| Parkinson Disease
Onapgo vs Neupro
Side-by-side clinical, coverage, and cost comparison for parkinson disease.Deep comparison between: Onapgo vs Neupro 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 signalsNeupro has a higher rate of injection site reactions vs Onapgo based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Neupro but not Onapgo, including UnitedHealthcare
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Category
Onapgo
Neupro
At A Glance
SC injection
Daily continuous infusion
Non-ergoline dopamine agonist
Transdermal patch
Daily
Dopamine agonist
Indications
- Parkinson Disease
- Parkinson Disease
- Restless Legs Syndrome
Dosing
Parkinson Disease Initial continuous dosage 1 mg/hr SC infusion over the waking day (up to 16 hours), titrated in 0.5-1 mg/hr increments up to 6 mg/hr; extra doses of 0.5-2 mg up to 3 times/day as needed; maximum total daily dosage 98 mg.
Parkinson Disease Early-stage: start 2 mg/24 hours, increase by 2 mg/24 hours weekly, max 6 mg/24 hours; advanced-stage: start 4 mg/24 hours, increase by 2 mg/24 hours weekly, max 8 mg/24 hours; applied transdermally once daily.
Restless Legs Syndrome Start 1 mg/24 hours, increase by 1 mg/24 hours weekly as needed, max 3 mg/24 hours; applied transdermally once daily.
Contraindications
- Concomitant use of 5HT3 antagonists, including antiemetics (e.g., ondansetron, granisetron, dolasetron, palonosetron) and alosetron
- Hypersensitivity or allergic reaction to apomorphine or any excipient of ONAPGO, including sulfite (sodium metabisulfite)
- Hypersensitivity to rotigotine or any component of the transdermal system
Adverse Reactions
Most common (>=10%) Infusion site nodule, nausea, somnolence, infusion site erythema, dyskinesia, headache, insomnia
Serious Syncope, hypotension, orthostatic hypotension, falls, hallucinations, psychotic-like behavior, hemolytic anemia, impulse control disorders, cardiac events, QTc prolongation, hypersensitivity, fibrotic complications, priapism
Postmarketing Hemolytic anemia
Most common (>=5% above placebo) Application site reactions, nausea, somnolence, dizziness, vomiting, disturbances in initiating and maintaining sleep, peripheral edema, dyskinesia, headache, hyperhidrosis, anorexia, visual disturbance
Serious Sulfite sensitivity, falling asleep during activities of daily living, hallucinations/psychosis, symptomatic hypotension, syncope, impulse control/compulsive behaviors, elevation of blood pressure and heart rate, weight gain and fluid retention, dyskinesia, augmentation and rebound in RLS, hyperpyrexia and confusion, withdrawal symptoms, fibrotic complications
Postmarketing Withdrawal symptoms, dropped head syndrome, rhabdomyolysis
Pharmacology
Non-ergoline dopamine agonist with high binding affinity for the dopamine D4 receptor and moderate affinity for D2, D3, D5, and adrenergic receptors; believed to act via stimulation of post-synaptic dopamine D2-type receptors within the caudate-putamen in the brain.
Rotigotine is a non-ergoline dopamine agonist thought to exert its therapeutic effects by stimulating dopamine receptors within the caudate-putamen in Parkinson's disease and dopamine receptors in Restless Legs Syndrome.
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Most Common Insurance
Anthem BCBS
Onapgo
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
Neupro
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Onapgo
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Neupro
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Onapgo
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (2/3) · Qty limit (3/3)
Neupro
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Onapgo.
No savings programs available for Neupro.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.