TABLE 2.
Therapeutic Alternatives to the Drugs Selected for IPAY 2027
| Selected drug | Primary indication | Therapeutic alternative |
|---|---|---|
| Ozempic, Rybelsus, Wegovy (semaglutide) | T2DM, MACE risk reduction in T2DM and CVD | Bydureon Bcise, Byetta (exenatide) Trulicity (dulaglutide)a Adlyxin (lixisenatide) Saxenda, Victoza (liraglutide)a Mounjaro (tirzepatide) Jardiance (empagliflozin)a,b Farxiga (dapagliflozin)a,b Invokana (canagliflozin)a |
| Trelegy Ellipta (fluticasone/umeclidinium/vilanterol) | Maintenance treatment for COPD | Breztri Aerosphere (budesonide/glycopyrrolate/formoterol) Symbicort, Breyna, Symbicort Aerosphere (budesonide/formoterol) + Spiriva, Spiriva Respimat (tiotropium) Advair Diskus, Wixela Inhubc (fluticasone/salmeterol) + Spiriva, Spiriva Respimat (tiotropium) Breo Ellipta (fluticasone/vilanterol) + Spiriva, Spiriva Respimat (tiotropium) |
| Xtandi (enzalutamide) | Prostate cancer | Erleada (apalutamide) Nubeqa (darolutamide) Zytiga (abiraterone acetate)c Taxotere (docetaxel)c Jevtana (cabazitaxel) |
| Pomalyst (pomalidomide) | Multiple myeloma | Darzalex + Kyprolis + Decadron (daratumumab + carfilzomib + dexamethasone) Darzalex + Velcadec + Decadron (daratumumab + bortezomib + dexamethasone) Kyprolis + Decadron (carfilzomib + dexamethasone) Cytoxanc + Velcadec + Decadron (cyclophosphamide + bortezomib + dexamethasone) |
| Ibrance (palbociclib) | HR+/HER2− metastatic breast cancer | Kisqali (ribociclib) Verzenio (abemaciclib) |
| Ofev (nintedanib-esylate) | Idiopathic pulmonary fibrosis | Esbriet (pirfenidone) |
| Linzess (linaclotide) | Chronic idiopathic constipation | Trulance (plecanatide) |
| Calquence (acalabrutinib) | CLL/SLL | Brukinsa (zanubrutinib)a Imbruvica +/− Venclexta (ibrutinibb +/− venetoclax) Venclexta + Gazyva (venetoclax + obinutuzumab)a Venclexta + Rituxan (venetoclax + rituximab)a |
| Austedo, Austedo XR (deutetrabenazine) | Tardive dyskinesia | Ingrezza (valbenazine) |
| Breo Elliptac (fluticasone/vilanterol) | Maintenance treatment for COPD | Breyna, Symbicort, Symbicort Aerosphere (budesonide/formoterol) Advair HFA, Advair Diskus, Airduo Respiclick, Wixela Inhubc (fluticasone/salmeterol) Dulera (mometasone/formoterol) |
| Maintenance treatment for asthma | ||
| Tradjenta (linagliptin) | Adjunct to diet and exercise in T2DM | Farxiga (dapagliflozin)a,b Jardiance (empagliflozin)a,b Trulicity (dulaglutide)a Ozempic, Rybelsus, Wegovy (semaglutide)a Amaryl (glimeperide)a,c Glucotrol XL (glipizide)c Januvia (sitagliptin)b Nesina (alogliptin) Onglyza (saxagliptin) Metformina,c Actos (pioglitazone)a,c |
| Xifaxan (rifaximin) | Reduction in risk of overt hepatic encephalopathy | No therapeutic alternatives |
| Vraylar (cariprazine) | Bipolar disorder 1 | Abilify (aripiprazole)c Saphris (asenapine)c Caplyta (lumateperone) Latuda (lurasidone) Zyprexa (olanzapine)c Seroquel, Seroquel XR (quetiapine)c Risperdal (risperidone)c Geodon (ziprasidone)c |
| Janumet, Janumet XR (sitagliptin/metformin) | T2DM | Kazano (alogliptin/metformin) Jentadueto, Jentadueto XR (linagliptin/metformin) saxagliptin/metformin Invokamet, Invokamet XR (canagliflozin/metformin) Xigduo XR (dapagliflozin/metformin) Synjardy, Synjardy XR (empagliflozin/metformin) Segluromet (ertugliflozin/metformin) |
| Otezla (apremilast) | Plaque psoriasis | Sotyktu (deucravacitinib) Trexall, Jylamvo, Otrexup, Rasuvo, Xatmep (methotrexate)c Soriatane (acitretin)c Gengraf, Neoral, Sandimmune (cyclosporine)c |
a
Products that were identified in the Centers for Medicare & Medicaid Services list of therapeutic alternatives to the drugs selected for IPAY 2026.
b
Products that were selected for negotiation in IPAY 2026 and thus have a negotiated price (maximum fair price) published.
c
Also available as a generic.
CLL/SLL = chronic lymphocytic leukemia/small lymphocytic lymphoma; COPD = chronic obstructive pulmonary disease; CVD = cardiovascular disease; HR = hormone receptor; HER2− = human epidermal growth factor receptor 2 negative; HR+ = hormone receptor positive; IPAY = Initial Price Applicability Year; MACE = major adverse cardiovascular events; T2DM = type 2 diabetes mellitus; XR = extended-release.