| Hormone refractory prostate cancer

Nubeqa vs Xofigo

Side-by-side clinical, coverage, and cost comparison for hormone refractory prostate cancer.
Deep comparison between: Nubeqa vs Xofigo with Prescriber.AI
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Safety signalsXofigo has a higher rate of injection site reactions vs Nubeqa based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xofigo but not Nubeqa, including UnitedHealthcare
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Nubeqa
Xofigo
At A Glance
Oral
Twice daily
Androgen receptor inhibitor
IV injection
Every 4 weeks
Alpha particle-emitting radiopharmaceutical
Indications
  • Hormone refractory prostate cancer
  • Metastatic Castration-Sensitive Prostate Carcinoma
  • Hormone refractory prostate cancer
Dosing
Hormone refractory prostate cancer 600 mg (two 300 mg tablets) orally twice daily with food; continue until disease progression or unacceptable toxicity.
Metastatic Castration-Sensitive Prostate Carcinoma 600 mg (two 300 mg tablets) orally twice daily with food; when used with docetaxel for mCSPC, administer first of 6 cycles of docetaxel within 6 weeks of starting NUBEQA; continue NUBEQA until disease progression or unacceptable toxicity.
Hormone refractory prostate cancer 55 kBq (1.49 microcurie) per kg body weight by slow IV injection over 1 minute, every 4 weeks for 6 injections.
Contraindications
—
—
Adverse Reactions
Most common (>=10%) Increased AST, decreased neutrophil count, increased bilirubin, fatigue, increased ALT (nmCRPC and mCSPC); constipation, rash, decreased appetite, hemorrhage, increased weight, hypertension (mCSPC with docetaxel).
Serious Febrile neutropenia (6%), decreased neutrophil count (2.8%), musculoskeletal pain (2.6%), pneumonia (2.6%), urinary retention, hematuria, arrhythmias, spinal cord compression, ischemic heart disease, heart failure.
Postmarketing COVID-19/COVID-19 pneumonia, myocardial infarction, sudden death, seizures, drug-induced liver injury.
Most common (>=10%) Nausea, diarrhea, vomiting, peripheral edema; hematologic: anemia, lymphocytopenia, leukopenia, thrombocytopenia, neutropenia.
Serious Bone marrow suppression.
Pharmacology
Darolutamide is an androgen receptor (AR) inhibitor that competitively inhibits androgen binding, AR nuclear translocation, and AR-mediated transcription. The major metabolite ketodarolutamide exhibits similar in vitro activity and decreased prostate cancer cell proliferation in vitro and tumor volume in xenograft models.
Radium-223 mimics calcium and forms complexes with bone mineral hydroxyapatite at areas of increased bone turnover such as bone metastases; the high linear energy transfer of alpha particles leads to a high frequency of double-strand DNA breaks in adjacent tumor cells, resulting in an anti-tumor effect on bone metastases.
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Most Common Insurance
Anthem BCBS
Nubeqa
  • Covered on 5 commercial plans
  • PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
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Xofigo
  • Covered on 5 commercial plans
  • PA (10/12) · Step Therapy (0/12) · Qty limit (0/12)
View full coverage details ›
UnitedHealthcare
Nubeqa
  • Covered on 4 commercial plans
  • PA (8/8) · Step Therapy (0/8) · Qty limit (7/8)
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Xofigo
  • Covered on 4 commercial plans
  • PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
View full coverage details ›
Humana
Nubeqa
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
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Xofigo
  • Covered on 0 commercial plans
  • PA (1/3) · Step Therapy (0/3) · Qty limit (0/3)
View full coverage details ›
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Prostate Cancer
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAssistance Fund: Prostate Cancer
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.