prodchem
Aug 20, 2026
The shift from injectable medicines toward oral drug delivery is becoming an increasingly important theme across biotech development in 2026. Khartis Therapeutics' planned oral selective IGF-1R inhibitor for thyroid eye disease (TED) provides a clear example of companies attempting to deliver a validated therapeutic mechanism through a more convenient route. Khartis plans to begin clinical testing of its candidate in the first quarter of 2027.
For pharmaceutical companies, investors and procurement teams, the trend is worth tracking because changing drug-delivery formats can influence patient convenience, treatment access, manufacturing requirements and the competitive positioning of therapies.
Injectable therapies can be highly effective, but they can also require:
Clinic visits
Infusion infrastructure
Healthcare professionals
Longer administration times
Additional treatment logistics
An effective oral alternative could potentially simplify treatment for patients and healthcare providers.
This creates a powerful development objective:
Preserve therapeutic activity while making treatment easier to administer.
Khartis is developing an oral selective IGF-1R inhibitor for TED.
The opportunity is particularly notable because the same target is already validated commercially. Amgen's Tepezza and Viridian's newly approved Lumvoa both target IGF-1R and are administered through intravenous infusion.
Khartis is therefore not simply pursuing a new target.
It is attempting to change how an established therapeutic mechanism is delivered.
The development of oral alternatives often begins with a practical question:
Can a patient take the medicine at home instead of receiving it in a clinical setting?
If the answer is yes without sacrificing efficacy or safety, the potential benefits can include:
Greater convenience
Lower administration burden
Reduced clinic dependence
Simpler treatment logistics
Potentially broader patient access
These advantages can become important differentiators in competitive therapeutic markets.
TED is an especially useful example because the current IGF-1R treatment landscape is already established.
Tepezza is administered by IV infusion, while Lumvoa was approved in June 2026 as another IGF-1R-targeted therapy. Lumvoa is also administered intravenously, although Viridian is developing a subcutaneous version aimed at potentially enabling home administration.
That means the competitive landscape is expanding in both mechanism and delivery format.
The broader trend should not be interpreted as oral delivery replacing every injectable therapy.
Biotech companies are also exploring:
Subcutaneous injections
Long-acting formulations
Self-administered therapies
Implantable delivery
Targeted delivery systems
The common objective is reducing the burden associated with traditional administration.
The TED market demonstrates this competition clearly.
Minghui Pharmaceutical is developing MHB018A, a subcutaneous anti-IGF-1R antibody, while Viridian is developing a subcutaneous version of Lumvoa.
This creates several competing convenience strategies:
IV infusion → Subcutaneous injection → Oral tablet
Each offers different trade-offs in manufacturing, pharmacokinetics, convenience and clinical performance.
Oral delivery is often easier to pursue with small molecules than with large biologic antibodies.
Khartis is specifically developing oral small-molecule medicines across immunology and chronic diseases.
This gives small-molecule developers an opportunity to compete against injectable biologics by targeting the same biological pathways through a different modality.
An oral drug must still achieve the required:
Absorption
Bioavailability
Exposure
Target engagement
Duration of action
Safety profile
A convenient tablet has little commercial value if it cannot reproduce the therapeutic effect of an injectable treatment.
Therefore, the real development equation is:
Convenience + Efficacy + Safety + Consistent exposure
Companies may have greater confidence pursuing oral alternatives when the biological target is already clinically validated.
IGF-1R is a good example.
Existing therapies have demonstrated that targeting the receptor can provide clinical benefits in TED. This allows a new developer to focus more heavily on molecular design and delivery optimization rather than proving an entirely new biological hypothesis.
The oral-versus-injectable debate is not limited to TED.
It can become relevant wherever established injectable therapies create:
Administration burdens
Patient adherence challenges
Healthcare-system costs
Limited treatment accessibility
Potential areas include:
Immunology
Metabolic disease
Oncology
Neurology
Rare diseases
Chronic inflammatory conditions
The commercial opportunity depends on whether an oral formulation can provide comparable clinical value.
As more therapies target similar biological pathways, delivery format can become a differentiator.
Two drugs may have comparable efficacy but very different administration requirements.
A patient may prefer:
A tablet at home
over
A scheduled infusion at a medical facility
if the clinical outcomes are sufficiently comparable.
This creates an additional competitive dimension beyond efficacy and safety.
Changing delivery format can also alter pharmaceutical manufacturing requirements.
An oral small molecule may require:
Specialized active pharmaceutical ingredients
Formulation development
Tablet manufacturing
Excipient optimization
Stability testing
High-purity intermediates
Injectable biologics, meanwhile, require different manufacturing and quality systems.
This means a shift toward oral therapies could gradually change demand across pharmaceutical supply chains.
For pharmaceutical procurement professionals, pipeline monitoring should include how a drug is delivered, not just what target it addresses.
Useful signals include:
Oral small-molecule candidates
Subcutaneous formulations
Long-acting formulations
Self-administered therapies
Reformulation programs
These can provide early indicators of future manufacturing and raw-material demand.
Investors should avoid assuming that oral automatically means better.
Important questions include:
Does the oral candidate match the established injectable?
Does changing delivery introduce new risks?
Will patients actually prefer the new format?
Can it be produced economically at scale?
Will payers recognize the value of greater convenience?
Are other oral or subcutaneous alternatives approaching the market?
The emergence of multiple delivery strategies means pharmaceutical competition is increasingly multidimensional.
A market can evolve from:
One injectable therapy
to:
Multiple injectable therapies
then:
Injectable + subcutaneous + oral alternatives
At that point, convenience becomes part of the product's competitive positioning.
Khartis is still at an early stage, with its first clinical trial planned for 2027.
Therefore, it is too early to determine whether its oral IGF-1R approach will ultimately succeed.
But its strategy illustrates a broader development philosophy: take clinically validated biology and attempt to make treatment easier to deliver.
That makes oral-versus-injectable development an important pipeline trend to monitor.
The growing focus on alternative delivery formats could reshape competition across several pharmaceutical markets.
For biotech companies, an oral formulation can provide a powerful differentiation strategy when competing against established injectable medicines.
For pharmaceutical companies, delivery innovation offers another way to extend the value of validated targets.
For investors, it creates a new dimension for evaluating pipeline quality.
And for procurement teams, changes in delivery modality can eventually translate into changes in API demand, formulation requirements, manufacturing capacity and specialty-chemical sourcing.
Khartis's oral IGF-1R program is therefore more than a single biotech pipeline story.
It represents a broader question facing pharmaceutical developers:
When the biology already works, can a better delivery format make the medicine more accessible, convenient and commercially competitive?
Oral drug development is becoming an important differentiation strategy in several biotech pipelines.
Khartis is developing an oral selective IGF-1R inhibitor for thyroid eye disease, with clinical testing planned for 2027.
Existing IGF-1R therapies for TED, including Tepezza and Lumvoa, are delivered intravenously.
Subcutaneous delivery is another major alternative being developed in the same therapeutic area.
Oral small molecules can potentially compete against injectable biologics when the same biological pathway is validated.
Convenience alone is not enough; efficacy, safety, bioavailability and manufacturing economics remain critical.
Delivery format can become an important competitive factor as therapeutic markets become more crowded.
Procurement teams should monitor pipeline modality alongside therapeutic targets.
Successful oral alternatives could influence API, formulation and specialty-chemical demand.
The broader trend reflects a pharmaceutical industry increasingly focused on making established therapeutic mechanisms easier to administer.
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