| Leukemia, Myelocytic, Acute
Onureg vs Tibsovo
Side-by-side clinical, coverage, and cost comparison for leukemia, myelocytic, acute.Deep comparison between: Onureg 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 Onureg based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Tibsovo but not Onureg, including UnitedHealthcare
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Category
Onureg
Tibsovo
At A Glance
Oral
Once daily, Days 1-14 of 28-day cycle
DNA methyltransferase inhibitor
Oral
Daily
IDH1 inhibitor
Indications
- Leukemia, Myelocytic, Acute
- Leukemia, Myelocytic, Acute
- MYELODYSPLASTIC SYNDROME
- Cholangiocarcinoma
Dosing
Leukemia, Myelocytic, Acute 300 mg orally once daily on Days 1 through 14 of each 28-day cycle; continue until disease progression or unacceptable toxicity.
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
- Known severe hypersensitivity to azacitidine or its components
—
Adverse Reactions
Most common (>=10%) Nausea, vomiting, diarrhea, fatigue/asthenia, constipation, upper respiratory tract infection, pneumonia, abdominal pain, arthralgia, decreased appetite, febrile neutropenia, dizziness, skin infection, pain in extremity
Serious Pneumonia, febrile neutropenia, sepsis (including 1 fatal case)
Postmarketing Hypersensitivity reaction, interstitial lung disease, tumor lysis syndrome, Sweet's syndrome (acute febrile neutrophilic dermatosis), necrotizing fasciitis (including fatal cases), differentiation syndrome
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
Azacitidine is a pyrimidine nucleoside analog of cytidine that inhibits DNA/RNA methyltransferases; incorporation into DNA reduces methylation and alters gene expression, while incorporation into RNA reduces RNA methylation and protein synthesis, inducing apoptosis in AML cells.
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
Onureg
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (12/12)
Tibsovo
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (4/12) · Qty limit (12/12)
UnitedHealthcare
Onureg
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Tibsovo
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Onureg
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
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 availableAccessia Health: Myelodysplastic Syndromes - Private Insurance: Waitlist
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.