| Glioblastoma
Gliadel vs Zirabev
Side-by-side clinical, coverage, and cost comparison for glioblastoma.Deep comparison between: Gliadel vs Zirabev 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 signalsZirabev has a higher rate of injection site reactions vs Gliadel based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Zirabev but not Gliadel, including UnitedHealthcare
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Category
Gliadel
Zirabev
At A Glance
Intracranial implant
Nitrosourea alkylating agent
IV infusion
Every 2-3 weeks
VEGF inhibitor
Indications
- Glioblastoma
- Metastasis from malignant neoplasm of colon and/or rectum
- Non-Small Cell Lung Carcinoma
- Glioblastoma
- Renal Cell Carcinoma
- Cervix carcinoma
- Malignant neoplasm of ovary
- Fallopian Tube Carcinoma
- Primary Peritoneal Cancer
Dosing
Glioblastoma Eight 7.7 mg wafers (61.6 mg total dose) implanted intracranially to cover as much of the resection cavity as possible following maximal tumor resection; wafers broken in half may be used but discard wafers broken in more than two pieces.
Metastasis from malignant neoplasm of colon and/or rectum 5 mg/kg IV every 2 weeks with bolus-IFL; 10 mg/kg IV every 2 weeks with FOLFOX4; 5 mg/kg IV every 2 weeks or 7.5 mg/kg IV every 3 weeks with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy after progression on a first-line bevacizumab product-containing regimen.
Non-Small Cell Lung Carcinoma 15 mg/kg IV every 3 weeks in combination with carboplatin and paclitaxel.
Glioblastoma 10 mg/kg IV every 2 weeks.
Renal Cell Carcinoma 10 mg/kg IV every 2 weeks in combination with interferon alfa.
Cervix carcinoma 15 mg/kg IV every 3 weeks in combination with paclitaxel and cisplatin or paclitaxel and topotecan.
Malignant neoplasm of ovary, Fallopian Tube Carcinoma, Primary Peritoneal Cancer Stage III/IV following initial surgical resection: 15 mg/kg IV every 3 weeks with carboplatin and paclitaxel for up to 6 cycles, followed by 15 mg/kg every 3 weeks as a single agent for up to 22 cycles. Platinum-resistant recurrent: 10 mg/kg IV every 2 weeks with paclitaxel, pegylated liposomal doxorubicin, or topotecan (weekly); or 15 mg/kg IV every 3 weeks with topotecan (every 3 weeks). Platinum-sensitive recurrent: 15 mg/kg IV every 3 weeks with carboplatin and paclitaxel or carboplatin and gemcitabine for 6-10 cycles, followed by 15 mg/kg every 3 weeks as a single agent.
Contraindications
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Adverse Reactions
Most common Nausea, vomiting, constipation, asthenia, wound healing abnormalities, depression, cerebral edema, fever, urinary tract infections
Serious Seizures, intracranial hypertension, impaired neurosurgical wound healing, meningitis
Most common (>10%) Epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, hemorrhage, lacrimation disorder, back pain, exfoliative dermatitis.
Serious Gastrointestinal perforations and fistulae, surgery and wound healing complications, hemorrhage, arterial thromboembolic events, venous thromboembolic events, hypertension, posterior reversible encephalopathy syndrome, renal injury and proteinuria, infusion-related reactions, ovarian failure, congestive heart failure.
Postmarketing Polyserositis, pulmonary hypertension, mesenteric venous occlusion, gastrointestinal ulcer, intestinal necrosis, anastomotic ulceration, pancytopenia, gallbladder perforation, osteonecrosis of the jaw, renal thrombotic microangiopathy, nasal septum perforation, arterial aneurysms/dissections/rupture.
Pharmacology
Carmustine is a DNA and RNA alkylating agent; GLIADEL Wafer releases cytotoxic concentrations of carmustine locally into the tumor resection cavity via hydrolysis of anhydride bonds in a biodegradable polifeprosan copolymer.
Bevacizumab-bvzr binds VEGF and prevents its interaction with receptors Flt-1 and KDR on the surface of endothelial cells, inhibiting endothelial cell proliferation, new blood vessel formation, and metastatic disease progression.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Gliadel
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (0/12)
Zirabev
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (9/12) · Qty limit (0/12)
UnitedHealthcare
Gliadel
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Zirabev
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Gliadel
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (0/3)
Zirabev
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Gliadel.
$0/fillfill
Zirabev Co-Pay Savings ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.