| Immune thrombocytopenic purpura
Nplate vs Gammaplex
Side-by-side clinical, coverage, and cost comparison for immune thrombocytopenic purpura.Deep comparison between: Nplate vs Gammaplex 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 signalsGammaplex has a higher rate of injection site reactions vs Nplate based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Gammaplex but not Nplate, including UnitedHealthcare
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Category
Nplate
Gammaplex
At A Glance
SC injection
Once weekly (ITP); single dose (HS-ARS)
Thrombopoietin receptor agonist
IV infusion
Every 3-4 weeks
Immune globulin (IgG replacement)
Indications
- Immune thrombocytopenic purpura
- Hematopoietic subsyndrome of acute radiation syndrome
- Common Variable Immunodeficiency
- X-linked agammaglobulinemia
- Congenital agammaglobulinemia
- Wiskott-Aldrich Syndrome
- Severe Combined Immunodeficiency
- Immune thrombocytopenic purpura
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).
Common Variable Immunodeficiency, X-linked agammaglobulinemia, Congenital agammaglobulinemia, Wiskott-Aldrich Syndrome, Severe Combined Immunodeficiency 300-800 mg/kg (3-8 mL/kg) IV every 3-4 weeks; initial infusion rate 0.5 mg/kg/min for 15 minutes, then increase gradually every 15 minutes to 8 mg/kg/min.
Immune thrombocytopenic purpura 1 g/kg (10 mL/kg) IV on 2 consecutive days (total dose 2 g/kg); initial infusion rate 0.5 mg/kg/min for 15 minutes, then increase gradually every 15 minutes to 8 mg/kg/min.
Contraindications
—
- Previous anaphylactic or severe systemic reaction to human immune globulin
- IgA deficiency with antibodies to IgA and a history of hypersensitivity
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%) in PI Headache, migraine, pyrexia
Most common (>=5%) in ITP Headache, vomiting, pyrexia, nausea, arthralgia, dehydration
Serious Thrombotic events, hemolysis; in ITP subjects: headache, vomiting, dehydration
Postmarketing Tachycardia, thromboembolism, hypertension, flushing, nausea, chills, chest discomfort, pyrexia, back pain, polymyositis, headache, dyspnea, rash, urticaria
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.
Polyclonal human IgG that provides replacement therapy for primary humoral immunodeficiency via a broad spectrum of opsonic and neutralizing IgG antibodies against pathogens and their toxins through antigen binding and effector functions; the mechanism of action in both PI and ITP has not been fully elucidated.
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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)
Gammaplex
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
UnitedHealthcare
Nplate
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Gammaplex
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (1/8) · Qty limit (0/8)
Humana
Nplate
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (0/3)
Gammaplex
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAmgen Safety Net Foundation
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Gammaplex.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.