If approved, tildrakizumab, licensed in globally by Sun Pharma but developed by Merck, will be pitted against established competitors in a crowded market of advanced biologics for plaque psoriasis. But experts believe several advantages can help the top Indian generic firm leap into the wide world of dermatology and anti-inflammatory compounds.

The market for psoriasis drugs will become increasingly competitive, with several drugs with novel mechanisms of action approaching commercialization. Their challenge will be to demonstrate efficacy that stands up to existing biologics and an ultra-clean safety profile, given the notoriously cautious prescriber base.

Proposal, which could be formally endorsed by MedPac this spring, would lower the payment rates for vaccines while simultaneously moving all preventative vaccine coverage to Medicare Part B. Commission signals further cuts to payment rate, through an average sales priced-based methodology that might eventually be recommended.