| Pulmonary arterial hypertension
Opsumit vs Uptravi
Side-by-side clinical, coverage, and cost comparison for pulmonary arterial hypertension.Deep comparison between: Opsumit vs Uptravi 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 signalsUptravi has a higher rate of injection site reactions vs Opsumit based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Uptravi but not Opsumit, including UnitedHealthcare
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Category
Opsumit
Uptravi
At A Glance
Oral
Daily
Endothelin receptor antagonist
Oral / IV infusion
Twice daily
Prostacyclin receptor agonist
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 Starting dose 200 mcg orally twice daily; increase by 200 mcg twice daily at weekly intervals to the highest tolerated dose up to 1600 mcg twice daily. For moderate hepatic impairment (Child-Pugh class B), start at 200 mcg once daily and increase by 200 mcg once daily at weekly intervals. When co-administered with a moderate CYP2C8 inhibitor, reduce dosing to once daily. IV infusion (80-minute) is dosed twice daily at the corresponding tablet dose for patients temporarily unable to take oral therapy.
Contraindications
- Pregnancy (may cause fetal harm)
- History of hypersensitivity reaction to macitentan or any component of the product
- Hypersensitivity to selexipag or any excipient
- Concomitant use of strong CYP2C8 inhibitors (e.g., gemfibrozil)
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%) Headache, diarrhea, nausea, vomiting, jaw pain, myalgia, pain in extremity, flushing, arthralgia, rash, anemia, decreased appetite
Postmarketing Symptomatic hypotension
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.
Selexipag is a prostacyclin receptor (IP receptor) agonist structurally distinct from prostacyclin; it is hydrolyzed by carboxylesterase 1 to an active metabolite approximately 37-fold more potent, selective for the IP receptor over other prostanoid receptors (EP1-4, DP, FP, and TP).
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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)
Uptravi
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (10/12)
UnitedHealthcare
Opsumit
- Covered on 4 commercial plans
- PA (7/8) · Step Therapy (0/8) · Qty limit (5/8)
Uptravi
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (1/8)
Humana
Opsumit
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Uptravi
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
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/fillfill
Janssen CarePath Oral PAH Savings Program: UptraviCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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OpsumitView full Opsumit profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.