 2018.

●● Naftin® (naftifine gel 1%): Tolmar/Amneal launched their generic version of Sebela’s Naftin Gel 1% for the topical treatment of certain fungal infections. Naftin Gel 1% is not protected by patents or regulatory exclusivities. Naftin had <$10 million in annual U.S. sales in 2018.

+Specialty

While the information in this newsletter is from sources we believe to be reliable, we do not warrant that the information in this document is free from error. Use it only as a guide. Statements regarding drugs or manufacturers are not intended as promotion; those statements should not be used to make assumptions about formulary status. Each trademarked drug name is the property of its respective owner. Drug Pipeline Monthly Update: June 2019 Page 2

New molecular entity approvals in the past twelve months

Generic name Brand name Manufacturer Indication(s) Date approved* solriamfetol Sunosi™ Jazz Narcolepsy or obstructive sleep apnea March 2019 (OSA) brexanolone Zulresso™ Sage Therapeutics Postpartum depression March 2019

triclabendazole Egaten® Novartis Fascioliasis February 2019

prucalopride Motegrity™ Shire Chronic idiopathic constipation December 2018

rifamycin Aemcolo™ Cosmo Travelers' diarrhea November 2018 Pharmaceuticals revefenacin Yupelri™ AcelRx COPD November 2018 Pharmaceuticals baloxavir marboxil Xofluza™ Shinogi & Co Influenza October 2018

omadacycline Nuzyra™ Paratek Pneumonia and skin infections October 2018 Pharmaceuticals sarecycline Seysara™ Allergan and Paratek Acne October 2018 Pharmaceuticals galcanezumab-gnlm Emgality™ Eli Lilly Prevention of migraine September 2018

fremanezumab-vfrm Ajovy™ Teva Prevention of migraine September 2018

doravirine Pifeltro™ Merck HIV September 2018

eravacycline Xerava™ Tetraphase Pharma Complicated intra-abdominal infections September 2018

/ Annovera™ TherapeuticsMD Inc Pregnancy prevention August 2018 ethinyl estradiol elagolix Orilissa® AbbVie Pain with endometriosis July 2018

tafenoquine Krintafel® GSK Radical cure of P. vivax malaria July 2018

tecovirimat Tpoxx™ Siga Technologies Smallpox July 2018

glycopyrronium tosylate Qbrexa™ Dermina Excessive sweating July 2018

plazomicin Zemdri™ Achaogen Complicated urinary tract infections July 2018

*Date indicates FDA approval date only. The product launch and marketing dates are determined by the approved product’s manufacturer. Drug Pipeline Monthly Update: June 2019 Page 3

Other new product approvals in the past twelve months

Generic name Brand name Manufacturer Indication(s) Date approved* budesonide Ortikos™ Sun Pharma Crohn’s disease June 2019

drospirenone Slynd™ Exeltis Pregnancy prevention June 2019

dapagliflozin, saxagliptin and Qternmet XR™ AstraZeneca Type 2 diabetes May 2019 metformin hydrochloride midazolam Nayzilam™ UCB and Proximagen Seizures May 2019

halobetasol propionate and Duobrii™ Ortho Dermatologics Plaque psoriasis April 2019 tazarotene (Valeant) ivabradine solution Corlanor™ Amgen To reduce the risk of hospitalization for April 2019 worsening heart failure in pediatric patients dolutegravir and lamivudine Dovato™ Viiv Healthcare HIV April 2019

colesevelam hydrochloride Welchol™ Daiichi Sankyo, Inc High cholesterol and type 2 diabetes April 2019

acyclovir ophthalmic ointment Avaclyr™ Fera Acute herpetic in patients with March 2019 herpes simplex virus tegaserod Zelnorm™ Sloan Pharma Irritable bowel syndrome with constipation March 2019 in women less than 65 years of age aclidinium and Duaklir™ Circassia and Chronic obstructive pulmonary disease March 2019 AstraZeneca (COPD) testosterone undecanoate Jatenzo™ Clarus Therapeutics Testosterone deficiency March 2019

efavirenz, lamivudine, and Symfi™ Macleods Pharam HIV March 2019 tenofovir disoproxil fumarate USA, Inc. netarsudil/latanoprost Rocklatan™ Aerie Glaucoma or ocular hypertension March 2019

methylphenidate hydrochloride Adhansia XR™ Adlon Therapeutics ADHD February 2019

etabonate Lotemax SM™ Bausch + Lomb Post-operative inflammation and pain February 2019

