{"id":628502,"date":"2024-06-06T19:23:56","date_gmt":"2024-06-06T23:23:56","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=628502"},"modified":"2024-10-25T09:55:41","modified_gmt":"2024-10-25T13:55:41","slug":"how-much-does-cyltezo-cost-without-insurance","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/how-much-does-cyltezo-cost-without-insurance\/","title":{"rendered":"How much does Cyltezo cost without insurance?"},"content":{"rendered":"

Cyltezo (adalimumab-adbm) is a prescription injectable drug that reduces inflammation that’s caused by a substance called <\/span>tumor necrosis factor (TNF)<\/span><\/a>. It’s used to treat autoimmune conditions like rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and <\/span>inflammatory bowel disease<\/span><\/a>. <\/span><\/p>\n

It’s a biosimilar of the drug Humira, which is a biologic drug <\/span>approved by the Food and Drug Administration (FDA)<\/span><\/a> for use in patients with many of the same autoimmune diseases as Cyltezo. According to rheumatologist <\/span>Astrud Lorraine Leyva, MD<\/span><\/a>, of Houston Methodist Rheumatology Associates, biologic medications are made with living cells and produced using advanced technology. Biosimilars are biologics that are a close—but not identical—copy of an earlier biologic. Cyltezo was found to be interchangeable with Humira in a study that switched patients back and forth between the two drugs.<\/span><\/p>\n

Both <\/span>biologics and biosimilars are expensive<\/span><\/a>. Without insurance, Cyltezo could cost more than $7,500 for a one-month dose. Here’s what to know about the price of Cyltezo, insurance coverage for the drug, and how to save money on your prescription.   <\/span><\/p>\n

How much does Cyltezo cost per month?<\/span><\/h2>\n

The average retail price of a two-pen injector kit of Cyltezo (a one-month supply) is around $7,580. However, most people with insurance coverage are able to get Cyltezo for much less, and drug coupons can also significantly lower the cost of the drug.<\/span><\/p>\n

Factors influencing the cost of Cyltezo<\/span><\/h2>\n

“There are several factors that affect the cost of Cyltezo,” said <\/span>Razan Hendi, Pharm.D.<\/span><\/a>, consultant pharmacist at DeltaCare Rx, including:<\/span><\/p>\n

    \n
  1. Insurance coverage –<\/b> Copays and deductible requirements can significantly impact your out-of-pocket cost. Plus, different insurance plans have varying levels of coverage and put Cyltezo in different insurance tiers, which can also affect the overall cost.<\/span><\/li>\n
  2. Drug formulary<\/b> – An insurance plan’s <\/span>formulary<\/span><\/a> consists of the generic and brand-name drugs it will cover when prescribed. A drug on your formulary may be preferred or nonpreferred. If Cyltezo is a preferred drug under your plan’s formulary, it will typically be less expensive out of pocket than if it’s nonpreferred. <\/span><\/li>\n
  3. Dosage and quantity –<\/b> Higher-strength dosages and larger quantities of Cyltezo can raise your out-of-pocket cost.  <\/span><\/li>\n
  4. Your pharmacy of choice<\/b> – Your local brick-and-mortar pharmacy may be convenient, but it could also increase the cost of your Cyltezo prescription compared to an online or mail-order pharmacy.  <\/span><\/li>\n
  5. Access to coupons, discounts, and rebates<\/b> – Many drug manufacturers have patient assistance programs to help patients pay for the cost of their medication, including manufacturer discounts or rebates. With its <\/span>BI Solutions Plus<\/span><\/a> program, Cyltezo is no exception, but its copay savings program has eligibility requirements that must be met. Coupon savings cards can also reduce overall out-of-pocket costs. <\/span><\/li>\n<\/ol>\n

    Is there a generic Cyltezo?<\/span><\/h2>\n

    Although Cyltezo is a biosimilar for the drug Humira and has proven effectiveness and safety, it is not considered a generic of Humira because it does not have exactly the same chemical structure. The structure is close enough however to function the same medically. <\/span><\/p>\n

