| Diffuse Large B-Cell Lymphoma
Kymriah vs Rituxan Hycela
Side-by-side clinical, coverage, and cost comparison for diffuse large b-cell lymphoma.Deep comparison between: Kymriah vs Rituxan Hycela 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 signalsRituxan Hycela has a higher rate of injection site reactions vs Kymriah based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Rituxan Hycela but not Kymriah, including UnitedHealthcare
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Category
Kymriah
Rituxan Hycela
At A Glance
IV infusion
Single dose
CD19-directed CAR T cell therapy
SC injection
Every 3-4 weeks
CD20-directed antibody
Indications
- Precursor Cell Lymphoblastic Leukemia Lymphoma
- Diffuse Large B-Cell Lymphoma
- Lymphoma, Follicular
- Lymphoma, Follicular
- Diffuse Large B-Cell Lymphoma
- Chronic Lymphocytic Leukemia
Dosing
Precursor Cell Lymphoblastic Leukemia Lymphoma Single IV infusion: 0.2 to 5.0 x 10^6 CAR-positive viable T cells/kg for patients 50 kg or less; 0.1 to 2.5 x 10^8 CAR-positive viable T cells (non-weight-based) for patients above 50 kg. Infuse 2 to 14 days after lymphodepleting chemotherapy (fludarabine 30 mg/m^2 IV daily x 4 days + cyclophosphamide 500 mg/m^2 IV daily x 2 days).
Diffuse Large B-Cell Lymphoma, Lymphoma, Follicular Single IV infusion: 0.6 to 6.0 x 10^8 CAR-positive viable T cells. Infuse 2 to 11 days (DLBCL) or 2 to 6 days (FL) after lymphodepleting chemotherapy (fludarabine 25 mg/m^2 IV daily x 3 days + cyclophosphamide 250 mg/m^2 IV daily x 3 days; bendamustine 90 mg/m^2 IV daily x 2 days as alternate).
Lymphoma, Follicular 1,400 mg/23,400 Units SC; for relapsed/refractory FL, once weekly for 3 or 7 weeks following an initial IV rituximab dose (4 or 8 weeks total); for previously untreated FL, on Day 1 of Cycles 2-8 of chemotherapy every 21 days, then maintenance every 8 weeks for 12 doses; for non-progressing FL after CVP, once weekly for 3 weeks every 6 months to a maximum of 16 doses.
Diffuse Large B-Cell Lymphoma 1,400 mg/23,400 Units SC on Day 1 of Cycles 2-8 of CHOP chemotherapy every 21 days for up to 7 cycles following an initial IV rituximab dose at Day 1, Cycle 1 (up to 6-8 cycles total).
Chronic Lymphocytic Leukemia 1,600 mg/26,800 Units SC on Day 1 of Cycles 2-6 in combination with fludarabine and cyclophosphamide every 28 days for 5 cycles following an initial IV rituximab dose at Day 1, Cycle 1 (6 cycles total).
Contraindications
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Adverse Reactions
Most common (>20%) CRS, infections-pathogen unspecified, fever, fatigue, musculoskeletal pain, headache, diarrhea, nausea, hypotension, edema, hemorrhage, hypogammaglobulinemia, viral infectious disorders, febrile neutropenia, vomiting, encephalopathy, cough, hypoxia, tachycardia, decreased appetite, acute kidney injury, dyspnea
Postmarketing Anaphylactic reaction, T cell malignancies, progressive multifocal leukoencephalopathy, blindness
Most common (>=20%) Infections, neutropenia, nausea, constipation, cough, fatigue (FL); infections, neutropenia, alopecia, nausea, anemia (DLBCL); infections, neutropenia, nausea, thrombocytopenia, pyrexia, vomiting, injection site erythema (CLL).
Serious Mucocutaneous reactions, hepatitis B reactivation, progressive multifocal leukoencephalopathy, hypersensitivity and administration reactions, tumor lysis syndrome, infections, cardiac arrhythmias, renal toxicity, bowel obstruction and perforation.
Postmarketing Prolonged pancytopenia, fatal cardiac failure, uveitis, viral infections including PML, Kaposi's sarcoma progression, severe mucocutaneous reactions, pyoderma gangrenosum, bowel obstruction and perforation, fatal bronchiolitis obliterans, fatal interstitial lung disease.
Pharmacology
KYMRIAH is a CD19-directed genetically modified autologous T cell immunotherapy that reprograms a patient's own T cells with a chimeric antigen receptor (CAR) to identify and eliminate CD19-expressing malignant and normal cells; the CAR incorporates 4-1BB (CD137) and CD3 zeta intracellular signaling domains that enhance T cell expansion, persistence, and antitumor activity.
Anti-CD20 chimeric murine/human IgG1 monoclonal antibody that binds the CD20 antigen on pre-B and mature B-lymphocytes, mediating B-cell lysis via complement dependent cytotoxicity (CDC) and antibody dependent cell mediated cytotoxicity (ADCC); combined with hyaluronidase human, which transiently depolymerizes subcutaneous hyaluronan to enhance rituximab absorption into systemic circulation.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Kymriah
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (0/12)
Rituxan Hycela
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Kymriah
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Rituxan Hycela
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Kymriah
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Rituxan Hycela
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (2/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableCancerCare: Acute Lymphoblastic Leukemia
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Rituxan Hycela.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.