| Leukemia, Myelocytic, Acute
Nivestym vs Tibsovo
Side-by-side clinical, coverage, and cost comparison for leukemia, myelocytic, acute.Deep comparison between: Nivestym vs Tibsovo 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 signalsTibsovo has a higher rate of injection site reactions vs Nivestym based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Tibsovo but not Nivestym, including UnitedHealthcare
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Category
Nivestym
Tibsovo
At A Glance
SC injection or IV infusion
Daily
G-CSF analog
Oral
Daily
IDH1 inhibitor
Indications
- Leukemia, Myelocytic, Acute
- Severe congenital neutropenia
- Cyclic neutropenia
- Idiopathic neutropenia
- Leukemia, Myelocytic, Acute
- MYELODYSPLASTIC SYNDROME
- Cholangiocarcinoma
Dosing
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.
Leukemia, Myelocytic, Acute 500 mg orally once daily; newly diagnosed: in combination with azacitidine 75 mg/m2 SC or IV on Days 1-7 of each 28-day cycle, or as monotherapy, for minimum 6 months; relapsed/refractory: monotherapy until disease progression or unacceptable toxicity.
MYELODYSPLASTIC SYNDROME 500 mg orally once daily as monotherapy until disease progression or unacceptable toxicity; continue for minimum 6 months.
Cholangiocarcinoma 500 mg orally once daily until disease progression or unacceptable toxicity.
Contraindications
- History of serious allergic reactions to human granulocyte colony-stimulating factors such as filgrastim products or pegfilgrastim products
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Adverse Reactions
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
Most common (>=25%) leukocytes decreased, diarrhea, hemoglobin decreased, platelets decreased, glucose increased, fatigue, alkaline phosphatase increased, edema, potassium decreased, nausea, vomiting, phosphatase decreased, decreased appetite, sodium decreased, leukocytosis, magnesium decreased, aspartate aminotransferase increased, arthralgia, dyspnea, uric acid increased, abdominal pain, creatinine increased, mucositis, rash, electrocardiogram QT prolonged, differentiation syndrome, calcium decreased, neutrophils decreased, myalgia
Serious differentiation syndrome, electrocardiogram QT prolonged, leukocytosis, Guillain-Barre syndrome
Pharmacology
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.
Ivosidenib is a small molecule inhibitor of the mutant isocitrate dehydrogenase 1 (IDH1) enzyme that reduces 2-hydroxyglutarate (2-HG) levels and induces myeloid differentiation in IDH1-mutated AML; in IDH1-mutated cholangiocarcinoma, it also reduces 2-HG levels in tumor tissue.
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Most Common Insurance
Anthem BCBS
Nivestym
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (7/12) · Qty limit (0/12)
Tibsovo
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (4/12) · Qty limit (12/12)
UnitedHealthcare
Nivestym
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Tibsovo
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Nivestym
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (1/3)
Tibsovo
- 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: Acute Myeloid Leukemia
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Tibsovo.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.