| Asthma
Alvesco vs Nucala
Side-by-side clinical, coverage, and cost comparison for asthma.Deep comparison between: Alvesco vs Nucala 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 signalsNucala has a higher rate of injection site reactions vs Alvesco based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Nucala but not Alvesco, including UnitedHealthcare
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Category
Alvesco
Nucala
At A Glance
Oral inhalation
Twice daily
Inhaled corticosteroid
SC injection
Every 4 weeks
IL-5 antagonist
Indications
- Asthma
- Asthma
- Chronic rhinosinusitis with multiple nasal polyps
- Chronic Obstructive Airway Disease
- Eosinophilic granulomatosis with polyangiitis
- Hypereosinophilic syndrome
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).
Asthma (>=12 years), Chronic rhinosinusitis with multiple nasal polyps, Chronic Obstructive Airway Disease 100 mg SC once every 4 weeks.
Asthma (6-11 years) 40 mg SC once every 4 weeks.
Eosinophilic granulomatosis with polyangiitis, Hypereosinophilic syndrome 300 mg SC once every 4 weeks, administered as 3 separate 100 mg injections at least 5 cm apart.
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
- History of hypersensitivity to mepolizumab or excipients in the formulation
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 (>=3%) headache, injection site reaction, back pain, fatigue, oropharyngeal pain, arthralgia, diarrhea, urinary tract infection, cough, pruritus, eczema
Serious herpes zoster
Postmarketing hypersensitivity reactions including anaphylaxis
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.
Mepolizumab is an IL-5 antagonist (IgG1 kappa) that binds IL-5 with high affinity, blocking its binding to the alpha chain of the IL-5 receptor complex on eosinophils, thereby inhibiting IL-5 signaling and reducing eosinophil production and survival.
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Most Common Insurance
Anthem BCBS
Alvesco
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (5/12) · Qty limit (9/12)
Nucala
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (11/12) · Qty limit (11/12)
UnitedHealthcare
Alvesco
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (3/8) · Qty limit (3/8)
Nucala
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (6/8) · Qty limit (6/8)
Humana
Alvesco
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (3/3)
Nucala
- 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 availableAccessia Health: Asthma - Private Insurance
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.