| Leukemia, Myelocytic, Acute
Onureg vs Vanflyta
Side-by-side clinical, coverage, and cost comparison for leukemia, myelocytic, acute.Deep comparison between: Onureg vs Vanflyta 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 signalsVanflyta has a higher rate of injection site reactions vs Onureg based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Vanflyta but not Onureg, including UnitedHealthcare
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Category
Onureg
Vanflyta
At A Glance
Oral
Once daily, Days 1-14 of 28-day cycle
DNA methyltransferase inhibitor
Oral
Once daily
FLT3 inhibitor
Indications
- Leukemia, Myelocytic, Acute
- Leukemia, Myelocytic, Acute
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 Induction: 35.4 mg orally once daily on Days 8 to 21 of each 28-day cycle, up to 2 cycles with cytarabine and anthracycline; Consolidation: 35.4 mg once daily on Days 6 to 19 of each cycle, up to 4 cycles with high-dose cytarabine; Maintenance: 26.5 mg once daily (escalate to 53 mg on Day 15 if QTcF <=450 ms), continuous once-daily with no break for up to 36 cycles.
Contraindications
- Known severe hypersensitivity to azacitidine or its components
- Severe hypokalemia
- Severe hypomagnesemia
- Long QT syndrome
- History of ventricular arrhythmias or torsades de pointes
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 (>=10%) Febrile neutropenia, diarrhea, mucositis, nausea, sepsis, abdominal pain, vomiting, neutropenia, headache, upper respiratory tract infection, hypertransaminasemia, thrombocytopenia, fungal infection, herpesvirus infection, decreased appetite, epistaxis, insomnia, electrocardiogram QT prolonged, anemia, dyspepsia, eye irritation.
Serious Febrile neutropenia, sepsis, fungal infections, brain edema, pneumonia, cerebral infarction, acute respiratory distress syndrome, pulmonary embolism, ventricular dysfunction, cardiac arrest.
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.
Quizartinib is a small molecule inhibitor of the receptor tyrosine kinase FLT3; it and its active metabolite AC886 bind the ATP binding domain of FLT3, inhibiting kinase activity and downstream FLT3 receptor signaling, thereby blocking FLT3-ITD-dependent cell proliferation.
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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)
Vanflyta
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (11/12)
UnitedHealthcare
Onureg
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Vanflyta
- 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)
Vanflyta
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (3/3)
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
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.