| Arthritis, Psoriatic
Acthar vs Enbrel
Side-by-side clinical, coverage, and cost comparison for arthritis, psoriatic.Deep comparison between: Acthar vs Enbrel 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 signalsEnbrel has a higher rate of injection site reactions vs Acthar based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Enbrel but not Acthar, including UnitedHealthcare
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Category
Acthar
Enbrel
At A Glance
IM or SC injection
Corticotropin analog
SC injection
Once weekly
TNF-alpha inhibitor
Indications
- Infantile Spasm
- Multiple Sclerosis
- Arthritis, Psoriatic
- Rheumatoid Arthritis
- Ankylosing spondylitis
- Lupus Erythematosus, Systemic
- Dermatomyositis
- Polymyositis
- Erythema Multiforme
- Stevens-Johnson Syndrome
- Serum Sickness
- Keratitis
- Iritis
- Iridocyclitis
- Uveitis, Posterior
- Choroiditis
- Optic Neuritis
- Chorioretinitis
- Sarcoidosis
- Nephrotic Syndrome
- Rheumatoid Arthritis
- Arthritis, Psoriatic
- Ankylosing spondylitis
- Psoriasis vulgaris
- Polyarticular Juvenile Idiopathic Arthritis, Rheumatoid Factor Negative
- Juvenile psoriatic arthritis
Dosing
Infantile Spasm 150 U/m2/day IM divided into 75 U/m2 twice daily for 2 weeks, then taper over 2 weeks; Acthar Gel vial only -- do not use the pre-filled SelfJect injector.
Multiple Sclerosis 80-120 units IM or SC daily for 2-3 weeks for acute exacerbations; taper as needed.
Arthritis, Psoriatic, Rheumatoid Arthritis, Ankylosing spondylitis, Lupus Erythematosus, Systemic, Dermatomyositis, Polymyositis, Erythema Multiforme, Stevens-Johnson Syndrome, Serum Sickness, Keratitis, Iritis, Iridocyclitis, Uveitis, Posterior, Choroiditis, Optic Neuritis, Chorioretinitis, Sarcoidosis, Nephrotic Syndrome 40-80 units IM or SC every 24-72 hours; individualize dosing based on disease severity and patient response; taper dose upon discontinuation.
Rheumatoid Arthritis, Arthritis, Psoriatic, Ankylosing spondylitis 50 mg SC once weekly, with or without MTX
Psoriasis vulgaris 50 mg SC twice weekly for 3 months (loading), then 50 mg SC once weekly (maintenance)
Polyarticular Juvenile Idiopathic Arthritis, Rheumatoid Factor Negative, Juvenile psoriatic arthritis 0.8 mg/kg SC once weekly, maximum 50 mg per week
Contraindications
- Intravenous administration
- Use in infants under 2 years of age with suspected congenital infections
- Concomitant live or live-attenuated vaccines during immunosuppressive doses of Acthar Gel
- Scleroderma
- Osteoporosis
- Systemic fungal infections
- Ocular herpes simplex
- Recent surgery
- History of or presence of peptic ulcer
- Congestive heart failure
- Uncontrolled hypertension
- Primary adrenocortical insufficiency
- Adrenocortical hyperfunction
- Sensitivity to proteins of porcine origin
- Sepsis
Adverse Reactions
Most common (>=5%) Infections, convulsions, hypertension, irritability, pyrexia (reported in infantile spasm trials at recommended dose)
Serious Cushing's syndrome, adrenal insufficiency upon withdrawal, elevated blood pressure, salt and water retention, hypokalemia, gastrointestinal perforation and bleeding, behavioral and mood disturbances, ophthalmic effects, decreased bone density, negative effects on growth and physical development
Postmarketing Anaphylaxis, necrotizing angitis, pancreatitis, intracranial hemorrhage, subdural hematoma, reversible brain shrinkage, vertebral compression fractures, insomnia, injection site reactions
Most common Infections (upper respiratory tract infection, sinusitis, influenza), injection site reactions (erythema, itching, pain, swelling)
Serious Serious infections (pneumonia, cellulitis, septic arthritis, sepsis), neurologic events, congestive heart failure, hematologic events
Postmarketing Pancytopenia, anemia, leukopenia, neutropenia, thrombocytopenia, aplastic anemia, congestive heart failure, inflammatory bowel disease, angioedema, autoimmune hepatitis, macrophage activation syndrome, systemic vasculitis, sarcoidosis, lupus-like syndrome, melanoma, non-melanoma skin cancers, Merkel cell carcinoma, convulsions, multiple sclerosis, demyelination, optic neuritis, transverse myelitis, uveitis, scleritis, glomerulonephritis, interstitial lung disease, Stevens-Johnson syndrome, toxic epidermal necrolysis, opportunistic infections
Pharmacology
Repository corticotropin (ACTH) analog that stimulates the adrenal cortex to secrete cortisol, corticosterone, aldosterone, and weak androgens; also reported to bind melanocortin receptors, with the trophic effects on the adrenal cortex appearing to be mediated by cyclic AMP.
Etanercept is a dimeric soluble form of the human p75 TNF receptor that inhibits binding of TNF-alpha and TNF-beta (lymphotoxin alpha) to cell surface TNF receptors, rendering TNF biologically inactive and modulating downstream inflammatory responses including adhesion molecule expression, cytokine levels, and matrix metalloproteinase levels.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Acthar
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (0/12)
Enbrel
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (12/12) · Qty limit (11/12)
UnitedHealthcare
Acthar
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Enbrel
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (6/8) · Qty limit (6/8)
Humana
Acthar
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (2/3)
Enbrel
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Acthar.
No savings programs available for Enbrel.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.