prabotulinumtoxin A-xvfs Jeuveau™ Evolus Frown lines February 2019

amphetamine sulfate Evekeo ODT™ Arbor Phars ADHD January 2019

colchicine Gloperba™ Romeg Therapeutics Prevention of gout flares January 2019

sumatriptan nasal spray Tosymra™ Promius Pharma/ Migraine January 2019 Dr. Reddy’s diclofenac epolamine Licart™ Institut Biochimique Acute pain December 2018

levetiracetam Elepsia XR™ Sun Pharma Partial-onset seizures December 2018

buprenorphine Brixadi™ Braeburn Opioid use disorder December 2018 (tentative approval) Pharmaceuticals levodopa Inbrija™ Accorda Therapeutics Parkinson’s disease December 2018

rosuvastatin Ezallor™ Sun Pharma Global High cholesterol December 2018

itraconazole capsule Tolsura™ Mayne Pharma Fungal infections December 2018

lamivudine/tenofovir disoproxil Temixys™ Celltrion HIV November 2018 fumarate

continued Drug Pipeline Monthly Update: June 2019 Page 4

Other new product approvals in the past twelve months (continued)

Generic name Brand name Manufacturer Indication(s) Date approved* sufentanil Dsuvia™ AcelRx Pain November 2018 Pharmaceuticals clobazam oral soluble film (OSF) Sympazan™ Aquestive Lennox-Gastaut syndrome November 2018 Therapeutics levoleucovorin Khapzory™ Spectrum Rescue after high-dose methotrexate October 2018 therapy halobetasol propionate lotion Bryhali™ Bausch Health Cos Plaque psoriasis October 2018 0.01% Inc (Valeant) meloxicam orally disintegrating Qmiiz ODT™ TerSera Pain and inflammation October 2018 tables estradiol and progesterone Bijuva™ TherapeuticsMD Vasomotor symptoms due to menopause October 2018

testosterone enanthate Xyosted™ Antares Testosterone replacement therapy October 2018

latanoprost Xelpros™ Sun Pharma Open-angle glaucoma September 2018

buprenorphine/naloxone SL film Cassipa™ Teva Opioid dependence September 2018

doravirine, lamivudine and Delstrigo™ Merck HIV September 2018 tenofovir disoproxil fumarate loteprednol etabonate Inveltys™ Kala Pharmaceuticals Post-operative inflammation and pain September 2018 following ocular surgery tretinoin Altreno™ Ortho Dermatologic Acne September 2018

methylphenidate Jornay PM™ Ironshore ADHD August 2018 Pharmaceuticals cyclosporine Cequa™ Sun Pharma Dry eye disease August 2018

tafenoquine Arakoda™ 60 Degrees Prevention of malaria August 2018 Pharmaceuticals risperidone injectable Perseris™ Indivior Schizophrenia August 2018

pimavanserin, 34 mg capsule, Nuplaxid® Acadia Parkinson’s disease psychosis July 2018 10 mg tablet Pharmaceutical darunavir, cobicistat, Symtuza® Janssen HIV July 2018 emtricitabine, tenofovir alafenamide aripiprazole lauroxil Aristada Initio™ Alkermes Schizophrenia July 2018

desmopressin Nocdurna™ Ferring Nocturia July 2018 Pharmaceuticals *Date indicates FDA approval date only. The product launch and marketing dates are determined by the approved product’s manufacturer. Drug Pipeline Monthly Update: June 2019 Page 5

Pipeline watch

Anticipated FDA Generic Name Brand Name Manufacturer Indication(s) Decision Date loxicodegol N/A Nektar Therapeutics Chronic lower back pain 2019

glucagon rescue pen XeriSol Glucagon™ Xeris Severe hypoglycemia June 2019 Pharmaceuticals tiopronin Thiola® Mission Pharmcal Cystinuria June 2019 and Retrophin bremelanotide Vyleesi™ AMAG/Palatin Hypoactive sexual desire disorder in June 2019 women diazepam Valtoco™ Neurelis Acute seizures 3Q2019

relebactam, cilastatin and N/A Merck Complicated urinary tract infection (cUTI) July 2019 imipenem or complicated intra-abdominal infection (cIAI) loteprednol etabonate N/A Kala Pharmaceuticals Dry eye disease August 2019

lefamulin N/A Nabriva Therapeutics Community acquired bacterial pneumonia August 2019

