| Pulmonary arterial hypertension
Opsumit vs Veletri
Side-by-side clinical, coverage, and cost comparison for pulmonary arterial hypertension.Deep comparison between: Opsumit vs Veletri 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 signalsVeletri has a higher rate of injection site reactions vs Opsumit based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Veletri but not Opsumit, including UnitedHealthcare
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Category
Opsumit
Veletri
At A Glance
Oral
Daily
Endothelin receptor antagonist
IV infusion
Continuous infusion
Prostacyclin
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 continuous IV infusion at 2 ng/kg/min via central venous catheter; increase in increments of 2 ng/kg/min every 15 minutes or longer until tolerance limit established or further increases are not clinically warranted; adjust maintenance dose by 1- to 2-ng/kg/min increments at intervals of at least 15 minutes based on symptom persistence or adverse events.
Contraindications
- Pregnancy (may cause fetal harm)
- History of hypersensitivity reaction to macitentan or any component of the product
- Chronic use in patients with congestive heart failure due to severe left ventricular systolic dysfunction
- Pulmonary edema developing during dose initiation (associated with pulmonary veno-occlusive disease)
- Known hypersensitivity to epoprostenol or structurally related compounds
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 (dose initiation and escalation) Flushing, headache, nausea, vomiting, hypotension, anxiety, chest pain, dizziness, bradycardia, abdominal pain, musculoskeletal pain, dyspnea, tachycardia
Most common (chronic dosing) Headache, jaw pain, flushing, diarrhea, nausea, vomiting, flu-like symptoms, anxiety
Postmarketing Anemia, hypersplenism, pancytopenia, splenomegaly, high output cardiac failure, hyperthyroidism
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.
Epoprostenol is a naturally occurring prostacyclin (metabolite of arachidonic acid) that produces direct vasodilation of pulmonary and systemic arterial vascular beds, reducing right- and left-ventricular afterload and increasing cardiac output, and inhibits platelet aggregation.
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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)
Veletri
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Opsumit
- Covered on 4 commercial plans
- PA (7/8) · Step Therapy (0/8) · Qty limit (5/8)
Veletri
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Opsumit
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Veletri
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$5/fillfill
Janssen CarePath Oral PAH Savings Program: OpsumitCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAssistance Fund: MPS II- Hunter Syndrome
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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OpsumitView full Opsumit profile
VeletriView full Veletri profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.