THE VALUE OF TARGETED ORAL PEPTIDES IN IMMUNOLOGY: A TARGETED LITERATURE REVIEW AND QUALITATIVE SYNTHESIS
Author(s)
Marie Chivers, PhD1, Lara Feghelm, M.Sc.2, Nan Li, PhD2, Ya-Wen Yang, MD, MSc.2, Paul Newbold, PhD3, Jun Feng, MSc. (HE)4, Kyunghwa Lim, PhD5.
1Facilipharma, Hertfordshire, United Kingdom, 2J&J Innovative Medicine, Horsham, PA, USA, 3J&J R&D, Preston, MD, USA, 4J&J Innovative Medicine, Singapore, Singapore, 5J&J Innovative Medicine, Seoul, Korea, Republic of.
1Facilipharma, Hertfordshire, United Kingdom, 2J&J Innovative Medicine, Horsham, PA, USA, 3J&J R&D, Preston, MD, USA, 4J&J Innovative Medicine, Singapore, Singapore, 5J&J Innovative Medicine, Seoul, Korea, Republic of.
OBJECTIVES: Targeted oral peptides (TOPs) are an oral modality with highly selective pharmacologic properties and set a new therapeutic paradigm in immunology. Peptide development provides high specificity and potency, with stability in the gastrointestinal tract supporting absorption into the systemic circulation. These properties enable a profile of high efficacy with favorable safety. This focused literature review examines the potential value of TOPs as a first-line systemic treatment option in immunology.
METHODS: Databases (Embase, PubMed) were searched from 2021 to 2026 using terms including ‘oral peptides’, ‘biologics’, ‘small molecules’, ‘injectables’, ‘oral administration’, ‘economic’, ‘costs’, ‘environment’, and ‘cold chain’. Gray literature and references were reviewed.
RESULTS: Searches identified 2,128 articles; 303 met inclusion criteria for qualitative synthesis. TOPs present an opportunity for system-level resource savings through reduced disease management costs (efficacy, uptake, or persistence-driven outcome improvements); reduced adverse event treatment costs (no identified off-target effects, no injection site reactions, low-risk for drug interactions); resource sparing and predictability (staff time, limited mandatory laboratory testing, no cold-chain logistics). For patients, current treatment options resulted in themes of treatment burden, preference for efficacious oral treatments, side effect concerns, injection site reactions, needle-phobia, and long-term persistence. For healthcare staff/prescribers, TOPs can ameliorate identified challenges of long-term safety and effectiveness; time constraints (preparation, administration, documentation, training, counseling); needlestick injury; and repetitive strain disorder. Societal opportunities identified for TOPs include environmental (avoidance of needle disposal in domestic waste, reduced single-use plastic, lower CO2 emissions than injectables or cold-chain products); access and equity (rural access, ease of administration to vulnerable patients); reduced patient burden and absenteeism.
CONCLUSIONS: TOPs may be undervalued when value frameworks do not consider the value elements identified. Mode of action, innovation, outcomes weighting, comparator selection, and system-level benefits are important considerations for decision-makers appraising TOPs.
METHODS: Databases (Embase, PubMed) were searched from 2021 to 2026 using terms including ‘oral peptides’, ‘biologics’, ‘small molecules’, ‘injectables’, ‘oral administration’, ‘economic’, ‘costs’, ‘environment’, and ‘cold chain’. Gray literature and references were reviewed.
RESULTS: Searches identified 2,128 articles; 303 met inclusion criteria for qualitative synthesis. TOPs present an opportunity for system-level resource savings through reduced disease management costs (efficacy, uptake, or persistence-driven outcome improvements); reduced adverse event treatment costs (no identified off-target effects, no injection site reactions, low-risk for drug interactions); resource sparing and predictability (staff time, limited mandatory laboratory testing, no cold-chain logistics). For patients, current treatment options resulted in themes of treatment burden, preference for efficacious oral treatments, side effect concerns, injection site reactions, needle-phobia, and long-term persistence. For healthcare staff/prescribers, TOPs can ameliorate identified challenges of long-term safety and effectiveness; time constraints (preparation, administration, documentation, training, counseling); needlestick injury; and repetitive strain disorder. Societal opportunities identified for TOPs include environmental (avoidance of needle disposal in domestic waste, reduced single-use plastic, lower CO2 emissions than injectables or cold-chain products); access and equity (rural access, ease of administration to vulnerable patients); reduced patient burden and absenteeism.
CONCLUSIONS: TOPs may be undervalued when value frameworks do not consider the value elements identified. Mode of action, innovation, outcomes weighting, comparator selection, and system-level benefits are important considerations for decision-makers appraising TOPs.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
HTA10
Topic
Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes, Systems & Structure, Value Frameworks & Dossier Format
Disease
SDC: Sensory System Disorders (Ear, Eye, Dental, Skin), SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)