pitolisant N/A Harmony Narcolepsy August 2019

istradefylline N/A Kyowa Kirin Parkinson’s disease August 2019

oxycodone controlled-release Rexista™ Intellipharmaceutics Pain August 2019

tenapanor N/A Ardelyx Irritable bowel syndrome with constipation September 2019

lumateperone N/A Intra-cellular Schizophrenia September 2019 therapies ferric maltol Ferracru™ Shield Therapeutics Iron deficiency October 2019

cetirizine Qzytir™ JDP Therapeutics Acute urticaria October 2019

lasmiditan N/A Lilly Migraine October 2019

acetonide Xipere™ Clearside Medical Macular edema with October 2019

minocycline foam 4% FMX 101 Foamix Acne vulgaris October 2019 Pharmaceuticals testosterone undecanoate Tlando™ Lipocine Oral testosterone November 2019

cenobamate N/A SK Partial-onset seizures November 2019 Biopharmaceuticals ethinyl estradiol and Twirla™ Agile Therapeutics Contraceptive patch November 2019 levonorgestrel ubrogepant N/A Allergan Acute migraine December 2019

lemborexant N/A Eisai/Prudue Pharma Insomnia December 2019

semaglutide N/A Novo Nordisk Reduction of CV risk in T2DM January 2020

bempedoic acid/ezetimibe N/A Esperion High cholesterol February 2020 Therapeutics eptinezumab N/A Adler Migraine prevention February 2020 BioPharmaceuticals bempedoic acid N/A Esperion High cholesterol February 2020 Therapeutics Drug Pipeline Monthly Update: June 2019 Page 6

First generic approvals of top selling brand name drugs in the past twelve months

Generic name Brand name Manufacturer Indication(s) Date approved* erlotinib+ Tarceva® Genentech Lung cancer May 2019

loteprednol etbonate Lotemax® Bausch Health May 2019

Vesicare® Astellas Incontinence April 2019

deferasirox Exjade® Novartis Chronic iron overload March 2019

buprenorphine/naloxone Suboxone® Indivior Inc Opioid dependence March 2019

Wixela™ Inhub™ Advair Diskus® Glaxo Smith Kline and COPD February 2019 (/) acyclovir Zovirax® Bausch Health Cold sores February 2019

cinacalcet Sensipar® Amgen Hyperparathyroidism or hypercalcemia January 2019

pimecrolimus Elidel® Valeant Atopic dermatitis January 2019

mesalamine Canasa® Allergan Ulcerative proctitis December 2018

epinephrine auto-injector, 0.3 mg Epipen® Mylan Specialty The emergency treatment of allergic December 2018 reactions clobazam tablet Onfi® Lundbeck Lennox-Gastaut syndrome November 2018

testosterone Androgel® 1.62% Abbvie Testosterone replacement therapy (TRT) October 2018 pump tadalafil Cialis® Lilly Benign prostatic hyperplasia (BPH) and October 2018 erectile dysfunction (ED) tadalafil Adcirca® Lilly PAH August 2018

mesalamine DR Asacol HD® Allergan Ulcerative colitis August 2018

*Date usually indicates FDA approval date. The product’s launch date is determined by the manufacturer. Generic approvals that do not come to market within three months of approval are listed and dated when they enter the market. +Specialty medication

Other first generic launches in the past twelve months

Generic name Brand name Manufacturer Indication(s) Date approved* naftifine gel, 1% Naftin gel® Amneal Fungal infections June 2019 Pharmaceuticals sildenafil for suspension+ Revatio® Pfizer Pulmonary arterial hypertension June 2019

Mifeprex® Dance Laboratories Termination of pregnancy May 2019

bosentan+ Tracleer® Actelion Pulmonary hypertension May 2019 Pharmaceuticals mesalamine Delzicol® Allergan IBD May 2019

penicillamine+ Cuprimine® Bausch Health Hepatic encephalopathy and Wilson’s May 2019 disease valrubicin Valstar® Endo Bladder cancer April 2019

ambrisentan+ Letairis® Gilead Sciences Pulmonary arterial hypertension April 2019

aliskiren Tekturna® Noden Pharma USA Hypertension April 2019

continued Drug Pipeline Monthly Update: June 2019 Page 7

Other first generic launches in the past twelve months (continued)

