| Leukemia, Myelocytic, Acute
Idhifa vs Nivestym
Side-by-side clinical, coverage, and cost comparison for leukemia, myelocytic, acute.Deep comparison between: Idhifa vs Nivestym 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 signalsNivestym has a higher rate of injection site reactions vs Idhifa based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Nivestym but not Idhifa, including UnitedHealthcare
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Category
Idhifa
Nivestym
At A Glance
Oral
Daily
IDH2 inhibitor
SC injection or IV infusion
Daily
G-CSF analog
Indications
- Leukemia, Myelocytic, Acute
- Leukemia, Myelocytic, Acute
- Severe congenital neutropenia
- Cyclic neutropenia
- Idiopathic neutropenia
Dosing
Leukemia, Myelocytic, Acute 100 mg orally once daily until disease progression or unacceptable toxicity; treat for a minimum of 6 months in patients without disease progression or unacceptable toxicity to allow time for clinical response.
Cancer receiving myelosuppressive chemotherapy, Leukemia, Myelocytic, Acute 5 mcg/kg/day SC injection, short IV infusion (15-30 min), or continuous IV infusion; administer at least 24 hours after cytotoxic chemotherapy; continue daily for up to 2 weeks or until ANC reaches 10,000/mm3 after the expected nadir.
Cancer undergoing bone marrow transplantation 10 mcg/kg/day IV infusion no longer than 24 hours; administer first dose at least 24 hours after cytotoxic chemotherapy and at least 24 hours after bone marrow infusion; titrate against neutrophil response per dosage adjustment table.
Autologous peripheral blood progenitor cell mobilization 10 mcg/kg/day SC injection; administer at least 4 days before first leukapheresis and continue until last leukapheresis; discontinue if WBC rises above 100,000/mm3.
Severe congenital neutropenia 6 mcg/kg SC injection twice daily; individualize based on clinical course and ANC with chronic daily administration.
Cyclic neutropenia, Idiopathic neutropenia 5 mcg/kg SC injection once daily; individualize based on clinical course and ANC with chronic daily administration.
Contraindications
—
- History of serious allergic reactions to human granulocyte colony-stimulating factors such as filgrastim products or pegfilgrastim products
Adverse Reactions
Most common (>=20%) Nausea, diarrhea, vomiting, decreased appetite, elevated bilirubin
Serious Differentiation syndrome, leukocytosis, tumor lysis syndrome, diarrhea, nausea, vomiting, decreased appetite
Most common (>=5% higher incidence vs placebo) Pyrexia, nausea, fatigue, thrombocytopenia, back pain, bone pain, rash, dizziness, dyspnea, cough, chest pain, arthralgia, pain in extremity, increased blood alkaline phosphatase, increased blood lactate dehydrogenase
Serious Splenic rupture, acute respiratory distress syndrome, serious allergic reactions, sickle cell disorders, glomerulonephritis, alveolar hemorrhage and hemoptysis, capillary leak syndrome, myelodysplastic syndrome, acute myeloid leukemia, thrombocytopenia, leukocytosis, cutaneous vasculitis, aortitis
Postmarketing Anaphylaxis, splenomegaly, Sweet's syndrome, decreased bone density and osteoporosis (pediatric chronic use), extramedullary hematopoiesis
Pharmacology
IDH2 inhibitor; enasidenib is a small molecule that selectively targets mutant IDH2 variants (R140Q, R172S, R172K), decreasing 2-hydroxyglutarate (2-HG) levels and inducing myeloid differentiation in IDH2-mutated AML.
Filgrastim-aafi is a recombinant G-CSF analog that binds to specific cell surface receptors on hematopoietic cells, stimulating neutrophil progenitor proliferation, differentiation, and end-cell functional activation; its activity is selective for the neutrophil lineage with minimal effects on other hematopoietic cell types.
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Most Common Insurance
Anthem BCBS
Idhifa
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Nivestym
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (7/12) · Qty limit (0/12)
UnitedHealthcare
Idhifa
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (5/8)
Nivestym
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Idhifa
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Nivestym
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (1/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Acute Myeloid Leukemia
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAssistance Fund: Acute Myeloid Leukemia
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.