Optometry Podcast: TYRVAYA™ (varenicline solution) Nasal Spray with Jeff Nau and Dr. Marian Macsai

Drs. Darryl Glover and Inna Lazar discuss TYRVAYA™ (varenicline solution) Nasal Spray with Oyster Point’s Jeff Nau, President and CEO, and Marian Macsai, Chief Medical Officer.


We found that oyster point with that concept of bringing transformative innovative medicines to the front of the eye. So to TYRVAYA™ was our first product that we were developing, which is obviously a little bit out of the norm, which is a nasal spray to treat an ocular surface disease. But then we also have a pipeline that is focused on bringing gene therapy to the front of the eye. So we’re actually delivering AV gene therapy to the lacrimal gland and harnessing the lacrimal gland to really do drug delivery to the ocular surface. And we think that that has the possibility to transform the way that we deliver therapeutics to the ocular surface where once we inject that patient’s lacrimal gland, the patient is set for some period of time that remains to be seen. We’re also working on some novel antimicrobial therapies in our pipeline called bacteriophages. These are really harnessing the small little viral particles to go after bacteria and we’re obviously working on a number of other things we can’t talk about just yet but we think we got the coolest pipeline in front of the eye and we got a cool company that’s really only focused on in front of the eye and many companies out there can claim that they’re in eye care, but we are truly ingrained in eye care


And so this particular class of receptors was identified and what’s interesting about the class of receptors is they’re made up of 5 subunits and the way that they work is once the drug or ligand binds to them, they open a pore and allow ions to flow in and that depolarizes the nerve and causes the nerve to send a signal back to the various structures that produce the tear film. And not all of these receptors will cause tearing. So very specific receptors will. And so we found that this product, this drug varenicline, which was already out on the market, was one of those drugs that will stimulate these receptors. So one of the nice things about this particular product was more than 20 million patients have taken this product orally for smoking cessation. So we had a giant safety record. Big safety database. Obviously, at much higher doses than we would deliver in the nasal cavity. And so it allowed us to move really quickly through development, but also it cleared some of those hurdles that we often run into and drug development where you don’t know what sort of safety issues you’re going to run into. And we had a well-studied product that had been in the market for a long period of time. So we felt very comfortable in delivering this to patients. So varenicline binds to that receptor, it depolarizes the nerve, a signal is then sent back up through the ganglion into the lacrimal glands and meibomian glands in the goblet cells and we get stimulation. So as long as we have healthy gland tissue healthy goblet cells, the nerve that’s opposed to them will stimulate.


So the drug itself is priced similar to other dry eye medications that are currently out. At the beginning, when we launch products into the marketplace as you guys know, insurance coverage takes some time. And so we put patient services into place to help patients so that they can experience the drug and help physicians so that they can get experience with the drug. So for commercially insured patients at the moment, we have programs where they can pay as little as zero or $10 depending upon their insurance coverage at the moment.


The other thing that we have is I’m sure sharing your rep told you that if you write this prescription to fill Rx, which is mail-ordered kind of pharmacy. Right. The thing that I want is it to be easy for the eye care provider. And I think that we all hate the word prior authorization. So in our market access team, was trying to figure out how are we going to get this on shelves? How are we going to get this in the patient’s hands? I’m like, we have to find some way to help with the PA. We can not make people do PAs as often as you have to do them. So by partnering with this company PhilRx they do a lot of the leg work, a lot of the legwork that makes it easier. I’m not saying they do it 100%, but from what I’ve seen, it should make it easier for you and easier for your patients. And as opposed to some of the other systems that the three of us have used. They’re not going to call your patients. Because if someone calls the patients, we all think it’s a robocall. And none of us are going to answer the patients aren’t going to answer. So we’ve developed a way that they text your patients. And it’s secure and it’s safe and they can text your patients so that they can exchange the information to do a lot of that background legwork to make it easier for both the patients and the eye care providers. And that’s our goal. 

Dr. Darryl Gloverhttp://www.drdarrylglover.com
Dr. Darryl Glover is a global optometrist, speaker, entrepreneur, and social media enthusiast. He has served the optometric community for nearly twenty years and has held every position in the field including eyewear consultant, optometric technician, office manager, and optometrist.

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