| Urothelial Carcinoma
Balversa vs Opdivo
Side-by-side clinical, coverage, and cost comparison for urothelial carcinoma.Deep comparison between: Balversa vs Opdivo 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 signalsOpdivo has a higher rate of injection site reactions vs Balversa based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Opdivo but not Balversa, including UnitedHealthcare
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Category
Balversa
Opdivo
At A Glance
Oral
Once daily
FGFR inhibitor
IV infusion
Every 2 weeks or Every 4 weeks
PD-1 blocking antibody
Indications
- Urothelial Carcinoma
- melanoma
- Non-Small Cell Lung Carcinoma
- Malignant Pleural Mesothelioma
- Renal Cell Carcinoma
- Hodgkin Disease
- Squamous cell carcinoma of the head and neck
- Urothelial Carcinoma
- Colorectal Carcinoma
- Liver carcinoma
- Squamous cell carcinoma of esophagus
- Stomach Carcinoma
- Gastroesophageal junction cancer
- Adenocarcinoma Of Esophagus
Dosing
Urothelial Carcinoma Starting dose 8 mg (two 4 mg tablets) orally once daily; increase to 9 mg (three 3 mg tablets) once daily at 14 to 21 days if serum phosphate level criteria are met and tolerability allows; continue until disease progression or unacceptable toxicity.
Melanoma Adults and pediatric >=40 kg: 240 mg every 2 weeks or 480 mg every 4 weeks; Pediatric <40 kg: 3 mg/kg every 2 weeks or 6 mg/kg every 4 weeks
Non-Small Cell Lung Carcinoma Neoadjuvant: 360 mg every 3 weeks with platinum-doublet chemotherapy for 3-4 cycles; Adjuvant after neoadjuvant: 480 mg every 4 weeks; Metastatic: 360 mg every 3 weeks with ipilimumab 1 mg/kg every 6 weeks; or 360 mg every 3 weeks with ipilimumab 1 mg/kg every 6 weeks and 2 cycles platinum-doublet chemotherapy; or 240 mg every 2 weeks or 480 mg every 4 weeks
Malignant Pleural Mesothelioma 360 mg every 3 weeks with ipilimumab 1 mg/kg every 6 weeks
Renal Cell Carcinoma 3 mg/kg with ipilimumab 1 mg/kg every 3 weeks for 4 doses, then 240 mg every 2 weeks or 480 mg every 4 weeks; or 240 mg every 2 weeks or 480 mg every 4 weeks with cabozantinib 40 mg daily orally; or 240 mg every 2 weeks or 480 mg every 4 weeks
Hodgkin Disease Previously untreated: Adults and pediatric >=40 kg: 240 mg with AVD every 2 weeks for 6 cycles; Pediatric <40 kg: 3 mg/kg with AVD every 2 weeks for 6 cycles; Relapsed or refractory: 240 mg every 2 weeks or 480 mg every 4 weeks
Squamous cell carcinoma of the head and neck 240 mg every 2 weeks or 480 mg every 4 weeks
Urothelial Carcinoma Adjuvant: 240 mg every 2 weeks or 480 mg every 4 weeks; First-line: 360 mg every 3 weeks with cisplatin and gemcitabine for up to 6 cycles, then 240 mg every 2 weeks or 480 mg every 4 weeks; Previously treated: 240 mg every 2 weeks or 480 mg every 4 weeks
Colorectal Carcinoma Adults and pediatric >=40 kg: 240 mg with ipilimumab 1 mg/kg every 3 weeks for maximum 4 doses, then 240 mg every 2 weeks or 480 mg every 4 weeks; Pediatric <40 kg: 3 mg/kg with ipilimumab 1 mg/kg every 3 weeks for maximum 4 doses, then 3 mg/kg every 2 weeks or 6 mg/kg every 4 weeks
Liver carcinoma 1 mg/kg with ipilimumab 3 mg/kg every 3 weeks for 4 doses, then 240 mg every 2 weeks or 480 mg every 4 weeks
Squamous cell carcinoma of esophagus Adjuvant resected: 240 mg every 2 weeks or 480 mg every 4 weeks for 1 year; First-line with chemotherapy: 240 mg every 2 weeks or 480 mg every 4 weeks with fluoropyrimidine- and platinum-containing chemotherapy; First-line with ipilimumab: 3 mg/kg every 2 weeks or 360 mg every 3 weeks with ipilimumab 1 mg/kg every 6 weeks; Previously treated: 240 mg every 2 weeks or 480 mg every 4 weeks
Stomach Carcinoma 360 mg every 3 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 3 weeks or 240 mg every 2 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 2 weeks
Gastroesophageal junction cancer 360 mg every 3 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 3 weeks or 240 mg every 2 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 2 weeks
Adenocarcinoma Of Esophagus 360 mg every 3 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 3 weeks or 240 mg every 2 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 2 weeks
Contraindications
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Adverse Reactions
Most common (>20%) Increased phosphate, nail disorders, stomatitis, diarrhea, increased creatinine, increased alkaline phosphatase, increased alanine aminotransferase, decreased hemoglobin, decreased sodium, increased aspartate aminotransferase, fatigue, dry mouth, dry skin, decreased phosphate, decreased appetite, dysgeusia, constipation, increased calcium, dry eye, palmar-plantar erythrodysesthesia syndrome, increased potassium, alopecia, central serous retinopathy
Serious Urinary tract infection, hematuria, hyponatremia, acute kidney injury, central serous retinopathy, general physical health deterioration
Most common (>=20%) fatigue, musculoskeletal pain, rash, diarrhea, pruritus, nausea, decreased appetite, cough, dyspnea, constipation, upper respiratory tract infection
Serious pneumonitis, colitis, hepatitis, endocrinopathies, nephritis, dermatologic reactions, myocarditis, neurological toxicities, infusion-related reactions
Pharmacology
Erdafitinib is a kinase inhibitor that binds to and inhibits enzymatic activity of FGFR1, FGFR2, FGFR3, and FGFR4; inhibition of FGFR phosphorylation and signaling decreases cell viability in tumor cell lines expressing FGFR genetic alterations, including point mutations, amplifications, and fusions.
Nivolumab is a PD-1 blocking antibody that binds to the PD-1 receptor and blocks its interaction with PD-L1 and PD-L2, releasing PD-1 pathway-mediated inhibition of the immune response, including the anti-tumor immune response.
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Most Common Insurance
Anthem BCBS
Balversa
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Opdivo
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (4/12) · Qty limit (0/12)
UnitedHealthcare
Balversa
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (4/8) · Qty limit (2/8)
Opdivo
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Balversa
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Opdivo
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$5/fillfill
J&J withMe Savings Program: BalversaCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Opdivo.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.