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Is Dupixent covered by insurance? | How much does Dupixent cost without insurance? | How to get Dupixent without insurance
Dupixent (dupilumab) is a brand-name prescription drug used to treat certain types of contact allergies including severe atopic dermatitis, severe asthma, and chronic rhinosinusitis with nasal polyps. Dupilumab, the active ingredient in Dupixent, is a monoclonal antibody that prevents contact allergy symptoms by blocking the allergic immune response. The dosage will depend on the condition being treated and, in some cases, body weight. Dupixent is administered as an injection beneath the skin every two to four weeks using either single-dose prefilled syringes or autoinjector pens. Dupixent is an extremely expensive drug and may not be affordable without insurance.
RELATED: Dupixent side effects
Is Dupixent covered by insurance?
Dupixent is covered by some insurance plans including Medicare and Medicaid. However, due to the cost, most health plans may require prior authorization, a letter of medical necessity, or step therapy. Patients should not be surprised if the insurance company initially refuses to cover the prescription.
Even with insurance, the out-of-pocket expense could be very high depending on the plan’s copay and deductible. About 68% of patients with commercial insurance and 71% of Medicare Part D consumers pay less than $100 each month, according to Sanofi, the manufacturer. Sanofi offers a Dupixent MyWay copay card to some patients with commercial insurance, but it has eligibility requirements and a yearly maximum of $13,000.
How much does Dupixent cost without insurance?
The average monthly retail price of Dupixent is $4,910 per 2, 2 mL of 300 mg/2 mL prefilled syringes. Depending on the dose, uninsured patients can expect to pay up to $59,000 per year for Dupixent treatment.
Dupixent is the only monoclonal antibody approved by the FDA to treat atopic dermatitis and eczema. For asthma or nasal polyposis, however, there are other monoclonal antibodies that work like Dupixent. Unfortunately, they are all brand-name injections that are also expensive, and some may only be available at specialty pharmacies. Additional fees, such as infusion costs, may also be involved.
For patients who can’t afford Dupixent, there are less expensive alternatives. For asthma, these include high-dose corticosteroid inhalants, long-acting beta-agonists (LABAs), and oral leukotriene modifiers. For atopic dermatitis, alternatives include oral and topical corticosteroids as well as non-pharmaceutical therapies such as light therapy or biofeedback.
There are no over-the-counter drugs or supplements that can effectively substitute for prescription asthma, nasal polyps, or atopic dermatitis treatments.
Compare Dupixent prices to related drugs |
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|---|---|---|---|
| Drug name | Price without insurance of brand-name drug | SingleCare price | Savings options |
| Dupixent (dupilumab) | $4,910 per 2, 2 mL of 300 mg/2 mL prefilled syringes | $3,310 per 2, 2 mL of 300 mg/2 mL prefilled syringes of brand-name Dupixent | See updated prices |
| Clobex (clobetasol propionate) | $1,075 per 1, 118 mL of 0.05% shampoo | $48 per 1, 118 mL of 0.05% shampoo of generic Clobex | See updated prices |
| Vanos (fluocinonide) | $3,710 per 1, 120 gm of 0.1% cream | $3 per 1, 120 gm of 0.1% cream of generic Vanos | See updated prices |
| Protopic (tacrolimus) | $359 per 1, 30 gm of 0.1% ointment | $32 per 1, 30 gm of 0.1% ointment of generic Protopic | See updated prices |
| Elidel (pimecrolimus) | $398 per 1, 30 gm of 1% cream | $54 per 1, 30 gm of 1% cream of generic Elidel | See updated prices |
| Eucrisa (crisaborole) | $900 per 1, 60 gm of 2% ointment | $487 per 1, 60 gm of 2% ointment of brand-name Eucrisa | See updated prices |
| Nucala (mepolizumab) | $4,305 per 1, 1 mL of 100 mg/mL autoinjector | $3,305 per 1, 1 mL of 100 mg/mL syringe of brand-name Nucala | See updated prices |
| Fasenra (benralizumab) | $6,458 per 1, 1 mL of 30 mg/mL prefilled syringe | $5,314 per 1, 1 mL of 30 mg/mL prefilled syringe of brand-name Fasenra | See updated prices |
| Xolair (omalizumab) | $3,791 per 2, 1 mL of 150 mg/mL prefilled syringes | $2,381 per 2, 1 mL of 150 mg/mL prefilled syringes of brand-name Xolair | See updated prices |
Prescription drug prices often change. These are the most accurate medication prices at the time of publishing. The listed price without insurance references the price of brand-name drugs. The listed SingleCare price references the price of generic drugs if available. Click the link under “Savings options” to see updated drug prices.
How to get Dupixent without insurance
Very few people can pay for a prescription drug like Dupixent without insurance. Even those with insurance may find themselves paying several thousand dollars a month for their prescription. Reducing that cost through whatever means is the only way most people will be able to take the drug. Here are a few options.
1. Use a SingleCare discount card
The most foolproof way to reduce out-of-pocket costs for Dupixent is a free coupon from SingleCare. A SingleCare savings card could reduce the cost of Dupixent without insurance as much as $1,600 per month. You can also use SingleCare on Dupixent alternatives to save even more money.
2. Ask the prescriber for a free sample
Your healthcare provider may have enough free samples to cover one month of treatment. If not, request them from the manufacturer. This will give you a chance to try the medicine and buy extra time to find ways to pay for the prescription in the following months.
3. Ask the prescriber about patient assistance
Uninsured patients can apply to the manufacturer’s patient assistance program, the Dupixent MyWay program. Eligible patients may receive Dupixent for free or at a reduced cost. The manufacturer can provide additional information and enrollment forms.
4. Switch medications
It’s unlikely that a healthcare professional would prescribe an extremely high-priced medication like Dupixent if other drugs hadn’t already been tried. Still, get medical advice and prescribing information from a healthcare professional about any Dupixent alternative that hasn’t been tried yet.
5. Get health insurance
Even a low-deductible plan will be less expensive than the cost of Dupixent. First, make sure the health plan will cover your Dupixent prescription. Second, research the plan’s rules for getting a Dupixent prescription accepted. Insurance providers may require step therapy or prior authorization before covering Dupixent. Finally, compare the plan’s premium, deductible, and copay to the price of Dupixent without insurance. Don’t just buy any plan. Make sure you’re investing in a plan that will reduce overall healthcare costs.
6. Find out if you qualify for Medicaid
If the combined cost of health insurance premiums and the out-of-pocket costs are still too high, see if you qualify for Medicaid. Consult your state’s Medicaid website for eligibility requirements before applying.
7. Apply to Medicare’s Extra Help program
If you’re eligible for Medicare, you may also qualify for Extra Help. Extra Help is a low-income subsidy that helps reduce Medicare Part D costs, including copays for prescriptions like Dupixent, and eliminates late enrollment fees.
8. Look for the lowest price
Even the cheapest medications like aspirin can cost more at one pharmacy than another. For drugs that cost thousands of dollars, finding the lowest price can save hundreds of dollars, so it pays to compare prices.
