| Metastatic melanoma
Cotellic [Cotellic + Zelboraf] vs Opdualag
Side-by-side clinical, coverage, and cost comparison for metastatic melanoma.Deep comparison between: Cotellic vs Opdualag 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 signalsOpdualag has a higher rate of injection site reactions vs Cotellic based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Opdualag but not Cotellic, including UnitedHealthcare
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Category
Cotellic
Opdualag
At A Glance
Oral
Once daily, 21 days per 28-day cycle
MEK inhibitor
IV infusion
Every 4 weeks
PD-1 / LAG-3 inhibitor
Indications
- Metastatic melanoma
- Histiocytosis
- Metastatic melanoma
Dosing
Metastatic melanoma 60 mg orally once daily for the first 21 days of each 28-day cycle in combination with vemurafenib; confirm BRAF V600E or V600K mutation prior to initiation; dose reductions to 40 mg then 20 mg for adverse reactions.
Histiocytosis 60 mg orally once daily for the first 21 days of each 28-day cycle as a single agent; dose reductions to 40 mg then 20 mg for adverse reactions; permanently discontinue if unable to tolerate 20 mg daily.
Metastatic melanoma 480 mg nivolumab and 160 mg relatlimab IV every 4 weeks until disease progression or unacceptable toxicity; for adults and pediatric patients >=12 years of age who weigh >=40 kg.
Contraindications
—
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Adverse Reactions
Most common (>=20%) Diarrhea, photosensitivity reaction, nausea, pyrexia, vomiting
Serious New primary cutaneous malignancies, hemorrhage, cardiomyopathy, serious dermatologic reactions, serous retinopathy, retinal vein occlusion, hepatotoxicity, rhabdomyolysis, severe photosensitivity
Most common (>=20%) Musculoskeletal pain, fatigue, rash, pruritus, diarrhea
Serious Adrenal insufficiency, anemia, colitis, pneumonia, acute myocardial infarction, myocarditis, pneumonitis, hemophagocytic lymphohistiocytosis, acute edema of the lung
Pharmacology
Cobimetinib is a reversible inhibitor of MEK1 and MEK2, upstream regulators of the ERK pathway that promotes cellular proliferation; BRAF V600E/K mutations result in constitutive activation of this pathway, and cobimetinib combined with vemurafenib targets two different kinases in the RAS/RAF/MEK/ERK pathway to increase apoptosis and reduce tumor growth.
OPDUALAG is a fixed-dose combination of nivolumab, a human IgG4 mAb that blocks PD-1 and its ligands PD-L1 and PD-L2, and relatlimab, a human IgG4 mAb that blocks LAG-3 and its ligands including MHC II; dual checkpoint blockade increases T-cell activation and anti-tumor immune response beyond either antibody alone.
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Most Common Insurance
Anthem BCBS
Cotellic
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Opdualag
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (9/12) · Qty limit (0/12)
UnitedHealthcare
Cotellic
- Covered on 4 commercial plans
- PA (7/8) · Step Therapy (0/8) · Qty limit (6/8)
Opdualag
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Cotellic
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Opdualag
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Cotellic.
Cost estimate not availableAssistance Fund: Melanoma: Waitlist
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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CotellicView full Cotellic profile
OpdualagView full Opdualag profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.