| Multiple Sclerosis, Relapsing-Remitting
Zeposia vs Tecfidera
Side-by-side clinical, coverage, and cost comparison for multiple sclerosis, relapsing-remitting.Deep comparison between: Zeposia vs Tecfidera 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 signalsTecfidera has a higher rate of injection site reactions vs Zeposia based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Tecfidera but not Zeposia, including UnitedHealthcare
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Category
Zeposia
Tecfidera
At A Glance
Oral
Once daily
S1P receptor modulator
Oral
Twice daily
Nrf2 pathway activator
Indications
- Multiple Sclerosis, Relapsing-Remitting
- Multiple Sclerosis, Secondary Progressive
- Clinically isolated syndrome
- Ulcerative Colitis
- Clinically isolated syndrome
- Multiple Sclerosis, Relapsing-Remitting
- 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.
Clinically isolated syndrome, Multiple Sclerosis, Relapsing-Remitting, Multiple Sclerosis, Secondary Progressive Starting dose 120 mg twice a day orally for 7 days; maintenance dose 240 mg twice a day orally.
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
- Known hypersensitivity to dimethyl fumarate or any excipient of TECFIDERA
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%) Flushing, abdominal pain, diarrhea, nausea
Serious Anaphylaxis, angioedema, progressive multifocal leukoencephalopathy, herpes zoster and other serious opportunistic infections, lymphopenia, liver injury
Postmarketing Acute pancreatitis, gastrointestinal perforation, ulceration, obstruction, and hemorrhage, liver function abnormalities, herpes zoster infection, rhinorrhea, alopecia
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.
Dimethyl fumarate (DMF) and its active metabolite monomethyl fumarate (MMF) activate the Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) pathway involved in the cellular response to oxidative stress; the mechanism by which DMF exerts its therapeutic effect in multiple sclerosis is unknown.
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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)
Tecfidera
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
UnitedHealthcare
Zeposia
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (3/8)
Tecfidera
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Zeposia
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Tecfidera
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Zeposia.
Cost estimate not availableAccessia Health: Multiple Sclerosis - Private Insurance: 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.