| Thyroid carcinoma
Gavreto vs Synthroid
Side-by-side clinical, coverage, and cost comparison for thyroid carcinoma.Deep comparison between: Gavreto vs Synthroid 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 signalsSynthroid has a higher rate of injection site reactions vs Gavreto based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Synthroid but not Gavreto, including UnitedHealthcare
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Category
Gavreto
Synthroid
At A Glance
Oral
Once daily
RET kinase inhibitor
Oral
Daily
Synthetic thyroid hormone (T4)
Indications
- Metastatic Lung Non-Small Cell Carcinoma
- Thyroid carcinoma
- Hypothyroidism
- Thyroid carcinoma
Dosing
Metastatic Lung Non-Small Cell Carcinoma, Thyroid carcinoma 400 mg orally once daily on an empty stomach (no food intake for at least 2 hours before and at least 1 hour after); continue until disease progression or unacceptable toxicity.
Hypothyroidism Once daily oral dose on an empty stomach one-half to one hour before breakfast; full replacement starting dose is 1.6 mcg/kg/day in adults (lower starting dose for patients at cardiac risk or geriatric patients); titrate by 12.5 to 25 mcg increments every 4 to 6 weeks based on serum TSH or free-T4; pediatric dosing starts at 10 to 15 mcg/kg/day in neonates and decreases with age.
Thyroid carcinoma Once daily oral dose; dosage is based on the target level of TSH suppression for the stage and clinical status of well-differentiated thyroid cancer.
Contraindications
—
- Uncorrected adrenal insufficiency
Adverse Reactions
Most common (>=25%) Musculoskeletal pain, constipation, hypertension, diarrhea, fatigue, edema, pyrexia, cough
Serious ILD/Pneumonitis, hypertension, hepatotoxicity, hemorrhagic events, tumor lysis syndrome, impaired wound healing, embryo-fetal toxicity
Most common Fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating, headache, hyperactivity, nervousness, anxiety, irritability, emotional lability, insomnia, tremors, muscle weakness, muscle spasm, palpitations, tachycardia, arrhythmias, increased pulse and blood pressure, dyspnea, diarrhea, vomiting, abdominal cramps, elevated liver function tests, hair loss, flushing, rash, decreased bone mineral density, menstrual irregularities, impaired fertility.
Serious Heart failure, angina, myocardial infarction, cardiac arrest, seizures (rare); in pediatric patients: pseudotumor cerebri, slipped capital femoral epiphysis, craniosynostosis in infants, and premature epiphyseal closure.
Postmarketing Hypersensitivity reactions to inactive ingredients including urticaria, pruritus, skin rash, flushing, angioedema, gastrointestinal symptoms, fever, arthralgia, serum sickness, and wheezing.
Pharmacology
Pralsetinib is a kinase inhibitor of wild-type RET and oncogenic RET fusions and mutations (IC50s <0.5 nM), blocking downstream signaling pathways that drive uncontrolled tumor cell proliferation in RET fusion-positive NSCLC and thyroid cancer.
Synthetic T4 (levothyroxine) exerts the same physiologic effect as endogenous thyroxine by binding thyroid receptor proteins in the cell nucleus to activate DNA transcription and protein synthesis; approximately 80% of circulating T3, the predominantly active form, is derived from peripheral deiodination of T4.
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Most Common Insurance
Anthem BCBS
Gavreto
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Synthroid
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Gavreto
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (6/8)
Synthroid
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Gavreto
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Synthroid
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Non-Small Cell Lung Cancer (NSCLC)
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Synthroid.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.