| Migraine Disorders
Emgality vs Tosymra
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Emgality vs Tosymra 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 signalsTosymra has a higher rate of injection site reactions vs Emgality based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Tosymra but not Emgality, including UnitedHealthcare
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Category
Emgality
Tosymra
At A Glance
SC injection
Monthly
CGRP antagonist
Nasal spray
Per migraine attack
5-HT1B/1D receptor agonist
Indications
- Migraine Disorders
- Cluster Headache
- Migraine Disorders
Dosing
Migraine Disorders 240 mg loading dose (two consecutive SC injections of 120 mg each) once, followed by 120 mg SC monthly.
Cluster Headache 300 mg (three consecutive SC injections of 100 mg each) at the onset of the cluster period, then monthly until the end of the cluster period.
Migraine Disorders 10 mg as a single spray in one nostril; max 30 mg in 24 hours with doses separated by at least 1 hour.
Contraindications
- Serious hypersensitivity to galcanezumab-gnlm or any of the excipients
- Ischemic coronary artery disease (angina pectoris, history of myocardial infarction, or documented silent ischemia) or coronary artery vasospasm, including Prinzmetal's angina
- Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders
- History of stroke or transient ischemic attack (TIA) or history of hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent use (within 24 hours) of ergotamine-containing or ergot-type medication, or another 5-HT1 agonist
- Concurrent administration or recent use (within 2 weeks) of an MAO-A inhibitor
- Hypersensitivity to sumatriptan
- Severe hepatic impairment
Adverse Reactions
Most common (>=2%) Injection site reactions
Serious Hypersensitivity reactions, hypertension, Raynaud's phenomenon
Postmarketing Anaphylaxis, angioedema, rash, hypertension, Raynaud's phenomenon
Most common (>=2%) Atypical sensations, tingling, dizziness/vertigo, warm/hot sensation, burning sensation, feeling of heaviness, flushing, weakness, neck pain/stiffness, chest discomfort, drowsiness/sedation
Serious Myocardial ischemia/infarction, arrhythmias, cerebrovascular events, vasospasm reactions, serotonin syndrome, increase in blood pressure, hypersensitivity reactions, seizures
Postmarketing Hypotension, palpitations, dystonia, tremor
Pharmacology
Galcanezumab-gnlm is a humanized monoclonal antibody that binds to calcitonin gene-related peptide (CGRP) ligand and blocks its binding to the receptor; it is not metabolized by cytochrome P450 enzymes, making interactions with CYP substrates, inducers, or inhibitors unlikely.
Sumatriptan is a selective 5-HT1B/1D receptor agonist that exerts its therapeutic effects through agonist activity at 5-HT1B/1D receptors on intracranial blood vessels and sensory nerves of the trigeminal system, resulting in cranial vessel constriction and inhibition of pro-inflammatory neuropeptide release.
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Most Common Insurance
Anthem BCBS
Emgality
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (10/12) · Qty limit (11/12)
Tosymra
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (10/12)
UnitedHealthcare
Emgality
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (7/8) · Qty limit (8/8)
Tosymra
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Emgality
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Tosymra
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Migraine
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Tosymra.
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EmgalityView full Emgality profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.