| Cystic Fibrosis
Symdeko vs Orkambi
Side-by-side clinical, coverage, and cost comparison for cystic fibrosis.Deep comparison between: Symdeko vs Orkambi 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 signalsOrkambi has a higher rate of injection site reactions vs Symdeko based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Orkambi but not Symdeko, including UnitedHealthcare
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Category
Symdeko
Orkambi
At A Glance
Oral
Twice daily
CFTR corrector/potentiator
Oral
Every 12 hours
CFTR corrector/potentiator
Indications
- Cystic Fibrosis
- Cystic Fibrosis
Dosing
Cystic Fibrosis Adults and patients >=12 years, or patients 6 to <12 years weighing >=30 kg: tezacaftor 100 mg/ivacaftor 150 mg in the morning and ivacaftor 150 mg in the evening, approximately 12 hours apart, with fat-containing food; patients 6 to <12 years weighing <30 kg: tezacaftor 50 mg/ivacaftor 75 mg in the morning and ivacaftor 75 mg in the evening, approximately 12 hours apart, with fat-containing food. Dose adjustment required for moderate or severe hepatic impairment and for co-administration with CYP3A inhibitors.
Cystic Fibrosis Weight- and age-based dosing orally every 12 hours with fat-containing food: ages 1-2 years receive lumacaftor 75-150 mg/ivacaftor 94-188 mg granules depending on weight; ages 2-5 years receive lumacaftor 100-150 mg/ivacaftor 125-188 mg granules; ages 6-11 years receive lumacaftor 200 mg/ivacaftor 250 mg (2 tablets); ages >=12 years receive lumacaftor 400 mg/ivacaftor 250 mg (2 tablets). Reduce dosage in moderate or severe hepatic impairment. Reduce dosage for the first week when initiating in patients taking strong CYP3A inhibitors.
Contraindications
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Adverse Reactions
Most common (>=3%) headache, nausea, sinus congestion, dizziness
Serious transaminase elevations, hypersensitivity reactions including anaphylaxis, intracranial hypertension, neuropsychiatric events including suicidal thoughts and behaviors, cataracts, distal intestinal obstruction syndrome
Postmarketing anaphylaxis, rash, intracranial hypertension, anxiety, depression, suicidal ideation and behavior, insomnia
Most common (>=5%) Dyspnea, nasopharyngitis, nausea, diarrhea, upper respiratory tract infection, fatigue, respiration abnormal, blood creatine phosphokinase increased, rash, flatulence, rhinorrhea, influenza
Serious Pneumonia, hemoptysis, cough, increased blood creatine phosphokinase, transaminase elevations, liver-related serious adverse reactions including hepatic encephalopathy
Postmarketing Liver function decompensation including liver failure leading to death (patients with pre-existing cirrhosis with portal hypertension), anaphylaxis, angioedema, intracranial hypertension, anxiety, depression, suicidal ideation and behavior, insomnia
Pharmacology
Tezacaftor/ivacaftor is a CFTR corrector/potentiator combination; tezacaftor facilitates cellular processing and trafficking of mutant CFTR protein (including F508del-CFTR) to the cell surface, while ivacaftor potentiates CFTR channel-open probability, together increasing the quantity and function of CFTR at the cell surface and resulting in increased chloride transport.
Lumacaftor is a CFTR corrector that improves the conformational stability of F508del-CFTR, resulting in increased processing and trafficking of mature protein to the cell surface; ivacaftor is a CFTR potentiator that facilitates increased chloride transport by potentiating the channel-open probability of CFTR at the cell surface. Together, the combination increases the quantity, stability, and function of F508del-CFTR in patients homozygous for the F508del mutation.
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Most Common Insurance
Anthem BCBS
Symdeko
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
Orkambi
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
UnitedHealthcare
Symdeko
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (0/8) · Qty limit (1/8)
Orkambi
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (4/8)
Humana
Symdeko
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (2/3)
Orkambi
- 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 availableAssistance Fund: Cystic Fibrosis
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAssistance Fund: Cystic Fibrosis
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.