Alternatives to NovoEight If You Can't Fill Your Prescription

If you have hemophilia A and your NovoEight (turoctocog alfa) prescription can't be filled — whether because of an insurance problem, a specialty pharmacy delay, or a coverage switch — knowing your alternatives is critical. Hemophilia A requires active, ongoing management, and interruptions in factor therapy can lead to dangerous bleeding episodes.

This guide covers the most important FDA-approved alternatives to NovoEight, organized by category, so you can have an informed conversation with your hematologist.

Important: Always Consult Your Hematologist Before Switching

Never switch your hemophilia A treatment on your own. Factor replacement therapy is highly individualized — your dosing regimen, half-life considerations, inhibitor history, and personal treatment goals all factor into which product is right for you. The options below are potential alternatives to discuss with your care team, not a self-substitution guide.

Standard Half-Life Factor VIII Alternatives

These products work similarly to NovoEight as standard half-life (SHL) recombinant factor VIII replacements, typically requiring dosing 2-3 times per week for prophylaxis.

Advate (octocog alfa): One of the most widely prescribed recombinant FVIII products, manufactured by Takeda. Approved for adults and children with hemophilia A. Generally widely available through most specialty pharmacy networks.

Kovaltry (octocog alfa): A recombinant FVIII manufactured by Bayer. Approved for adults and children with hemophilia A. Offers twice-weekly or every-other-day dosing options.

Nuwiq (simoctocog alfa): A human-cell-line derived recombinant FVIII from Octapharma. Notably produced in a human cell line rather than hamster cells — an advantage for patients with hamster protein allergies.

Afstyla (lonoctocog alfa): A single-chain FVIII molecule made by CSL Behring. Unique molecular structure may offer more consistent dosing for some patients.

Extended Half-Life Factor VIII Alternatives

Extended half-life (EHL) products last longer in the bloodstream, allowing less frequent dosing. They may be a good option if you're considering switching and want fewer injections.

Esperoct (turoctocog alfa pegol): The next-generation version of NovoEight, also made by Novo Nordisk. Esperoct uses the same turoctocog alfa molecule with added PEGylation technology to extend half-life. Allows dosing every 4 days instead of every other day, reducing infusion burden by up to 50%.

Altuviiio (efanesoctocog alfa): The newest extended half-life FVIII, approved in 2023 for adults and children 12+. Offers once-weekly dosing with among the longest half-life of any factor VIII product. Made by Sanofi.

Jivi (damoctocog alfa pegol): A PEGylated extended half-life FVIII from Bayer, approved for previously treated patients aged 7 and older. Allows every 5-day or once-weekly dosing.

Eloctate (efmoroctocog alfa): An Fc-fusion FVIII from Sanofi that extends half-life by binding to natural recycling receptors. Approved for adults and children.

Non-Factor Therapies: A Different Approach

Non-factor therapies don't replace missing FVIII directly — instead, they work through alternative pathways to restore hemostasis. These are especially relevant for patients who have developed factor VIII inhibitors, making traditional factor products ineffective.

Hemlibra (emicizumab): A bispecific antibody given by subcutaneous injection (under the skin) that mimics the function of factor VIII. Hemlibra is approved for adults and children with hemophilia A with or without factor VIII inhibitors. It can be given weekly, every 2 weeks, or once monthly. Currently one of the most widely prescribed hemophilia therapies.

Hympavzi (marstacimab): Approved in 2024 for hemophilia A or B without inhibitors in patients aged 12+. Subcutaneous once-weekly injection. An alternative for those seeking to avoid IV infusions.

What to Ask Your Hematologist When Considering a Switch

What is my current annualized bleeding rate on NovoEight?

Do I have inhibitors to factor VIII? (This significantly affects which alternatives are safe)

Would an extended half-life product improve my outcomes with fewer infusions?

Does my insurance cover the alternative option, and what would my out-of-pocket cost be?

If you'd prefer to stay on NovoEight and want help locating it, read How to Find NovoEight In Stock Near You for practical strategies.

Need help locating any of these alternatives near you? medfinder calls pharmacies on your behalf to find which ones have your medication in stock.