| Rheumatoid Arthritis
Actemra vs Remicade
Side-by-side clinical, coverage, and cost comparison for rheumatoid arthritis.Deep comparison between: Actemra vs Remicade 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 signalsRemicade has a higher rate of injection site reactions vs Actemra based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Remicade but not Actemra, including UnitedHealthcare
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Category
Actemra
Remicade
At A Glance
IV infusion or SC injection
Every 4 weeks (IV) or Every week to Every other week (SC)
IL-6 receptor antagonist
IV infusion
Every 8 weeks
TNF-alpha inhibitor
Indications
- Rheumatoid Arthritis
- Giant Cell Arteritis
- Lung disease with systemic sclerosis
- Juvenile polyarthritis
- Systemic onset juvenile chronic arthritis
- Cytokine Release Syndrome
- COVID-19 Virus Disease
- Crohn Disease
- Ulcerative Colitis
- Rheumatoid Arthritis
- Arthritis, Psoriatic
- Psoriasis vulgaris
Dosing
Rheumatoid Arthritis IV: 4 mg/kg every 4 weeks, increase to 8 mg/kg every 4 weeks based on response; SC: 162 mg every other week (for <100 kg) or every week (for >=100 kg), increase to every week based on response.
Giant Cell Arteritis IV: 6 mg/kg every 4 weeks with tapering glucocorticoids; SC: 162 mg every week with tapering glucocorticoids (may use every other week based on clinical considerations).
Systemic Sclerosis-Associated Interstitial Lung Disease SC: 162 mg every week.
Polyarticular Juvenile Idiopathic Arthritis IV: 10 mg/kg every 4 weeks (<30 kg) or 8 mg/kg every 4 weeks (>=30 kg); SC: 162 mg every 3 weeks (<30 kg) or every 2 weeks (>=30 kg).
Systemic Juvenile Idiopathic Arthritis IV: 12 mg/kg every 2 weeks (<30 kg) or 8 mg/kg every 2 weeks (>=30 kg); SC: 162 mg every 2 weeks (<30 kg) or every week (>=30 kg).
Cytokine Release Syndrome IV: 12 mg/kg (<30 kg) or 8 mg/kg (>=30 kg) as single dose, alone or with corticosteroids; up to 3 additional doses at least 8 hours apart if no improvement.
COVID-19 IV: 12 mg/kg (<30 kg) or 8 mg/kg (>=30 kg) as single 60-minute infusion; one additional dose at least 8 hours later if clinical signs worsen or do not improve.
Crohn Disease, Ulcerative Colitis 5 mg/kg IV induction at 0, 2, and 6 weeks, then 5 mg/kg every 8 weeks (adults and pediatric patients >= 6 years).
Rheumatoid Arthritis 3 mg/kg IV induction at 0, 2, and 6 weeks, then 3 mg/kg every 8 weeks in combination with methotrexate; dose may be increased up to 10 mg/kg every 8 weeks or every 4 weeks for incomplete responders.
Arthritis, Psoriatic, Psoriasis vulgaris 5 mg/kg IV induction at 0, 2, and 6 weeks, then 5 mg/kg every 8 weeks.
Contraindications
- Known hypersensitivity to tocilizumab
- Doses >5 mg/kg in patients with moderate or severe heart failure
- Previous severe hypersensitivity reaction to infliximab, any inactive ingredient of REMICADE, or any murine proteins (including anaphylaxis, hypotension, and serum sickness)
Adverse Reactions
Most common (>=5%) Upper respiratory tract infections, nasopharyngitis, headache, hypertension, increased ALT, injection site reactions (SC only).
Serious Serious infections (pneumonia, urinary tract infection, cellulitis, herpes zoster, gastroenteritis, diverticulitis, sepsis, bacterial arthritis), gastrointestinal perforations, hypersensitivity reactions including anaphylaxis.
Postmarketing Fatal anaphylaxis, Stevens-Johnson Syndrome, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), pancreatitis, drug-induced liver injury, hepatitis, hepatic failure, jaundice, hypofibrinogenemia.
Most common (>10%) Infections (upper respiratory tract infection, sinusitis, pharyngitis), infusion-related reactions, headache, abdominal pain.
Serious Pneumonia, cellulitis, abscess, sepsis, bacterial infection, hepatotoxicity, acute liver failure, malignancies (including lymphoma), pancytopenia, thrombocytopenia, leukopenia.
Postmarketing Neutropenia, agranulocytosis, interstitial lung disease, Stevens-Johnson Syndrome, toxic epidermal necrolysis, peripheral demyelinating disorders, anaphylactic shock, cerebrovascular accidents, myocardial ischemia/infarction.
Pharmacology
Tocilizumab is a humanized IgG1 kappa monoclonal antibody that binds to soluble and membrane-bound IL-6 receptors, inhibiting IL-6-mediated signaling involved in inflammatory and immune processes.
TNF-alpha antagonist; infliximab is a chimeric IgG1 monoclonal antibody that neutralizes the biological activity of TNF-alpha by binding with high affinity to both soluble and transmembrane forms of TNF-alpha and inhibiting its binding to receptors, thereby reducing inflammation in RA, CD, UC, AS, PsA, and Ps.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Actemra
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
Remicade
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (12/12) · Qty limit (0/12)
UnitedHealthcare
Actemra
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (4/8) · Qty limit (0/8)
Remicade
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Actemra
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Remicade
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Actemra.
No savings programs available for Remicade.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.