| Hematopoietic subsyndrome of acute radiation syndrome
Neulasta vs Leukine
Side-by-side clinical, coverage, and cost comparison for hematopoietic subsyndrome of acute radiation syndrome.Deep comparison between: Neulasta vs Leukine 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 signalsLeukine has a higher rate of injection site reactions vs Neulasta based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Leukine but not Neulasta, including UnitedHealthcare
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Category
Neulasta
Leukine
At A Glance
SC injection
Once per chemotherapy cycle
G-CSF (colony-stimulating factor)
IV infusion or SC injection
Once daily
GM-CSF
Indications
- Febrile Neutropenia
- Hematopoietic subsyndrome of acute radiation syndrome
- Leukemia, Myelocytic, Acute
- Lymphoma, Non-Hodgkin
- Acute lymphocytic leukemia
- Hodgkin Disease
- Hematopoietic subsyndrome of acute radiation syndrome
Dosing
Febrile Neutropenia 6 mg SC once per chemotherapy cycle for adults and pediatric patients >=45 kg; weight-based dosing (1.5-4 mg SC) for pediatric patients weighing 10-44 kg; 0.1 mg/kg for those <10 kg. Do not administer between 14 days before and 24 hours after chemotherapy.
Hematopoietic Subsyndrome of Acute Radiation Syndrome Two doses of 6 mg each SC one week apart for adults and pediatric patients >=45 kg; weight-based dosing for pediatric patients <45 kg. Administer first dose as soon as possible after suspected or confirmed exposure to radiation >2 Gy, and second dose one week after.
Leukemia, Myelocytic, Acute 250 mcg/m2/day IV over a 4-hour period starting day 11 or four days after induction chemotherapy completion; continue until ANC >1500 cells/mm3 for 3 consecutive days or up to 42 days.
Lymphoma, Non-Hodgkin, Acute lymphocytic leukemia, Hodgkin Disease 250 mcg/m2/day IV over 24 hours or SC once daily beginning immediately following progenitor cell infusion; continue until ANC >1500 cells/mm3 for three consecutive days.
Autologous or allogeneic bone marrow transplantation 250 mcg/m2/day IV over a 2-hour period beginning 2-4 hours after bone marrow infusion; continue until ANC >1500 cells/mm3 for three consecutive days.
Delayed neutrophil recovery or graft failure 250 mcg/m2/day for 14 days as a 2-hour IV infusion; may repeat after 7 days off therapy if neutrophil recovery has not occurred, up to three courses.
Hematopoietic subsyndrome of acute radiation syndrome SC injection once daily: 7 mcg/kg for adults and pediatric patients >40 kg, 10 mcg/kg for pediatric patients 15-40 kg, 12 mcg/kg for pediatric patients <15 kg; continue until ANC >1000/mm3 for three consecutive CBCs.
Contraindications
- History of serious hypersensitivity reaction to pegfilgrastim or filgrastim, including anaphylaxis
- History of serious allergic reactions, including anaphylaxis, to sargramostim, yeast-derived products, or any component of the product
Adverse Reactions
Most common (>=5%) Bone pain, pain in extremity
Serious Splenic rupture, acute respiratory distress syndrome, serious hypersensitivity reactions, sickle cell crisis, glomerulonephritis, leukocytosis, thrombocytopenia, capillary leak syndrome, myelodysplastic syndrome, acute myeloid leukemia, aortitis
Postmarketing Splenic rupture, splenomegaly, ARDS, anaphylaxis, skin rash, urticaria, sickle cell crisis, glomerulonephritis, leukocytosis, thrombocytopenia, capillary leak syndrome, injection site reactions, Sweet's syndrome, cutaneous vasculitis, MDS, AML, aortitis, alveolar hemorrhage
Most common (>=10%) Fever, nausea, diarrhea, vomiting, rash, alopecia, stomatitis, asthenia, malaise, anorexia, edema, headache, chills, peripheral edema, dyspnea
Serious Hypersensitivity and anaphylaxis, infusion-related reactions, severe myelosuppression, effusions, capillary leak syndrome, supraventricular arrhythmias, leukocytosis
Postmarketing Infusion-related reactions, serious allergic reactions including anaphylaxis, effusions, capillary leak syndrome, supraventricular arrhythmias, leukocytosis including eosinophilia, thromboembolic events, injection site reactions
Pharmacology
Pegfilgrastim is a PEGylated G-CSF analogue (colony-stimulating factor) that binds specific cell surface receptors on hematopoietic cells, stimulating proliferation, differentiation, commitment, and functional activation; clearance is neutrophil receptor-mediated and nonlinear with dose.
Sargramostim (GM-CSF) is a colony-stimulating factor that supports survival, clonal expansion, and differentiation of hematopoietic progenitor cells, inducing partially committed progenitors to divide and differentiate into granulocyte-macrophage pathways including neutrophils, monocytes/macrophages, and myeloid-derived dendritic cells; it can also activate mature granulocytes and macrophages and promote proliferation of megakaryocytic and erythroid progenitors.
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Most Common Insurance
Anthem BCBS
Neulasta
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (1/12) · Qty limit (11/12)
Leukine
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (6/12) · Qty limit (0/12)
UnitedHealthcare
Neulasta
- Covered on 4 commercial plans
- PA (2/8) · Step Therapy (0/8) · Qty limit (0/8)
Leukine
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Neulasta
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Leukine
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (1/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableCancerCare: Chemotherapy Induced Neutropenia
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableCancerCare: Chemotherapy Induced Neutropenia
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.