| Neurofibromatosis 1
Gomekli vs Koselugo
Side-by-side clinical, coverage, and cost comparison for neurofibromatosis 1.Deep comparison between: Gomekli vs Koselugo 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 signalsKoselugo has a higher rate of injection site reactions vs Gomekli based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Koselugo but not Gomekli, including UnitedHealthcare
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Category
Gomekli
Koselugo
At A Glance
Oral
Twice daily
MEK1/2 inhibitor
Oral
Twice daily
MEK1/2 inhibitor
Indications
- Neurofibromatosis 1
- Neurofibromatosis 1
Dosing
Neurofibromatosis 1 2 mg/m2 orally twice daily for the first 21 days of each 28-day cycle; maximum dose 4 mg twice daily; BSA-based dosing (1-4 mg twice daily).
Neurofibromatosis 1 25 mg/m2 orally twice daily (capsules or oral granules); reduce to 20 mg/m2 twice daily for moderate hepatic impairment (Child-Pugh B); dosage not established for severe hepatic impairment (Child-Pugh C).
Contraindications
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—
Adverse Reactions
Most common (>25%) rash, diarrhea, musculoskeletal pain, nausea, vomiting, abdominal pain, headache, paronychia, left ventricular dysfunction, fatigue
Serious ocular toxicity, left ventricular dysfunction, dermatologic adverse reactions, embryo-fetal toxicity
Most common (>=40%) Pediatrics: vomiting, diarrhea, increased creatine phosphokinase, dry skin, paronychia, nausea, dermatitis acneiform, pyrexia. Adults: rash, dermatitis acneiform, diarrhea.
Serious Left ventricular dysfunction, ocular toxicity, gastrointestinal toxicity, skin toxicity, increased creatine phosphokinase.
Pharmacology
Mirdametinib is a MEK1/2 inhibitor that blocks kinase activity of MEK1 and MEK2, suppressing downstream ERK phosphorylation and reducing neurofibroma tumor volume and proliferation in NF1 models.
Selumetinib is an inhibitor of mitogen-activated protein kinase kinases 1 and 2 (MEK1/2), blocking the RAS-regulated RAF-MEK-ERK pathway and suppressing ERK phosphorylation to inhibit neurofibroma growth.
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Most Common Insurance
Anthem BCBS
Gomekli
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (11/12)
Koselugo
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Gomekli
- Covered on 4 commercial plans
- PA (7/8) · Step Therapy (0/8) · Qty limit (2/8)
Koselugo
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (6/8)
Humana
Gomekli
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (1/3)
Koselugo
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableGomekli Bridge Program
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$0
Alexion OneSourceCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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GomekliView full Gomekli profile
KoselugoView full Koselugo profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.