| Multiple Sclerosis
Lemtrada vs Acthar
Side-by-side clinical, coverage, and cost comparison for multiple sclerosis.Deep comparison between: Lemtrada vs Acthar 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 signalsActhar has a higher rate of injection site reactions vs Lemtrada based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Acthar but not Lemtrada, including UnitedHealthcare
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Category
Lemtrada
Acthar
At A Glance
IV infusion
Annual treatment courses
Anti-CD52 monoclonal antibody
IM or SC injection
Corticotropin analog
Indications
- Multiple Sclerosis
- Infantile Spasm
- Multiple Sclerosis
- Arthritis, Psoriatic
- Rheumatoid Arthritis
- Ankylosing spondylitis
- Lupus Erythematosus, Systemic
- Dermatomyositis
- Polymyositis
- Erythema Multiforme
- Stevens-Johnson Syndrome
- Serum Sickness
- Keratitis
- Iritis
- Iridocyclitis
- Uveitis, Posterior
- Choroiditis
- Optic Neuritis
- Chorioretinitis
- Sarcoidosis
- Nephrotic Syndrome
Dosing
Multiple Sclerosis First course: 12 mg/day IV infusion on 5 consecutive days; second course: 12 mg/day on 3 consecutive days 12 months after first course; subsequent courses: 12 mg/day on 3 consecutive days as needed, at least 12 months after the last prior dose. Premedicate with high-dose corticosteroids for the first 3 days of each course; administer antiviral prophylaxis starting on the first day of each course for a minimum of 2 months or until CD4+ count >= 200 cells/microliter.
Infantile Spasm 150 U/m2/day IM divided into 75 U/m2 twice daily for 2 weeks, then taper over 2 weeks; Acthar Gel vial only -- do not use the pre-filled SelfJect injector.
Multiple Sclerosis 80-120 units IM or SC daily for 2-3 weeks for acute exacerbations; taper as needed.
Arthritis, Psoriatic, Rheumatoid Arthritis, Ankylosing spondylitis, Lupus Erythematosus, Systemic, Dermatomyositis, Polymyositis, Erythema Multiforme, Stevens-Johnson Syndrome, Serum Sickness, Keratitis, Iritis, Iridocyclitis, Uveitis, Posterior, Choroiditis, Optic Neuritis, Chorioretinitis, Sarcoidosis, Nephrotic Syndrome 40-80 units IM or SC every 24-72 hours; individualize dosing based on disease severity and patient response; taper dose upon discontinuation.
Contraindications
- Known hypersensitivity or anaphylactic reaction to alemtuzumab or any excipient
- HIV infection
- Active infection
- Intravenous administration
- Use in infants under 2 years of age with suspected congenital infections
- Concomitant live or live-attenuated vaccines during immunosuppressive doses of Acthar Gel
- Scleroderma
- Osteoporosis
- Systemic fungal infections
- Ocular herpes simplex
- Recent surgery
- History of or presence of peptic ulcer
- Congestive heart failure
- Uncontrolled hypertension
- Primary adrenocortical insufficiency
- Adrenocortical hyperfunction
- Sensitivity to proteins of porcine origin
Adverse Reactions
Most common (>=10%) Rash, headache, pyrexia, nasopharyngitis, nausea, urinary tract infection, fatigue, insomnia, upper respiratory tract infection, herpes viral infection, urticaria, pruritus, thyroid gland disorders, fungal infection, arthralgia, pain in extremity, back pain, diarrhea, sinusitis, oropharyngeal pain, paresthesia, dizziness, abdominal pain, flushing, vomiting
Serious Autoimmunity, infusion reactions, stroke and cervicocephalic arterial dissection, malignancies, immune thrombocytopenia, glomerular nephropathies including anti-GBM disease, thyroid disorders, other autoimmune cytopenias, autoimmune hepatitis, hemophagocytic lymphohistiocytosis, adult onset Still's disease, thrombotic thrombocytopenic purpura, autoimmune encephalitis, acquired hemophilia A, immune-mediated colitis, infections, progressive multifocal leukoencephalopathy, acute acalculous cholecystitis, pneumonitis
Postmarketing Acquired hemophilia A, neutropenia, thrombocytopenia, thrombotic thrombocytopenic purpura, stroke (hemorrhagic and ischemic), cervicocephalic arterial dissection, cholecystitis, immune-mediated colitis, autoimmune hepatitis, viral hepatitis, opportunistic infections, progressive multifocal leukoencephalopathy, vasculitis, Guillain-Barre syndrome, hemophagocytic lymphohistiocytosis, sarcoidosis, adult onset Still's disease, autoimmune encephalitis, myasthenia gravis, Lambert-Eaton myasthenic syndrome, pulmonary alveolar hemorrhage, alopecia
Most common (>=5%) Infections, convulsions, hypertension, irritability, pyrexia (reported in infantile spasm trials at recommended dose)
Serious Cushing's syndrome, adrenal insufficiency upon withdrawal, elevated blood pressure, salt and water retention, hypokalemia, gastrointestinal perforation and bleeding, behavioral and mood disturbances, ophthalmic effects, decreased bone density, negative effects on growth and physical development
Postmarketing Anaphylaxis, necrotizing angitis, pancreatitis, intracranial hemorrhage, subdural hematoma, reversible brain shrinkage, vertebral compression fractures, insomnia, injection site reactions
Pharmacology
Alemtuzumab is a humanized IgG1 kappa monoclonal antibody that binds to CD52, a cell surface antigen on T and B lymphocytes, natural killer cells, monocytes, and macrophages, resulting in antibody-dependent cellular cytolysis and complement-mediated lysis; the precise mechanism by which this exerts therapeutic effects in MS is unknown.
Repository corticotropin (ACTH) analog that stimulates the adrenal cortex to secrete cortisol, corticosterone, aldosterone, and weak androgens; also reported to bind melanocortin receptors, with the trophic effects on the adrenal cortex appearing to be mediated by cyclic AMP.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Lemtrada
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
Acthar
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (0/12)
UnitedHealthcare
Lemtrada
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Acthar
- Covered on 4 commercial plans
- PA (1/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Lemtrada
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Acthar
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (2/3)
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
No savings programs available for Acthar.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.