| Asthma
Alvesco vs Dupixent
Side-by-side clinical, coverage, and cost comparison for asthma.Deep comparison between: Alvesco vs Dupixent 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 signalsDupixent has a higher rate of injection site reactions vs Alvesco based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Dupixent but not Alvesco, including UnitedHealthcare
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Category
Alvesco
Dupixent
At A Glance
Oral inhalation
Twice daily
Inhaled corticosteroid
SC injection
Every 2 weeks
IL-4Ra antagonist
Indications
- Asthma
- Dermatitis, Atopic
- Asthma
- Chronic rhinosinusitis with multiple nasal polyps
- Eosinophilic esophagitis
- Prurigo nodularis
- Chronic Obstructive Airway Disease
- Chronic Spontaneous Urticaria
- Bullous pemphigoid
- Allergic Fungal Rhinosinusitis
Dosing
Asthma 80 mcg twice daily by oral inhalation as starting dose for patients on bronchodilators alone or inhaled corticosteroids, up to 320 mcg twice daily; patients previously on oral corticosteroids start at 320 mcg twice daily (maximum).
Dermatitis, Atopic Adults: 600 mg initial dose, then 300 mg SC Q2W; pediatric patients 6 months to 5 years: weight-based Q4W without loading dose; pediatric patients >=6 years: weight-based loading dose then Q2W or Q4W.
Asthma Adults and pediatric >=12 years: 400 mg or 600 mg loading dose, then 200 mg or 300 mg SC Q2W; pediatric 6-11 years: weight-based Q2W or Q4W without loading dose.
Chronic rhinosinusitis with multiple nasal polyps 300 mg SC Q2W for adults and pediatric patients >=12 years.
Eosinophilic esophagitis SC weight-based dosing for patients >=1 year weighing >=15 kg: 200 mg Q2W (15 to <30 kg), 300 mg Q2W (30 to <40 kg), or 300 mg weekly (>=40 kg).
Prurigo nodularis Adults: 600 mg initial dose, then 300 mg SC Q2W.
Chronic Obstructive Airway Disease Adults: 300 mg SC Q2W.
Chronic Spontaneous Urticaria Adults: 600 mg initial dose, then 300 mg SC Q2W; pediatric 12-17 years: weight-based 400 mg or 600 mg loading, then 200 mg or 300 mg Q2W.
Bullous pemphigoid Adults: 600 mg initial dose, then 300 mg SC Q2W in combination with a tapering course of oral corticosteroids.
Allergic Fungal Rhinosinusitis Adults: 300 mg SC Q2W; pediatric 6-17 years: weight-based Q2W or Q4W (15 to <30 kg: 300 mg Q4W; 30 to <60 kg: 200 mg Q2W; >=60 kg: 300 mg Q2W).
Contraindications
- Primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required
- Known hypersensitivity to ciclesonide or any ingredient of ALVESCO
- Known hypersensitivity to dupilumab or any excipients of DUPIXENT
Adverse Reactions
Most common (>=3%) Headache, nasopharyngitis, sinusitis, pharyngolaryngeal pain, upper respiratory infection, arthralgia, nasal congestion, pain in extremity, back pain
Serious Oropharyngeal candidiasis, immunosuppression and risk of infections, hypercorticism, adrenal suppression, reduction in bone mineral density, growth effects in pediatric patients, glaucoma, cataracts
Postmarketing Immediate or delayed hypersensitivity reactions including angioedema with swelling of lips, tongue, and pharynx
Most common (>=1%) Injection site reactions, conjunctivitis, oral herpes, blepharitis, keratitis, eye pruritus, other herpes simplex virus infection, dry eye
Serious Hypersensitivity reactions, conjunctivitis and keratitis, psoriasis, arthralgia and psoriatic arthritis, parasitic (helminth) infections
Postmarketing Angioedema, psoriatic arthritis, facial skin reactions (erythema, rash, scaling, edema, papules, pruritus, burning, pain), new-onset psoriasis, vasculitis
Pharmacology
Ciclesonide is an inhaled corticosteroid prodrug hydrolyzed by esterases to its active metabolite des-ciclesonide, which binds glucocorticoid receptors with 120-fold greater affinity than the parent compound and exerts broad anti-inflammatory activity against mast cells, eosinophils, lymphocytes, macrophages, and neutrophils involved in the asthmatic response.
Dupilumab is a human monoclonal IgG4 antibody that inhibits IL-4 and IL-13 signaling by binding to the IL-4Ra subunit shared by the IL-4 and IL-13 receptor complexes, blocking cytokine-induced inflammatory responses including release of proinflammatory cytokines, chemokines, nitric oxide, and IgE.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Alvesco
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (5/12) · Qty limit (9/12)
Dupixent
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (12/12) · Qty limit (2/12)
UnitedHealthcare
Alvesco
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (3/8) · Qty limit (3/8)
Dupixent
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (8/8) · Qty limit (6/8)
Humana
Alvesco
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (3/3)
Dupixent
- 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 Alvesco.
Cost estimate not availableHealthWell Foundation: Asthma
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Final cost depends on formulary coverage
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.