| Pulmonary arterial hypertension
Opsumit vs Letairis
Side-by-side clinical, coverage, and cost comparison for pulmonary arterial hypertension.Deep comparison between: Opsumit vs Letairis 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 signalsLetairis has a higher rate of injection site reactions vs Opsumit based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Letairis but not Opsumit, including UnitedHealthcare
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Category
Opsumit
Letairis
At A Glance
Oral
Daily
Endothelin receptor antagonist
Oral
Daily
Endothelin receptor antagonist
Indications
- Pulmonary arterial hypertension
- Pulmonary arterial hypertension
Dosing
Pulmonary arterial hypertension 10 mg once daily orally; doses higher than 10 mg once daily have not been studied in patients with PAH and are not recommended.
Pulmonary arterial hypertension Initiate at 5 mg once daily, with or without tadalafil 20 mg once daily; titrate at 4-week intervals as needed and tolerated to Letairis 10 mg or tadalafil 40 mg; do not split, crush, or chew tablets.
Contraindications
- Pregnancy (may cause fetal harm)
- History of hypersensitivity reaction to macitentan or any component of the product
- Pregnancy (Letairis may cause fetal harm when administered to a pregnant female)
- Idiopathic Pulmonary Fibrosis, including IPF patients with pulmonary hypertension (WHO Group 3)
Adverse Reactions
Most common (>=3%) anemia, nasopharyngitis/pharyngitis, bronchitis, headache, influenza, urinary tract infection
Serious embryo-fetal toxicity, hepatotoxicity, fluid retention, decrease in hemoglobin
Postmarketing hypersensitivity reactions (angioedema, pruritus, rash), flushing, nasal congestion, liver aminotransferase elevations and liver injury, edema/fluid retention, symptomatic hypotension
Most common (>3% placebo-adjusted) Peripheral edema, nasal congestion, sinusitis, flushing
Postmarketing Anemia requiring transfusion, heart failure (associated with fluid retention), symptomatic hypotension, hypersensitivity (angioedema, rash), liver aminotransferase elevations (ALT, AST)
Pharmacology
Macitentan is an endothelin receptor antagonist that inhibits binding of ET-1 to both ETA and ETB receptors with high affinity and sustained occupancy in human pulmonary arterial smooth muscle cells; an active metabolite contributes approximately 40% of total pharmacologic activity.
Ambrisentan is a high-affinity, selective ETA receptor antagonist that blocks the vasoconstriction and cell proliferation mediated by endothelin-1 (ET-1) in pulmonary vasculature, where ET-1 concentrations and mRNA are markedly elevated in PAH patients.
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Most Common Insurance
Anthem BCBS
Opsumit
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (12/12)
Letairis
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (11/12)
UnitedHealthcare
Opsumit
- Covered on 4 commercial plans
- PA (7/8) · Step Therapy (0/8) · Qty limit (5/8)
Letairis
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (8/8)
Humana
Opsumit
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Letairis
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$5/fillfill
Janssen CarePath Oral PAH Savings Program: OpsumitCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
$5/momo
Letairis Co-Pay Coupon ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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OpsumitView full Opsumit profile
LetairisView full Letairis profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.