| Multiple Myeloma
Xgeva vs Pomalyst
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Xgeva vs Pomalyst 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 signalsPomalyst has a higher rate of injection site reactions vs Xgeva based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Pomalyst but not Xgeva, including UnitedHealthcare
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Category
Xgeva
Pomalyst
At A Glance
SC injection
Every 4 weeks
RANKL inhibitor
Oral
Once daily, Days 1-21 of 28-day cycles
Thalidomide analogue (immunomodulatory)
Indications
- Multiple Myeloma
- Metastatic malignant neoplasm to bone
- Giant Cell Tumor of Bone
- Humoral hypercalcemia of malignancy (disorder)
- Multiple Myeloma
- Kaposi Sarcoma
Dosing
Multiple Myeloma, Metastatic malignant neoplasm to bone 120 mg SC every 4 weeks in the upper arm, upper thigh, or abdomen.
Giant Cell Tumor of Bone, Humoral hypercalcemia of malignancy (disorder) 120 mg SC every 4 weeks with additional 120 mg doses on Days 8 and 15 of the first month of therapy, in the upper arm, upper thigh, or abdomen.
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.
Contraindications
- Pre-existing hypocalcemia
- Known clinically significant hypersensitivity to Xgeva or denosumab products
- Pregnancy
- Severe hypersensitivity (e.g., angioedema, anaphylaxis) to pomalidomide or any excipient
Adverse Reactions
Most common (>=25%) Fatigue/asthenia, hypophosphatemia, nausea
Serious Dyspnea, osteonecrosis of the jaw, hypocalcemia, atypical subtrochanteric and diaphyseal femoral fracture, multiple vertebral fractures following treatment discontinuation
Postmarketing Severe symptomatic hypocalcemia (including fatal cases), severe symptomatic hypercalcemia following treatment discontinuation, hypersensitivity including anaphylactic reactions, severe musculoskeletal pain, lichenoid drug eruptions, alopecia
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
Pharmacology
Xgeva is a RANKL inhibitor; it binds to RANKL, a protein essential for osteoclast formation, function, and survival, thereby preventing osteoclast-mediated bone resorption and modulating calcium release from bone in solid tumor bone metastases, multiple myeloma, giant cell tumor of bone, and hypercalcemia of malignancy.
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).
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Most Common Insurance
Anthem BCBS
Xgeva
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (9/12) · Qty limit (11/12)
Pomalyst
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
UnitedHealthcare
Xgeva
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Pomalyst
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (7/8)
Humana
Xgeva
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (2/3) · Qty limit (2/3)
Pomalyst
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Xgeva.
$0
Bristol-Myers Squibb Patient Assistance Foundation (BMSPAF)Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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PomalystView full Pomalyst profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.