| Multiple Sclerosis, Relapsing-Remitting
Gilenya vs Ocrevus
Side-by-side clinical, coverage, and cost comparison for multiple sclerosis, relapsing-remitting.Deep comparison between: Fingolimod vs Ocrevus 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 signalsOcrevus has a higher rate of injection site reactions vs Fingolimod based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Ocrevus but not Fingolimod, including UnitedHealthcare
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Category
Fingolimod
Ocrevus
At A Glance
Oral
Daily
Sphingosine 1-phosphate receptor modulator
IV infusion
Every 6 months
CD20 antagonist
Indications
- Multiple Sclerosis, Relapsing-Remitting
- Clinically isolated syndrome
- Multiple Sclerosis, Secondary Progressive
- Clinically isolated syndrome
- Multiple Sclerosis, Relapsing-Remitting
- Multiple Sclerosis, Primary Progressive
Dosing
Multiple Sclerosis, Relapsing-Remitting, Clinically isolated syndrome, Multiple Sclerosis, Secondary Progressive 0.5 mg orally once daily for adults and pediatric patients >40 kg; 0.25 mg orally once daily for pediatric patients 10 years of age and older weighing <=40 kg; may be taken with or without food; first-dose monitoring for bradycardia required.
Clinically isolated syndrome, Multiple Sclerosis, Relapsing-Remitting, Multiple Sclerosis, Primary Progressive Initial dose: 300 mg IV infusion, followed two weeks later by a second 300 mg IV infusion; subsequent doses: 600 mg IV infusion every 6 months.
Contraindications
- Myocardial infarction, unstable angina, stroke, TIA, decompensated heart failure requiring hospitalization, or Class III/IV heart failure within the last 6 months
- History or presence of Mobitz Type II second-degree or third-degree AV block or sick sinus syndrome without a functioning pacemaker
- Baseline QTc interval >= 500 msec
- Cardiac arrhythmias requiring anti-arrhythmic treatment with Class Ia or Class III anti-arrhythmic drugs
- Hypersensitivity to fingolimod or any excipient in fingolimod capsules
- Active HBV infection
- History of life-threatening infusion reaction to OCREVUS
Adverse Reactions
Most common (>=10%) Headache, liver transaminase elevation, diarrhea, cough, influenza, sinusitis, back pain, abdominal pain, pain in extremity
Serious Bradyarrhythmia, AV block, infections, progressive multifocal leukoencephalopathy, macular edema, liver injury, posterior reversible encephalopathy syndrome, fetal risk, malignancies, hypersensitivity reactions
Postmarketing Hemolytic anemia, thrombocytopenia, cryptococcal infections, HPV infection, seizures including status epilepticus, melanoma, Merkel cell carcinoma, cutaneous T-cell lymphoma, Kaposi's sarcoma, squamous cell carcinoma
Most common (>=10%) Upper respiratory tract infections, infusion reactions, skin infections, lower respiratory tract infections
Serious Infusion reactions, infections, progressive multifocal leukoencephalopathy, reduction in immunoglobulins, malignancies, immune-mediated colitis, liver injury
Postmarketing Immune-mediated colitis, liver injury, serious herpes infections, progressive multifocal leukoencephalopathy, babesiosis, pyoderma gangrenosum
Pharmacology
Sphingosine 1-phosphate (S1P) receptor modulator; fingolimod is metabolized to fingolimod-phosphate, which binds S1P receptors 1, 3, 4, and 5 with high affinity, blocking lymphocyte egress from lymph nodes and reducing peripheral blood lymphocyte counts, potentially reducing lymphocyte migration into the central nervous system.
CD20 antagonist; ocrelizumab is a recombinant humanized IgG1 monoclonal antibody that binds to CD20 on pre-B and mature B lymphocytes, resulting in antibody-dependent cellular cytolysis and complement-mediated lysis.
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Most Common Insurance
Anthem BCBS
Fingolimod
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (2/12) · Qty limit (11/12)
Ocrevus
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
UnitedHealthcare
Fingolimod
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (8/8)
Ocrevus
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Fingolimod
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (3/3)
Ocrevus
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Multiple Sclerosis: Waitlist
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAccessia Health: Multiple Sclerosis - Private Insurance: Waitlist
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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FingolimodView full Fingolimod profile
OcrevusView full Ocrevus profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.