| Multiple Sclerosis
Lemtrada vs Purified Cortrophin Gel
Side-by-side clinical, coverage, and cost comparison for multiple sclerosis.Deep comparison between: Lemtrada vs Purified Cortrophin Gel 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 signalsPurified Cortrophin Gel has a higher rate of injection site reactions vs Lemtrada based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Purified Cortrophin Gel but not Lemtrada, including UnitedHealthcare
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Category
Lemtrada
Purified Cortrophin Gel
At A Glance
IV infusion
Annual treatment courses
Anti-CD52 monoclonal antibody
SC/IM injection
Corticotropin (ACTH)
Indications
- Multiple Sclerosis
- Arthritis, Psoriatic
- Rheumatoid Arthritis
- Ankylosing spondylitis
- Primary gout
- Lupus Erythematosus, Systemic
- Polymyositis
- Stevens-Johnson Syndrome
- Psoriasis
- Dermatitis, Atopic
- Serum Sickness
- Allergic Conjunctivitis
- Keratitis
- Iritis
- Iridocyclitis
- Uveitis
- Optic Neuritis
- Chorioretinitis
- Sarcoidosis
- Nephrotic Syndrome
- Multiple Sclerosis
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.
Arthritis, Psoriatic, Rheumatoid Arthritis, Ankylosing spondylitis, Primary gout, Lupus Erythematosus, Systemic, Polymyositis, Stevens-Johnson Syndrome, Psoriasis, Dermatitis, Atopic, Serum Sickness, Allergic Conjunctivitis, Keratitis, Iritis, Iridocyclitis, Uveitis, Optic Neuritis, Chorioretinitis, Sarcoidosis, Nephrotic Syndrome Dose individualized based on disease severity, plasma and urine corticosteroid levels, and patient response; administer SC or IM; verify adrenal responsiveness prior to treatment (up to 80 units as a single injection); chronic doses above 40 units daily associated with uncontrollable adverse effects.
Multiple Sclerosis 80-120 units daily SC or IM for 2-3 weeks for acute exacerbations.
Contraindications
- Known hypersensitivity or anaphylactic reaction to alemtuzumab or any excipient
- HIV infection
- Active infection
- Intravenous administration
- Scleroderma
- Osteoporosis
- Systemic fungal infections
- Ocular herpes simplex
- Recent surgery
- History of or presence of a peptic ulcer
- Congestive heart failure
- Hypertension
- Sensitivity to proteins derived from porcine sources
- Primary adrenocortical insufficiency
- Adrenocortical hyperfunction
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
Fluid and Electrolyte Sodium retention, hypokalemic alkalosis, fluid retention, calcium loss, potassium loss
Musculoskeletal Muscle weakness, loss of muscle mass, steroid myopathy, osteoporosis, vertebral compression fractures, aseptic necrosis of femoral and humeral heads, pathologic fracture of long bones
Gastrointestinal Peptic ulcer with possible perforation and hemorrhage, abdominal distention, ulcerative esophagitis, pancreatitis
Dermatologic Injection site reactions, impaired wound healing, increased sweating, thin fragile skin, suppression of skin test reactions, petechiae and ecchymoses, acne, hyperpigmentation, facial erythema
Cardiovascular Hypertension, congestive heart failure, necrotizing angiitis
Neurological Convulsions, increased intracranial pressure with papilledema, headache, vertigo
Endocrine Menstrual irregularities, Cushingoid state, suppression of growth in children, secondary adrenocortical and pituitary insufficiency, decreased carbohydrate tolerance, manifestations of latent diabetes mellitus, increased requirements for insulin or oral hypoglycemic agents, hirsutism
Ophthalmic Posterior subcapsular cataracts, increased intraocular pressure, glaucoma with possible damage to optic nerve, exophthalmos
Metabolic Negative nitrogen balance due to protein catabolism
Allergic Dizziness, nausea and vomiting, skin reactions, anaphylaxis (anaphylactic shock, urticaria, respiratory compromise, edema)
Miscellaneous Weight gain, abscess, development of antibodies and loss of stimulatory effect
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.
Purified Cortrophin Gel is an anterior pituitary hormone (corticotropin/ACTH) that stimulates the functioning adrenal cortex to produce and secrete adrenocortical hormones; it is formulated as a porcine-derived purified ACTH in a sterile gelatin solution for prolonged activity.
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)
Purified Cortrophin Gel
- 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)
Purified Cortrophin Gel
- Covered on 4 commercial plans
- PA (5/8) · 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)
Purified Cortrophin Gel
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · 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 Purified Cortrophin Gel.
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LemtradaView full Lemtrada profile
Purified Cortrophin GelView full Purified Cortrophin Gel profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.