| Multiple Myeloma
Revlimid vs Velcade
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Revlimid 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 Revlimid based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Velcade but not Revlimid, including UnitedHealthcare
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Category
Revlimid
Velcade
At A Glance
Oral
Daily on Days 1-21 of repeated 28-day cycles
Immunomodulatory agent targeting cereblon
SC or IV injection
Twice weekly
Proteasome inhibitor
Indications
- Multiple Myeloma
- Myelodysplastic Syndrome with Isolated del(5q)
- Mantle cell lymphoma
- Lymphoma, Follicular
- Marginal Zone B-Cell Lymphoma
- Multiple Myeloma
- Carcinoma in situ of other and unspecified small intestine NOS
Dosing
Multiple Myeloma (combination therapy) 25 mg orally once daily on Days 1-21 of repeated 28-day cycles, in combination with dexamethasone
Multiple Myeloma (maintenance therapy following auto-HSCT) 10 mg orally once daily continuously on Days 1-28 of repeated 28-day cycles
Myelodysplastic Syndrome with Isolated del(5q) 10 mg orally once daily
Mantle cell lymphoma 25 mg orally once daily on Days 1-21 of repeated 28-day cycles
Follicular Lymphoma 20 mg orally once daily on Days 1-21 of repeated 28-day cycles for up to 12 cycles, in combination with a rituximab-product
Marginal Zone B-Cell Lymphoma 20 mg orally once daily on Days 1-21 of repeated 28-day cycles for up to 12 cycles, in combination with a rituximab-product
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 to lenalidomide including angioedema, Stevens-Johnson syndrome, toxic epidermal necrolysis
- Hypersensitivity (not including local reactions) to bortezomib, boron, or mannitol, including anaphylactic reactions
- Intrathecal administration
Adverse Reactions
Most common (>=20%) - Multiple Myeloma combination therapy Diarrhea, anemia, constipation, peripheral edema, neutropenia, fatigue, back pain, nausea, asthenia, insomnia
Most common (>=20%) - Multiple Myeloma maintenance therapy Neutropenia, thrombocytopenia, leukopenia, anemia, upper respiratory tract infection, bronchitis, diarrhea, rash, fatigue
Most common (>=20%) - Myelodysplastic Syndromes Thrombocytopenia, neutropenia, pruritus, rash, diarrhea, constipation, nausea, nasopharyngitis, cough, dyspnea, pharyngitis, epistaxis, fatigue, pyrexia, peripheral edema, asthenia, arthralgia, back pain, muscle cramp
Most common (>=20%) - Mantle Cell Lymphoma Neutropenia, thrombocytopenia, anemia, fatigue, diarrhea, nausea, cough, dyspnea, rash, pruritus
Most common (>=20%) - Follicular and Marginal Zone Lymphoma Neutropenia, fatigue, diarrhea, constipation, nausea, cough
Serious Venous thromboembolism, arterial thromboembolism, infections including pneumonia, second primary malignancies, hepatotoxicity, severe cutaneous reactions, tumor lysis syndrome, tumor flare reactions
Postmarketing Hypothyroidism, hyperthyroidism, hepatic failure, toxic hepatitis, angioedema, anaphylaxis, acute graft-versus-host disease, viral reactivation, progressive multifocal leukoencephalopathy, pneumonitis, Stevens-Johnson Syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms
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
Lenalidomide is an immunomodulatory agent that mediates cellular activities through binding to cereblon, a component of a cullin ring E3 ubiquitin ligase enzyme complex, leading to degradation of substrate proteins and resulting in direct cytotoxic and immunomodulatory effects.
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
Revlimid
- Covered on 5 commercial plans
- PA (11/12) · 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
Revlimid
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (8/8) · Qty limit (7/8)
Velcade
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Revlimid
- Covered on 0 commercial plans
- PA (2/3) · 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
No savings programs available for Revlimid.
No savings programs available for Velcade.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.