| Lymphoma, Follicular

Brukinsa vs Kymriah

Side-by-side clinical, coverage, and cost comparison for lymphoma, follicular.
Deep comparison between: Brukinsa vs Kymriah with Prescriber.AI
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Safety signalsKymriah has a higher rate of injection site reactions vs Brukinsa based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Kymriah but not Brukinsa, including UnitedHealthcare
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Brukinsa
Kymriah
At A Glance
Oral
Once or twice daily
BTK inhibitor
IV infusion
Single dose
CD19-directed CAR T cell therapy
Indications
  • Mantle cell lymphoma
  • Waldenstrom Macroglobulinemia
  • Marginal Zone B-Cell Lymphoma
  • Chronic Lymphocytic Leukemia
  • Small Lymphocytic Lymphoma
  • Lymphoma, Follicular
  • Precursor Cell Lymphoblastic Leukemia Lymphoma
  • Diffuse Large B-Cell Lymphoma
  • Lymphoma, Follicular
Dosing
Mantle cell lymphoma, Waldenstrom Macroglobulinemia, Marginal Zone B-Cell Lymphoma, Chronic Lymphocytic Leukemia, Small Lymphocytic Lymphoma 160 mg orally twice daily or 320 mg orally once daily, with or without food, until disease progression or unacceptable toxicity.
Lymphoma, Follicular 160 mg orally twice daily in combination with obinutuzumab, with or without food, until disease progression or unacceptable toxicity.
Precursor Cell Lymphoblastic Leukemia Lymphoma Single IV infusion: 0.2 to 5.0 x 10^6 CAR-positive viable T cells/kg for patients 50 kg or less; 0.1 to 2.5 x 10^8 CAR-positive viable T cells (non-weight-based) for patients above 50 kg. Infuse 2 to 14 days after lymphodepleting chemotherapy (fludarabine 30 mg/m^2 IV daily x 4 days + cyclophosphamide 500 mg/m^2 IV daily x 2 days).
Diffuse Large B-Cell Lymphoma, Lymphoma, Follicular Single IV infusion: 0.6 to 6.0 x 10^8 CAR-positive viable T cells. Infuse 2 to 11 days (DLBCL) or 2 to 6 days (FL) after lymphodepleting chemotherapy (fludarabine 25 mg/m^2 IV daily x 3 days + cyclophosphamide 250 mg/m^2 IV daily x 3 days; bendamustine 90 mg/m^2 IV daily x 2 days as alternate).
Contraindications
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Adverse Reactions
Most common (>=30%) Neutrophil count decreased, platelet count decreased, upper respiratory tract infection, hemorrhage, musculoskeletal pain
Serious Hemorrhage, pneumonia, cytopenias, second primary malignancies, cardiac arrhythmias, hepatotoxicity including drug-induced liver injury
Postmarketing Drug-induced liver injury
Most common (>20%) CRS, infections-pathogen unspecified, fever, fatigue, musculoskeletal pain, headache, diarrhea, nausea, hypotension, edema, hemorrhage, hypogammaglobulinemia, viral infectious disorders, febrile neutropenia, vomiting, encephalopathy, cough, hypoxia, tachycardia, decreased appetite, acute kidney injury, dyspnea
Postmarketing Anaphylactic reaction, T cell malignancies, progressive multifocal leukoencephalopathy, blindness
Pharmacology
Zanubrutinib is a small-molecule inhibitor of Bruton's tyrosine kinase (BTK) that forms a covalent bond with a cysteine residue in the BTK active site, inhibiting BTK activity and thereby blocking B-cell proliferation, trafficking, chemotaxis, and adhesion pathways driven by B-cell antigen receptor and cytokine receptor signaling.
KYMRIAH is a CD19-directed genetically modified autologous T cell immunotherapy that reprograms a patient's own T cells with a chimeric antigen receptor (CAR) to identify and eliminate CD19-expressing malignant and normal cells; the CAR incorporates 4-1BB (CD137) and CD3 zeta intracellular signaling domains that enhance T cell expansion, persistence, and antitumor activity.
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Most Common Insurance
Anthem BCBS
Brukinsa
  • Covered on 5 commercial plans
  • PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
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Kymriah
  • Covered on 5 commercial plans
  • PA (0/12) · Step Therapy (0/12) · Qty limit (0/12)
View full coverage details ›
UnitedHealthcare
Brukinsa
  • Covered on 4 commercial plans
  • PA (5/8) · Step Therapy (5/8) · Qty limit (4/8)
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Kymriah
  • Covered on 4 commercial plans
  • PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
View full coverage details ›
Humana
Brukinsa
  • Covered on 0 commercial plans
  • PA (1/3) · Step Therapy (0/3) · Qty limit (0/3)
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Kymriah
  • Covered on 0 commercial plans
  • PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
View full coverage details ›
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Brukinsa.
Cost estimate not availableCancerCare: Acute Lymphoblastic 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.