| Multiple Myeloma
Pomalyst vs Velcade
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Pomalyst vs Velcade 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 signalsVelcade has a higher rate of injection site reactions vs Pomalyst based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Velcade but not Pomalyst, including UnitedHealthcare
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Category
Pomalyst
Velcade
At A Glance
Oral
Once daily, Days 1-21 of 28-day cycles
Thalidomide analogue (immunomodulatory)
SC or IV injection
Twice weekly
Proteasome inhibitor
Indications
- Multiple Myeloma
- Kaposi Sarcoma
- Multiple Myeloma
- Carcinoma in situ of other and unspecified small intestine NOS
Dosing
Multiple Myeloma 4 mg once daily orally with or without food on Days 1 through 21 of each 28-day cycle until disease progression; given in combination with dexamethasone.
Kaposi Sarcoma 5 mg once daily orally with or without food on Days 1 through 21 of each 28-day cycle until disease progression or unacceptable toxicity; continue HAART as HIV treatment in patients with AIDS-related KS.
Multiple Myeloma 1.3 mg/m2 SC or IV; previously untreated: twice weekly (Days 1, 4, 8, 11) in cycles 1-4 then once weekly (Days 1, 8, 22, 29) in cycles 5-9 with melphalan and prednisone for 9 six-week cycles; relapsed: twice weekly (Days 1, 4, 8, 11) every 3 weeks as single agent or with dexamethasone.
Carcinoma in situ of other and unspecified small intestine NOS 1.3 mg/m2 IV twice weekly (Days 1, 4, 8, 11) for 2 weeks followed by a 10-day rest period, in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (VcR-CAP) for 6 three-week cycles.
Contraindications
- Pregnancy
- Severe hypersensitivity (e.g., angioedema, anaphylaxis) to pomalidomide or any excipient
- Hypersensitivity (not including local reactions) to bortezomib, boron, or mannitol, including anaphylactic reactions
- Intrathecal administration
Adverse Reactions
Most common (>=10%) Neutropenia, anemia, fatigue/asthenia, constipation, nausea, diarrhea, dyspnea, upper respiratory tract infection, pneumonia, back pain, peripheral neuropathy, edema peripheral, pyrexia, thrombocytopenia, rash
Serious Venous and arterial thromboembolism, hematologic toxicity (neutropenia, thrombocytopenia, febrile neutropenia), hepatotoxicity, severe cutaneous reactions, pneumonia, sepsis, dizziness and confusional state, neuropathy, tumor lysis syndrome
Postmarketing Pancytopenia, hepatic failure, Stevens-Johnson Syndrome, toxic epidermal necrolysis, DRESS, progressive multifocal leukoencephalopathy, hepatitis B virus reactivation, herpes zoster, tumor lysis syndrome, basal cell carcinoma, squamous cell carcinoma of the skin
Most common (>=10%) Nausea, diarrhea, fatigue, peripheral neuropathies, thrombocytopenia, vomiting, constipation, pyrexia, anorexia, anemia, headache, neutropenia, rash, paresthesia, dizziness, weakness
Serious Diarrhea, vomiting, pyrexia, nausea, dehydration, thrombocytopenia, pneumonia, dyspnea, peripheral neuropathies, herpes zoster
Postmarketing Cardiac tamponade, bilateral deafness, optic neuropathy, blindness, ischemic colitis, progressive multifocal leukoencephalopathy, herpes meningoencephalitis, posterior reversible encephalopathy syndrome, Guillain-Barre syndrome, demyelinating polyneuropathy, acute diffuse infiltrative pulmonary disease, Stevens-Johnson syndrome/toxic epidermal necrolysis, acute febrile neutrophilic dermatosis
Pharmacology
Pomalidomide is a thalidomide analogue with immunomodulatory, antiangiogenic, and antineoplastic properties; it acts through cereblon (a cullin ring E3 ubiquitin ligase component), targeting substrate proteins Aiolos and Ikaros for ubiquitination and degradation, producing direct cytotoxic and immunomodulatory effects including enhanced T cell- and NK cell-mediated immunity and inhibition of pro-inflammatory cytokines (TNF-alpha and IL-6).
Bortezomib is a reversible inhibitor of the chymotrypsin-like activity of the 26S proteasome in mammalian cells; inhibition of this pathway disrupts homeostatic proteolysis, affecting multiple signaling cascades and leading to cell death in various cancer cell types including multiple myeloma.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Pomalyst
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Velcade
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Pomalyst
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (7/8)
Velcade
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Pomalyst
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Velcade
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$0
Bristol-Myers Squibb Patient Assistance Foundation (BMSPAF)Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Velcade.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.