Generic name Brand name Manufacturer Indication(s) Date approved* treprostinil sodium+ Remodulin® United Therapeutics Pulmonary arterial hypertension (PAH) March 2019 Corp ranolazine ER Ranexa® Gilead Sciences Chronic angina March 2019

minocycline ER Solodyn® Bausch Health Acne March 2019

erythromycin ethylsuccinate EryPed 400® Arbor Infection caused by listeria and bordetella March 2019 Pharmaceuticals pyridostigmine bromide syrup Mestinon® Bausch Health Myasthenia gravis March 2019

sirolimus Rapamune® Pfizer Prevention of organ rejection February 2019

toremifene+ Fareston® Kyowa Kirin Metastatic breast cancer January 2019

vigabatrin+ Sabril® Lundbeck Partial seizures or infantile spasms January 2019

aminocaproic acid Amicar® Clover Hemostasis December 2018 Pharmaceuticals silodosin Rapaflo® Allergan BPH December 2018

abiraterone tab+ Zytiga® Janssen Biotech Cancer chemotherapy November 2018

testosterone transdermal gel Fortesta® Endo TRT November 2018 pump Pharmaceuticals buprenorphine Butrans® Purdue Pain November 2018

estradiol patch Minivelle® Noven Therapeutics Menopause November 2018

vardenafil Staxyn® Bayer Erectile dysfunction November 2018

glycopyrrolate tablet Glycate® Carwin Peptic ulcer disease (PUD) November 2018 Pharmaceutical Associates vardenafil Levitra® Bayer Erectile dysfunction October 2018

itraconazole oral solution Sporanox® Janssen Fungal infections September 2018

dalfampridine ER+ Ampyra® Acorda Therapeutics Multiple sclerosis September 2018

carmustine BiCNU® Heritage Cancer chemotherapy September 2018

nevirapine Viramune® Boehringer Ingelheim HIV September 2018

albendazole Albenza® Amedra Parasitic disease September 2018

dorzolamide/timolol Cosopt PF® Merck Sharp & Glaucoma August 2018 Dohme Dexpak® Valeant Inflammation/allergic reactions/ August 2018 autoimmune diseases crotamiton Eurax® Ranbaxy Scabies and itchy skin August 2018

Topicort® Taro Plaque psoriasis August 2018 Topical Spray colesevelam oral suspension Welchol® Sankyo High cholesterol/diabetes July 2018

budesonide Uceris® Valeant Ulcerative colitis July 2018

*Date usually indicates FDA approval date. The product’s launch date is determined by the manufacturer. Generic approvals that do not come to market within three months of approval are listed and dated when they enter the market. +Specialty medication Drug Pipeline Monthly Update: June 2019 Page 8

Generics of top selling brand drugs potentially available soon

Generic name Brand name Manufacturer Indication(s) To market date* cyclosporine Restasis® Allergan Dry eye 2019

ascorbic acid; PEG; potassium Moviprep® Salix Valeant Osmotic laxative 2019 chloride; sodium ascorbate; sodium chloride; sodium sulfate Durezol® Alcon/Novartis Eye inflammation 2019

exenatide Byetta® AstraZeneca Diabetes 2019

ethinyl estradiol/ NuvaRing® Organon/Merck & Co Pregnancy prevention 1H2019

albuterol sulfate Proventil® HFA/ Merck/Teva Asthma/COPD 2H2019 ProAir® HFA ramelteon Rozerem® Takeda Insomnia 2H2019

pregabalin Lyrica® Pfizer CNS July 2019

teriparatide+ Forteo® Lilly Osteoporosis November 2019

icatibant acetate+ Firazyr® Shire HAE 2019

deferasirox+ Jadenu® Novartis Iron overload 2019

tolvaptan+ Samsca® Otsuka Hypernatremia 2019

travoprost Travatan Z® Alcon Glaucoma 2019

dapsone A c z o n e 7.5% ® Allergan Acne January 2020

topiramate Qudexy XR® Upsher-Smith Seizures March 2020

vilazodone hydrochloride Viibryd® Forest Depression March 2020

ethinyl estradiol Taytulla® Allergan Pregnancy prevention March 2020

ivermectin Sklice® Arbor Lice May 2020 Pharmaceuticals varenicline tartrate Chantix® Pfizer Smoking cessation May 2020

/formoterol Dulera® Merck & Co Asthma May 2020 fumarate ipratropium Atrovent HFA® Boehringer Ingelheim Chronic obstructive pulmonary disease May 2020 (COPD) * Expected to market dates are predictions made by Prime based on industry information. +Specialty medication

References 1. https://www.biospace.com/article/releases/exeltis-usa-inc-announces-the-approval-of-slynd-the-first-and-only-progestin-only-pill-providing-pregnancy-prevention-with-a-24-4-dosing-regimen-and- 24-hour-missed-pill-window/

All brand names are property of their respective owners.

2992-A1 © Prime Therapeutics LLC 06/19