| Hematopoietic subsyndrome of acute radiation syndrome
Nplate vs Neulasta
Side-by-side clinical, coverage, and cost comparison for hematopoietic subsyndrome of acute radiation syndrome.Deep comparison between: Nplate vs Neulasta 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 signalsNeulasta has a higher rate of injection site reactions vs Nplate based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Neulasta but not Nplate, including UnitedHealthcare
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Category
Nplate
Neulasta
At A Glance
SC injection
Once weekly (ITP); single dose (HS-ARS)
Thrombopoietin receptor agonist
SC injection
Once per chemotherapy cycle
G-CSF (colony-stimulating factor)
Indications
- Immune thrombocytopenic purpura
- Hematopoietic subsyndrome of acute radiation syndrome
- Febrile Neutropenia
- Hematopoietic subsyndrome of acute radiation syndrome
Dosing
Immune thrombocytopenic purpura Initial dose 1 mcg/kg SC injection once weekly; adjust by 1 mcg/kg increments based on platelet count; maximum weekly dose 10 mcg/kg.
Hematopoietic subsyndrome of acute radiation syndrome 10 mcg/kg as a single SC injection, administered as soon as possible after suspected or confirmed exposure to myelosuppressive doses of radiation (>2 Gy).
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.
Contraindications
—
- History of serious hypersensitivity reaction to pegfilgrastim or filgrastim, including anaphylaxis
Adverse Reactions
Most common (>=5%) Arthralgia, myalgia, pain in extremity, shoulder pain, dizziness, paresthesia, insomnia, abdominal pain, dyspepsia (adults); contusion, upper respiratory tract infection, oropharyngeal pain, pyrexia, rash, diarrhea (pediatric)
Serious Progression of myelodysplastic syndromes, thrombotic/thromboembolic complications, loss of response, bone marrow reticulin formation and collagen fibrosis
Postmarketing Erythromelalgia, hypersensitivity reactions including angioedema and anaphylaxis
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
Pharmacology
Thrombopoietin receptor agonist; Fc-peptide fusion protein (peptibody) that binds and activates the TPO receptor to increase platelet production through a mechanism analogous to endogenous TPO.
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.
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Most Common Insurance
Anthem BCBS
Nplate
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
Neulasta
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (1/12) · Qty limit (11/12)
UnitedHealthcare
Nplate
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Neulasta
- Covered on 4 commercial plans
- PA (2/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Nplate
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (0/3)
Neulasta
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAmgen Safety Net Foundation
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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NplateView full Nplate profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.