| Immune thrombocytopenic purpura
Nplate vs Gamunex - C
Side-by-side clinical, coverage, and cost comparison for immune thrombocytopenic purpura.Deep comparison between: Nplate vs Gamunex-C 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 signalsGamunex-C has a higher rate of injection site reactions vs Nplate based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Gamunex-C but not Nplate, including UnitedHealthcare
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Category
Nplate
Gamunex-C
At A Glance
SC injection
Once weekly (ITP); single dose (HS-ARS)
Thrombopoietin receptor agonist
IV infusion / SC injection
Every 3-4 weeks
Immune globulin
Indications
- Immune thrombocytopenic purpura
- Hematopoietic subsyndrome of acute radiation syndrome
- Common Variable Immunodeficiency
- X-linked agammaglobulinemia
- Wiskott-Aldrich Syndrome
- Severe Combined Immunodeficiency
- Congenital agammaglobulinemia
- Immune thrombocytopenic purpura
- Polyradiculoneuropathy, Chronic Inflammatory Demyelinating
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, Wiskott-Aldrich Syndrome, Severe Combined Immunodeficiency, Congenital agammaglobulinemia IV: 300-600 mg/kg every 3-4 weeks; SC: initial weekly dose = prior monthly IGIV dose (g) x 1.37 divided by the number of weeks between IV doses, adjusted based on clinical response and IgG trough levels.
Immune thrombocytopenic purpura IV only: total dose of 2 g/kg given as 1 g/kg on two consecutive days or 0.4 g/kg on five consecutive days; do not administer subcutaneously.
Polyradiculoneuropathy, Chronic Inflammatory Demyelinating IV loading dose: 2 g/kg over 2-4 consecutive days; maintenance: 1 g/kg every 3 weeks (or 0.5 g/kg on two consecutive days every 3 weeks).
Contraindications
—
- Previous anaphylactic or severe systemic reaction to human immune globulin
- IgA deficiency with antibodies against IgA and history of hypersensitivity reaction
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%) Headache, pyrexia, nausea, cough, rhinitis, pharyngitis, asthma, diarrhea, sinusitis, vomiting, ecchymosis, rash, arthralgia, chills, hypertension, asthenia, fatigue, local infusion site reactions (SC administration), upper respiratory tract infection, back pain, dyspepsia, abdominal pain.
Serious Exacerbation of autoimmune pure red cell aplasia, pulmonary embolism, hemolytic anemia.
Postmarketing Anaphylaxis, tachycardia, acute renal dysfunction/failure, acute respiratory distress syndrome, TRALI, pulmonary edema, bronchospasm, cardiac arrest, thromboembolism, vascular collapse, coma, seizures, aseptic meningitis, tremor, Stevens-Johnson syndrome, epidermolysis, erythema multiforme, pancytopenia, leukopenia, hemolytic anemia, hepatic dysfunction.
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.
GAMUNEX-C supplies a broad spectrum of opsonic and neutralizing IgG antibodies against bacterial, viral, parasitic, and mycoplasmal agents and their toxins; the precise mechanisms of action in ITP and CIDP have 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)
Gamunex-C
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (7/12) · Qty limit (0/12)
UnitedHealthcare
Nplate
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Gamunex-C
- 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)
Gamunex-C
- 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 Gamunex-C.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.