GlaxoSmithKline's Nucala scores convenience boost with at-home dosing options

GlaxoSmithKline’s Nucala has suffered against a more convenient AstraZeneca rival, but the company finally has an answer.

Thursday, the FDA greenlighted two new delivery options for Nucala: an autoinjector and a prefilled syringe, both of which severe eosinophilic asthma patients can self-administer at home.

“Choice is good for patients,” who will be able to decide with their doctors on either in-office or at-home dosing every four weeks, Sheri Mullen, senior vice president of GSK’s U.S. specialty business unit, said.

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Patients doctors deem eligible for an at-home option will go through training, either in the doctor’s office or on GSK’s website, Mullen said, adding that “it’s very simple and easy to use after that initial 1-2-3 step training.”

And those who struggle to stay compliant or need more frequent doctor check-ins will still have the option to come in for dosing as they have in the past.

“It very much is a shared decision between the physician and the patient. Some patients do like to come in and physicians want them to come in, and other patients, based on their lifestyle and the physicians believing that they can do this at home, will select that option,” Mullen said.

With the approval, Nucala becomes the only drug in its class with an autoinjector option—a convenience advantage GSK hopes can put it on more even footing with archrival Fasenra from AstraZeneca. That drug has managed to snap up significant share despite a years-long Nucala head start, thanks in part to its every-eight-weeks dosing schedule that can’t be “neutralized,” as GSK pharma chief Luke Miels put it last year.

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But GSK is about to change its game in another area, too, and that’s detailing. Late last month, the company said it would roll back strict performance-based pay rules for its U.S. specialty force, allowing reps to take home more money the more prescription sales they generate. The reason? To help boost drugs such as Nucala.

“Specialty medicine is very much about high science. You want to have the best people, and what we were seeing was that we weren’t as competitive as we could be based on the needs of the professionals in that space,” Mullen said.