| Multiple Sclerosis, Secondary Progressive
Gilenya vs Kesimpta
Side-by-side clinical, coverage, and cost comparison for multiple sclerosis, secondary progressive.Deep comparison between: Fingolimod vs Kesimpta 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 signalsKesimpta has a higher rate of injection site reactions vs Fingolimod based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Kesimpta but not Fingolimod, including UnitedHealthcare
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Category
Fingolimod
Kesimpta
At A Glance
Oral
Daily
Sphingosine 1-phosphate receptor modulator
SC injection
Once monthly
Anti-CD20 monoclonal antibody
Indications
- Multiple Sclerosis, Relapsing-Remitting
- Clinically isolated syndrome
- Multiple Sclerosis, Secondary Progressive
- Multiple Sclerosis, Relapsing-Remitting
- Multiple Sclerosis, Secondary Progressive
- Clinically isolated syndrome
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.
Multiple Sclerosis, Relapsing-Remitting, Multiple Sclerosis, Secondary Progressive, Clinically isolated syndrome 20 mg SC injection at Weeks 0, 1, and 2 (loading doses), then 20 mg SC once monthly starting at Week 4.
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 hypersensitivity to ofatumumab or life-threatening injection-related reaction to KESIMPTA, including anaphylaxis and angioedema
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, injection-related reactions (systemic), headache, injection-site reactions (local)
Serious infections, injection-related reactions and hypersensitivity reactions, reduction in immunoglobulins, liver injury
Postmarketing hypersensitivity reactions, liver injury
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.
Ofatumumab is a recombinant human IgG1 monoclonal antibody that binds CD20 on pre-B and mature B lymphocytes, resulting in antibody-dependent cellular cytolysis and complement-mediated lysis; the precise mechanism in multiple sclerosis is unknown but is presumed to involve B-lymphocyte depletion.
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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)
Kesimpta
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (9/12) · Qty limit (9/12)
UnitedHealthcare
Fingolimod
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (8/8)
Kesimpta
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (4/8)
Humana
Fingolimod
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (3/3)
Kesimpta
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
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
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.