| Thyroid carcinoma
Gavreto vs Tirosint
Side-by-side clinical, coverage, and cost comparison for thyroid carcinoma.Deep comparison between: Gavreto vs Tirosint 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 signalsTirosint has a higher rate of injection site reactions vs Gavreto based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Tirosint but not Gavreto, including UnitedHealthcare
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Category
Gavreto
Tirosint
At A Glance
Oral
Once daily
RET kinase inhibitor
Oral
Daily
Thyroid hormone replacement
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 Average full replacement dose approximately 1.6 mcg/kg/day orally once daily on an empty stomach, one-half to one hour before breakfast; dose individualized by age, body weight, cardiovascular status, and clinical response; adjust by 12.5 to 25 mcg increments every 4 to 6 weeks; elderly or cardiovascular patients start at 12.5 to 25 mcg/day.
Thyroid carcinoma TSH generally suppressed to below 0.1 mIU/L; usually requires TIROSINT dose greater than 2 mcg/kg/day; target TSH suppression level may be lower in high-risk tumors.
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, dyspnea, diarrhea, vomiting, abdominal cramps, elevated liver function tests, hair loss, flushing, rash, decreased bone mineral density, menstrual irregularities, impaired fertility
Serious Arrhythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest, seizures (rare), pseudotumor cerebri and slipped capital femoral epiphysis in children, craniosynostosis in infants, premature closure of epiphyses in children
Hypersensitivity Urticaria, pruritus, skin rash, flushing, angioedema, abdominal pain, nausea, vomiting, diarrhea, fever, arthralgia, serum sickness, wheezing (reactions to inactive ingredients)
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 levothyroxine (T4) that exerts the same physiologic effect as endogenous T4; thyroid hormones control DNA transcription and protein synthesis by diffusing into the cell nucleus and binding thyroid receptor proteins attached to DNA, with physiological actions produced predominantly by T3, approximately 80% of which is derived from T4 by peripheral deiodination.
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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)
Tirosint
- Covered on 5 commercial plans
- PA (3/12) · 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)
Tirosint
- 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)
Tirosint
- 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 Tirosint.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.