| Multiple Sclerosis, Relapsing-Remitting

Zeposia vs Gilenya

Side-by-side clinical, coverage, and cost comparison for multiple sclerosis, relapsing-remitting.
Deep comparison between: Zeposia vs Fingolimod with Prescriber.AI
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Safety signalsFingolimod has a higher rate of injection site reactions vs Zeposia based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Fingolimod but not Zeposia, including UnitedHealthcare
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Zeposia
Fingolimod
At A Glance
Oral
Once daily
S1P receptor modulator
Oral
Daily
Sphingosine 1-phosphate receptor modulator
Indications
  • Multiple Sclerosis, Relapsing-Remitting
  • Multiple Sclerosis, Secondary Progressive
  • Clinically isolated syndrome
  • Ulcerative Colitis
  • Multiple Sclerosis, Relapsing-Remitting
  • Clinically isolated syndrome
  • Multiple Sclerosis, Secondary Progressive
Dosing
Multiple Sclerosis, Relapsing-Remitting, Multiple Sclerosis, Secondary Progressive, Clinically isolated syndrome, Ulcerative Colitis Initiate with 7-day titration (0.23 mg once daily days 1-4, 0.46 mg once daily days 5-7); maintenance dose 0.92 mg orally once daily starting day 8; patients with mild or moderate hepatic impairment (Child-Pugh class A or B) take 0.92 mg once every other day after titration.
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.
Contraindications
  • Myocardial infarction, unstable angina, stroke, TIA, decompensated heart failure requiring hospitalization, or Class III or IV heart failure in the last 6 months
  • Mobitz type II second-degree or third-degree atrioventricular block, sick sinus syndrome, or sino-atrial block without a functioning pacemaker
  • Severe untreated sleep apnea
  • Concurrent use of a monoamine oxidase (MAO) inhibitor
  • 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
Adverse Reactions
Most common (>=4%) Upper respiratory infection, hepatic transaminase elevation, orthostatic hypotension, urinary tract infection, back pain, hypertension (MS); liver test increased, upper respiratory infection, headache (UC)
Serious Infections, progressive multifocal leukoencephalopathy, bradyarrhythmia and AV conduction delays, liver injury, fetal risk, increased blood pressure, respiratory effects, macular edema, cutaneous malignancies, posterior reversible encephalopathy syndrome
Postmarketing Liver injury
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
Pharmacology
Ozanimod is an S1P receptor modulator that binds with high affinity to S1P receptors 1 and 5, blocking lymphocyte egress from lymph nodes and reducing peripheral blood lymphocyte counts; the therapeutic mechanism in MS and ulcerative colitis is unknown but may involve reduced lymphocyte migration into the CNS and intestine.
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.
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Most Common Insurance
Anthem BCBS
Zeposia
  • Covered on 5 commercial plans
  • PA (10/12) · Step Therapy (9/12) · Qty limit (9/12)
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Fingolimod
  • Covered on 5 commercial plans
  • PA (11/12) · Step Therapy (2/12) · Qty limit (11/12)
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UnitedHealthcare
Zeposia
  • Covered on 4 commercial plans
  • PA (4/8) · Step Therapy (0/8) · Qty limit (3/8)
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Fingolimod
  • Covered on 4 commercial plans
  • PA (6/8) · Step Therapy (0/8) · Qty limit (8/8)
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Humana
Zeposia
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
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Fingolimod
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (2/3) · Qty limit (3/3)
View full coverage details ›
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Zeposia.
Cost estimate not availableAssistance Fund: Multiple Sclerosis: Waitlist
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.