| Hormone refractory prostate cancer
Xofigo vs Xtandi
Side-by-side clinical, coverage, and cost comparison for hormone refractory prostate cancer.Deep comparison between: Xofigo vs Xtandi 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 signalsXtandi has a higher rate of injection site reactions vs Xofigo based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xtandi but not Xofigo, including UnitedHealthcare
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Category
Xofigo
Xtandi
At A Glance
IV injection
Every 4 weeks
Alpha particle-emitting radiopharmaceutical
Oral
Once daily
Androgen receptor inhibitor
Indications
- Hormone refractory prostate cancer
- Hormone refractory prostate cancer
- Metastatic Castration-Sensitive Prostate Carcinoma
- Nonmetastatic Castration-Sensitive Prostate Carcinoma
Dosing
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.
Hormone refractory prostate cancer, Metastatic Castration-Sensitive Prostate Carcinoma 160 mg orally once daily until disease progression or unacceptable toxicity; concurrent GnRH analog or prior bilateral orchiectomy required.
Nonmetastatic Castration-Sensitive Prostate Carcinoma 160 mg orally once daily until disease progression or unacceptable toxicity; GnRH analog may be given with or without XTANDI.
Contraindications
—
—
Adverse Reactions
Most common (>=10%) Nausea, diarrhea, vomiting, peripheral edema; hematologic: anemia, lymphocytopenia, leukopenia, thrombocytopenia, neutropenia.
Serious Bone marrow suppression.
Most common (>=10%) Musculoskeletal pain, fatigue, hot flush, constipation, decreased appetite, diarrhea, hypertension, hemorrhage, fall, fracture, headache
Serious Seizure, posterior reversible encephalopathy syndrome, hypersensitivity, ischemic heart disease, falls and fractures
Postmarketing Vomiting, dysphagia, hypersensitivity (edema of face, tongue, lip, or pharynx), posterior reversible encephalopathy syndrome, dysgeusia, rash, severe cutaneous adverse reactions (Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, DRESS, acute generalized exanthematous pustulosis)
Pharmacology
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.
Enzalutamide is an androgen receptor inhibitor that competitively inhibits androgen binding to androgen receptors and consequently inhibits nuclear translocation of androgen receptors and their interaction with DNA; its major metabolite, N-desmethyl enzalutamide, exhibits similar in vitro activity.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Xofigo
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (0/12)
Xtandi
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (12/12)
UnitedHealthcare
Xofigo
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Xtandi
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (5/8)
Humana
Xofigo
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (0/3)
Xtandi
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
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.