| Multiple Myeloma
Ninlaro vs Carvykti
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Ninlaro vs Carvykti 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 signalsCarvykti has a higher rate of injection site reactions vs Ninlaro based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Carvykti but not Ninlaro, including UnitedHealthcare
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Category
Ninlaro
Carvykti
At A Glance
Oral
Once weekly (Days 1, 8, 15 of 28-day cycle)
Proteasome inhibitor
IV infusion
Single infusion
BCMA-directed CAR-T cell therapy
Indications
- Multiple Myeloma
- Multiple Myeloma
Dosing
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.
Multiple Myeloma 0.5-1.0x10^6 CAR-positive viable T cells/kg IV (max 1x10^8 cells) as a single infusion, administered 2-4 days after lymphodepleting chemotherapy (cyclophosphamide 300 mg/m^2 IV and fludarabine 30 mg/m^2 IV daily for 3 days); premedicate with acetaminophen and an H1-antihistamine 30-60 minutes prior to infusion.
Contraindications
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Adverse Reactions
Most common (>=20%) Thrombocytopenia, neutropenia, diarrhea, constipation, peripheral neuropathy, nausea, peripheral edema, rash, vomiting, bronchitis
Serious Diarrhea, thrombocytopenia, bronchitis
Postmarketing Angioedema, toxic epidermal necrolysis
Most common (>20%) Pyrexia, cytokine release syndrome, hypogammaglobulinemia, hypotension, musculoskeletal pain, fatigue, infections-pathogen unspecified, cough, chills, diarrhea, nausea, encephalopathy, decreased appetite, upper respiratory tract infection, headache, tachycardia, dizziness, dyspnea, edema, viral infections, coagulopathy, constipation, vomiting
Serious Pneumonia, cytokine release syndrome, sepsis, encephalopathy, viral infection, cranial nerve palsies
Postmarketing T cell malignancies including T-cell lymphoma, immune effector cell-associated enterocolitis and gastrointestinal perforation, infusion related reactions, JC virus progressive multifocal leukoencephalopathy
Pharmacology
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.
CARVYKTI is a BCMA-directed, genetically modified autologous T cell immunotherapy that reprograms a patient's own T cells with a transgene encoding a CAR featuring two BCMA-targeting single-domain antibodies, a 4-1BB co-stimulatory domain, and a CD3-zeta signaling domain; upon binding to BCMA-expressing cells, the CAR promotes T cell activation, expansion, and elimination of target cells.
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Most Common Insurance
Anthem BCBS
Ninlaro
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Carvykti
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Ninlaro
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Carvykti
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Ninlaro
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Carvykti
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
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 availableLeukemia & Lymphoma Society (LLS): Myeloma
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.