| Multiple Myeloma
Elrexfio vs Ninlaro
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Elrexfio vs Ninlaro 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 signalsNinlaro has a higher rate of injection site reactions vs Elrexfio based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Ninlaro but not Elrexfio, including UnitedHealthcare
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Category
Elrexfio
Ninlaro
At A Glance
SC injection
Weekly to every 4 weeks
BCMA-directed T-cell engager
Oral
Once weekly (Days 1, 8, 15 of 28-day cycle)
Proteasome inhibitor
Indications
- Multiple Myeloma
- Multiple Myeloma
Dosing
Multiple Myeloma Step-up SC dosing: 12 mg on Day 1, 32 mg on Day 4, then 76 mg weekly starting Day 8 through week 24; for responders, transitions to 76 mg every 2 weeks (weeks 25-48), then 76 mg every 4 weeks (week 49 onward); continue until disease progression or unacceptable toxicity.
Multiple Myeloma 4 mg orally once weekly on Days 1, 8, and 15 of a 28-day cycle in combination with lenalidomide 25 mg daily (Days 1-21) and dexamethasone 40 mg (Days 1, 8, 15, 22); reduce starting dose to 3 mg for moderate or severe hepatic impairment, severe renal impairment (CrCl <30 mL/min), or ESRD requiring dialysis.
Contraindications
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Adverse Reactions
Most common (>=20%) CRS, fatigue, injection site reaction, diarrhea, upper respiratory tract infection, musculoskeletal pain, pneumonia, decreased appetite, rash, cough, nausea, pyrexia
Serious Pneumonia, sepsis, CRS, upper respiratory tract infection, acute kidney injury, urinary tract infection, COVID-19, encephalopathy, pyrexia, febrile neutropenia
Most common (>=20%) Thrombocytopenia, neutropenia, diarrhea, constipation, peripheral neuropathy, nausea, peripheral edema, rash, vomiting, bronchitis
Serious Diarrhea, thrombocytopenia, bronchitis
Postmarketing Angioedema, toxic epidermal necrolysis
Pharmacology
Elranatamab-bcmm is a bispecific BCMA-directed CD3 T-cell engaging antibody that simultaneously binds BCMA on plasma cells, plasmablasts, and multiple myeloma cells and CD3 on T-cells, leading to T-cell activation and cytolysis of BCMA-expressing cells.
Ixazomib is a reversible proteasome inhibitor that preferentially binds and inhibits the chymotrypsin-like activity of the beta 5 subunit of the 20S proteasome, inducing apoptosis in multiple myeloma cell lines and demonstrating synergistic cytotoxic effects in combination with lenalidomide.
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Most Common Insurance
Anthem BCBS
Elrexfio
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
Ninlaro
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
UnitedHealthcare
Elrexfio
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Ninlaro
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Elrexfio
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (0/3)
Ninlaro
- 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 availableCancerCare: Multiple Myeloma
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableCancerCare: Multiple Myeloma
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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ElrexfioView full Elrexfio profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.