| Leukemia, Myelocytic, Acute
Neupogen vs Nivestym
Side-by-side clinical, coverage, and cost comparison for leukemia, myelocytic, acute.Deep comparison between: Neupogen 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 Neupogen based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Nivestym but not Neupogen, including UnitedHealthcare
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Category
Neupogen
Nivestym
At A Glance
SC injection
Daily
G-CSF
SC injection or IV infusion
Daily
G-CSF analog
Indications
- Febrile Neutropenia
- Leukemia, Myelocytic, Acute
- Neutropenia
- Severe congenital neutropenia
- Cyclic neutropenia
- Idiopathic neutropenia
- Hematopoietic subsyndrome of acute radiation syndrome
- Leukemia, Myelocytic, Acute
- Severe congenital neutropenia
- Cyclic neutropenia
- Idiopathic neutropenia
Dosing
Febrile Neutropenia, 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.
Neutropenia (bone marrow transplantation) 10 mcg/kg/day IV infusion no longer than 24 hours; administer at least 24 hours after cytotoxic chemotherapy and bone marrow infusion.
Autologous PBPC collection 10 mcg/kg/day SC injection; administer for at least 4 days before first leukapheresis and continue until last leukapheresis.
Severe congenital neutropenia 6 mcg/kg SC injection twice daily.
Cyclic neutropenia, Idiopathic neutropenia 5 mcg/kg SC injection daily.
Hematopoietic subsyndrome of acute radiation syndrome 10 mcg/kg/day SC injection; administer as soon as possible after suspected or confirmed exposure to radiation doses >2 Gy.
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 or pegfilgrastim
- History of serious allergic reactions to human granulocyte colony-stimulating factors such as filgrastim products or pegfilgrastim products
Adverse Reactions
Most common (>=5%) Pyrexia, nausea, fatigue, thrombocytopenia, bone pain, back pain, rash, dizziness, cough, dyspnea, chest pain, arthralgia
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 Splenic rupture, splenomegaly, anaphylaxis, sickle cell disorders, glomerulonephritis, alveolar hemorrhage and hemoptysis, capillary leak syndrome, leukocytosis, cutaneous vasculitis, Sweet's syndrome, decreased bone density and osteoporosis, myelodysplastic syndrome, acute myeloid leukemia, aortitis, extramedullary hematopoiesis
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
Filgrastim is a recombinant human G-CSF that binds to specific cell surface receptors on hematopoietic cells, stimulating neutrophil progenitor proliferation and differentiation and enhancing end-cell functional activities including phagocytic ability, respiratory burst priming, and antibody-dependent killing.
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.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Neupogen
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (6/12) · Qty limit (0/12)
Nivestym
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (7/12) · Qty limit (0/12)
UnitedHealthcare
Neupogen
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (1/8) · Qty limit (0/8)
Nivestym
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Neupogen
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (1/3)
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.