| Multiple Sclerosis, Secondary Progressive
Mavenclad vs Vumerity
Side-by-side clinical, coverage, and cost comparison for multiple sclerosis, secondary progressive.Deep comparison between: Mavenclad vs Vumerity 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 signalsVumerity has a higher rate of injection site reactions vs Mavenclad based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Vumerity but not Mavenclad, including UnitedHealthcare
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Category
Mavenclad
Vumerity
At A Glance
Oral
2 yearly treatment courses
Nucleoside metabolic inhibitor
Oral
Twice daily
Nrf2 pathway activator
Indications
- Multiple Sclerosis, Relapsing-Remitting
- Multiple Sclerosis, Secondary Progressive
- Clinically isolated syndrome
- Multiple Sclerosis, Relapsing-Remitting
- Multiple Sclerosis, Secondary Progressive
Dosing
Multiple Sclerosis, Relapsing-Remitting, Multiple Sclerosis, Secondary Progressive Cumulative dose of 3.5 mg/kg administered orally, divided into 2 yearly treatment courses (1.75 mg/kg per course); each course consists of 2 cycles of 4 to 5 consecutive days of dosing; no more than 2 tablets (20 mg) per day; do not administer additional treatment during the 2 years following completion of 2 courses.
Clinically isolated syndrome, Multiple Sclerosis, Relapsing-Remitting, Multiple Sclerosis, Secondary Progressive Starting dose 231 mg twice daily orally for 7 days; maintenance dose 462 mg (two 231 mg capsules) twice daily orally; temporary reduction to 231 mg twice daily may be considered for tolerability, resuming 462 mg twice daily within 4 weeks.
Contraindications
- Current malignancy
- Pregnancy, or women or men of reproductive potential not using effective contraception during dosing and for 6 months after the last dose in each treatment course
- HIV infection
- Active chronic infections (e.g., hepatitis or tuberculosis)
- History of hypersensitivity to cladribine
- Breastfeeding on a treatment day and for 10 days after the last dose
- Known hypersensitivity to diroximel fumarate, dimethyl fumarate, or any excipient of VUMERITY (reactions may include anaphylaxis and angioedema)
- Concomitant use of dimethyl fumarate
Adverse Reactions
Most common (>20%) Upper respiratory tract infection, headache, lymphopenia
Serious Malignancies, teratogenicity, lymphopenia, infections, hematologic toxicity, graft-versus-host disease with blood transfusion, liver injury, hypersensitivity, cardiac failure, seizures, myelodysplastic syndrome
Postmarketing Nocardiosis, varicella zoster, histoplasmosis, cryptococcosis, toxoplasmosis, 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, serious gastrointestinal reactions
Postmarketing Acute pancreatitis, gastrointestinal perforation/ulceration/obstruction/hemorrhage, liver function abnormalities (transaminases >=3 times ULN with total bilirubin >2 times ULN), herpes zoster infection, rhinorrhea, alopecia
Pharmacology
Cladribine is a nucleoside metabolic inhibitor that exerts cytotoxic effects on B and T lymphocytes through impairment of DNA synthesis, resulting in depletion of lymphocytes; this lymphocyte-depleting mechanism is thought to underlie its therapeutic effects in relapsing forms of multiple sclerosis.
Diroximel fumarate is a prodrug converted to its active metabolite monomethyl fumarate (MMF), which activates the Nrf2 pathway involved in cellular response to oxidative stress and acts as a nicotinic acid receptor agonist in vitro; the mechanism by which it exerts therapeutic effect in multiple sclerosis is unknown.
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Most Common Insurance
Anthem BCBS
Mavenclad
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
Vumerity
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (5/12) · Qty limit (10/12)
UnitedHealthcare
Mavenclad
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (4/8)
Vumerity
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Mavenclad
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (1/3)
Vumerity
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAccessia Health: Multiple Sclerosis - Private Insurance: 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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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.