After Pfizer saw increased risks in a surveillance study of Xeljanz, three other products have also seen their user fee dates pushed back; if FDA were to convene an expert panel, it could lead to more consistent labeling across the class, as requested in a recent citizen petition.

Together with a similar delay for AbbVie’s Rinvoq, the delays appear to stem from a study that raised concerns about the class. But the potential sales impact is less clear.

Drugs for inflammatory conditions and cancer drove the increase in spending among the pharmacy benefit manager’s commercial plans, according to a drug trend report from Cigna's Evernorth.