| Anemia in chronic kidney disease
Retacrit vs Mircera
Side-by-side clinical, coverage, and cost comparison for anemia in chronic kidney disease.Deep comparison between: Retacrit vs Mircera with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsMircera has a higher rate of injection site reactions vs Retacrit based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Mircera but not Retacrit, including UnitedHealthcare
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Category
Retacrit
Mircera
At A Glance
SC or IV injection
3 times weekly or weekly
Erythropoiesis-stimulating agent (ESA)
SC or IV injection
Every 2-4 weeks
Erythropoiesis-stimulating agent (ESA)
Indications
- Anemia in chronic kidney disease
- Anemia co-occurrent with human immunodeficiency virus infection
- Anemia due to and following chemotherapy
- Anemia in chronic kidney disease
Dosing
Anemia in chronic kidney disease Adults: 50-100 Units/kg 3 times weekly IV or SC (IV recommended for hemodialysis); pediatric patients (>= 1 month): 50 Units/kg 3 times weekly IV or SC; individualize maintenance dose.
Anemia co-occurrent with human immunodeficiency virus infection 100 Units/kg IV or SC 3 times weekly; increase by 50-100 Units/kg at 4- to 8-week intervals if no response after 8 weeks; maximum 300 Units/kg 3 times weekly.
Anemia due to and following chemotherapy Adults: 150 Units/kg SC 3 times weekly or 40,000 Units SC weekly until completion of chemotherapy course; pediatric patients (5-18 years): 600 Units/kg IV weekly until completion of chemotherapy course.
Surgery patients 300 Units/kg SC daily for 15 days (10 days pre-surgery, day of surgery, 4 days post-surgery) or 600 Units/kg SC weekly for 4 doses administered 21, 14, and 7 days before surgery and on the day of surgery.
Anemia in chronic kidney disease (adult, on dialysis) Initial: 0.6 mcg/kg IV or SC once every 2 weeks; once hemoglobin is stabilized, may convert to once monthly at twice the every-2-week dose.
Anemia in chronic kidney disease (adult, not on dialysis) Initial: 1.2 mcg/kg SC once monthly, or 0.6 mcg/kg IV or SC once every 2 weeks; may convert to once monthly at twice the every-2-week dose once hemoglobin is stabilized.
Anemia in chronic kidney disease (pediatric, ESA conversion) IV or SC once every 4 weeks (ages 3 months to 17 years); starting dose based on prior weekly ESA dose per conversion table; patients requiring < 30 mcg should not be treated with Mircera.
Contraindications
- Uncontrolled hypertension
- Pure red cell aplasia (PRCA) that begins after treatment with RETACRIT or other erythropoietin protein drugs
- Serious allergic reactions to RETACRIT or other epoetin alfa products
- Use of multiple-dose vials (benzyl alcohol formulation) in neonates, infants, pregnant women, and lactating women
- Uncontrolled hypertension
- Pure red cell aplasia (PRCA) beginning after treatment with Mircera or other erythropoietin protein drugs
- Serious or severe allergic reactions to Mircera (e.g., anaphylactic reactions, angioedema, bronchospasm, skin rash, urticaria)
Adverse Reactions
Most common (>=5%) Hypertension, arthralgia, nausea, vomiting, pyrexia, rash, muscle spasm, dizziness, cough, myalgia, headache, pruritus, injection site pain
Serious Increased mortality, myocardial infarction, stroke, thromboembolism, tumor progression or recurrence, hypertension, seizures, PRCA, serious allergic reactions, severe cutaneous reactions
Postmarketing Seizures, PRCA, serious allergic reactions, injection site reactions (irritation and pain), porphyria, severe cutaneous reactions
Most common (>=5%) Hypertension, diarrhea, nasopharyngitis, upper respiratory tract infection, headache, muscle spasms, procedural hypotension, fluid overload, vomiting, back pain, cough, arteriovenous fistula thrombosis, arteriovenous fistula site complication, constipation, hypotension, urinary tract infection, pain in extremity
Serious Increased mortality, myocardial infarction, stroke, thromboembolism, tumor progression, hypertension, seizures, pure red cell aplasia, serious allergic reactions, severe cutaneous reactions
Postmarketing Stevens-Johnson syndrome/toxic epidermal necrolysis, pure red cell aplasia (PRCA)
Pharmacology
Epoetin alfa-epbx is an erythropoiesis-stimulating agent (ESA) that stimulates erythropoiesis by the same mechanism as endogenous erythropoietin, increasing reticulocyte count within 10 days and raising RBC count, hemoglobin, and hematocrit within 2 to 6 weeks.
Mircera is a PEGylated erythropoietin receptor activator with greater in vivo activity and longer half-life than endogenous erythropoietin; it stimulates erythroid progenitor cells to increase red blood cell production, correcting the erythropoietin deficiency that is the primary cause of anemia in CKD.
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Most Common Insurance
Anthem BCBS
Retacrit
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (9/12) · Qty limit (10/12)
Mircera
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Retacrit
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (6/8)
Mircera
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Retacrit
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Mircera
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Hepatitis C
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Mircera.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.