Express Scripts Adds Voquezna to Formulary for Gastroesophageal Reflux

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Voquezna is a potassium-competitive acid blocker, which has a mechanism similar to proton pump inhibitors but with a more rapid action. It has a list price of $650 for a 30-count bottle.

Express Scripts has added Phathom Pharmaceuticals’ Voquezna (vonoprazan) tablets to its national formularies. The addition is effective immediately. The FDA approved Voquezna in November 2023 to treat adults with erosive esophagitis, also known as erosive GERD (gastroesophageal reflux disease). It is also indicated as a maintenance therapy for erosive GERD and for the relief of heartburn associated with erosive GERD.

Phathom officials said commercial access for Voquezna is now estimated at 60 million covered lives in the United States. The wholesale acquisition cost (WAC) of Voquezna tablets is $650 for both (10 mg and 20 mg) 30-count bottles. Phathom is also offering programs for commercial patients who face coverage or affordability issues, including co-pay assistance where commercial patients may pay as little as $25. Their copay assistance program has an annual cap of $2,820.

Erosive GERD affects about 20 million people in the United States. Patients with inadequately treated erosive GERD may develop more severe diseases including Barrett’s esophagus, a condition in which esophageal tissue changes can progress to cancer.

Voquezna is a novel potassium-competitive acid blocker (PCAB), which has a mechanism similar to proton pump inhibitors but with a more rapid action and that doesn’t require dosing 30 minutes before meals. Voquezna is expected to be available in December 2023.

Related: FDA Approves Novel Therapy for Gastroesophageal Reflux

The approval is based on results from the phase 3 PHALCON-EE study, which enrolled 1,024 patients with erosive GERD. The study compared Voquezna to the proton pump inhibitor lansoprazole in the healing and maintenance of healing of erosive GERD. Study results, which were published in October 2022 in Gastroenterology, showed that Voquezna was non-inferior to lansoprazole with complete healing by week eight. Patients with all grades of erosive GERD taking Voquezna experienced a healing rate of 93% compared with 85% for lansoprazole 30 mg. Voquezna also demonstrated non-inferiority to lansoprazole in the mean percentage of 24-hour heartburn-free days over the healing period.

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