TABLE 2.
Therapeutic Alternatives for the 10 Selected Medicare Drugs by FDA-Approved Indication
| Drug | FDA-approved indication | Therapeutic alternative |
|---|---|---|
| Eliquis (apixaban) | Treatment and prevention of VTEs | Dabigatran Xarelto (rivaroxaban) Warfarin |
| Nonvalvular atrial fibrillation | ||
| Treatment and prevention of stroke | ||
| Xarelto (rivaroxaban) | Treatment and prevention of VTEs | Pradaxa (dabigatran) Eliquis (apixaban) Warfarin |
| Nonvalvular atrial fibrillation | ||
| Treatment and prevention of stroke | ||
| Reducing the risk of CV events in CAD/PAD | ||
| Jardiance (empagliflozin) | Reduce the risk of CV death and hospitalizations for patients with HF | Invokana (canagliflozin) Farxiga (dapagliflozin) Steglatro (ertugliflozin) |
| Reduce the risk of CV death in patients with T2D and established CVD | ||
| Adjunct therapy to diet and exercise to improve glycemic control in patients with T2D | ||
| Farxiga (dapagliflozin) | Reduce the risk of CV death and hospitalizations for patients with HFrRF | Invokana (canagliflozin) Jardiance (empagliflozin) Steglatro (ertugliflozin) |
| Reduce the risk of CV death in patients with T2D and established CVD or multiple cardiovascular risk factors | ||
| Adjunct therapy to diet and exercise to improve glycemic control in patients with T2D | ||
| Reduce the risk of sustained eGFR decline, ESRD, CV death and hospitalization for HF in adults with CKD at risk of progression | ||
| Januvia (sitagliptin) | Adjunct to diet and exercise to improve glycemic control in patients with T2D | Onglyza (saxagliptin) Tradjenta (linagliptin) Nesina (alogliptin) Farxiga (dapagliflozin) Invokana (canagliflozin) Jardiance (empagliflozin) Steglatro (ertugliflozin) Bydureon (exenatide) Adlyxin (lixisenatide) Trulicity (dulaglutide) Victoza (liraglutide) Ozempic (semaglutide) |
| Fiasp & Novolog (insulin aspart) | Glycemic control for diabetes mellitus | Humalog (insulin lispro) Admelog (insulin lispro) |
| Entresto (sacubitril/valsartan) | Reduce the risk of CV death and hospitalization for HF in adults with CHF | Captopril Enalapril Lisinopril Ramipril Candesartan Losartan Valsartan |
| Treatment of symptomatic HF with systemic left ventricular dysfunction | ||
| Enbrel (etanercept) | Rheumatoid arthritis | Adalimumab Cimzia (certolizumab) Infliximab Simponi (golimumab) |
| Juvenile idiopathic arthritis | ||
| Ankylosing spondylitis | ||
| Plaque psoriasis | ||
| Psoriatic arthritis | ||
| Stelara (ustekinumab) | Moderate to severe plaque psoriasis | Skyrizi (risankizumab) |
| Active psoriatic arthritis | ||
| Moderate to severe Crohn’s disease | ||
| Moderate to severe ulcerative colitis | ||
| Imbruvica (ibrutinib) | Chronic lymphocytic leukemia/small lymphocytic lymphoma | Calquence (acalabrutinib) Brukinsa (zanubrutinib) |
| Waldenstrom macroglobulinemia | ||
| Chronic graft-vs-host disease |
ACE = angiotensin-converting enzyme; ARB = angiotensin receptor blocker; CAD = coronary artery disease; CHF = chronic heart failure; CKD = chronic kidney disease; CV = cardiovascular; CVD = cardiovascular disease; FDA = US Food and Drug Administration; HF = heart failure; HFrRF = heart failure with reduced ejection fraction; VTE = venous thromboembolism; PAD = peripheral artery disease; T2D = type 2 diabetes.