    RELATED: Cyltezo vs. Humira<\/a><\/strong><\/p>\n

    When prescribed Cyltezo, some people may receive a prescription labeled only as adalimumab-adbm instead of Cyltezo. According to the manufacturer, Boehringer Ingelheim, <\/span>the two medications are exactly the same<\/span><\/a>. But some insurance companies only pay for Cyltezo’s generic, adalimumab-adbm, so your pharmacy may give it to you when you’re prescribed Cyltezo instead of the more expensive brand-name drug.<\/span><\/p>\n

    Is Cyltezo covered by insurance?<\/span><\/h2>\n

    According to Dr. Hendi, Cyltezo is typically covered by both commercial and private insurance plans, as well as Medicaid and Medicare. But it’s important to keep in mind, she added, that coverage and reimbursement policies vary depending on the specific insurance plan and the reason for treatment, so you should always verify coverage with your insurance carrier.  <\/span><\/p>\n

    How much does Cyltezo cost without insurance?<\/span><\/h2>\n

    As noted, a one-month supply of Cyltezo costs around $7,580 without insurance. This includes two 40 mg\/0.8 mL auto-injector pens, so each pen costs around $3,750. If your healthcare provider has instructed you to use both pens each month, you could end up spending $90,000 per year on Cyltezo without any insurance coverage, discounts, or patient assistance.<\/span><\/p>\n

    However, the out-of-pocket amount you pay for Cyltezo will vary based on the factors we outlined above: your insurance plan and formulary, your dosage, your pharmacy, and any discounts available to you will all affect your overall cost.<\/span><\/p>\n

    If Cyltezo and generic adalimumab-adbm are still too expensive for you, you may want to speak to your healthcare provider about other medications that can also treat autoimmune symptoms. Several other biosimilars to Humira <\/span>came onto the market in 2023<\/span><\/a>, including Hadlima, Amjevita, Hulio, and Yuflyma.  <\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n
    \n
    Drug name<\/b><\/td>\nPrice without insurance of brand-name drug<\/b><\/td>\nSingleCare price<\/b><\/td>\nSavings options<\/b><\/td>\n<\/tr>\n
    Cyltezo<\/b><\/td>\n$7,581 per auto-injector kit with 2, 40 mg\/0.8 ml pens<\/span><\/td>\n$6,557 per auto-injector kit with 2, 40 mg\/0.8 ml pens<\/span><\/td>\nSee latest prices<\/span><\/a><\/td>\n<\/tr>\n
    Adalimumab-adbm<\/b><\/td>\n$1,582 per box of 2 prefilled syringes<\/span><\/td>\n$812 per box of 2 prefilled syringes<\/span><\/td>\nSee latest prices<\/span><\/a><\/td>\n<\/tr>\n
    Humira<\/b><\/a><\/td>\n$8,714 per box of 2 syringes <\/span><\/td>\n$6,259 per box of 2 syringes<\/span><\/td>\nSee latest prices<\/span><\/a><\/td>\n<\/tr>\n
    Hadlima<\/b><\/a><\/td>\n$1,407 for 2, 2 ml of 40 mg\/0.4 ml syringes<\/span><\/td>\n$1,040 for 2, 2 ml of 40 mg\/0.4 ml syringes<\/span><\/td>\nSee latest prices<\/span><\/a><\/td>\n<\/tr>\n
    Hulio<\/b><\/td>\n$7,762 per kit of 2, 40 mg\/0.8 ml auto-injector pens<\/span><\/td>\n$616 per kit of 2, 40 mg\/0.8 ml auto-injector pens<\/span><\/td>\nSee latest prices<\/span><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
    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 (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available. Click the “See latest prices” link for the most current drug prices.<\/span><\/i><\/h6>\n

    How to save on Cyltezo without insurance<\/span><\/h2>\n

    Biologics and their biosimilars are all expensive drugs, and it’s difficult for most people to pay for them—especially without insurance coverage. While many people can enroll in patient assistance programs or use manufacturer discounts, not everyone is eligible for them. But there are several ways to save money on Cyltezo, with or without insurance coverage. Here are some ways to potentially reduce your out-of-pocket cost.<\/span><\/p>\n

    1. Use a SingleCare discount card<\/span><\/h3>\n

    The <\/span>SingleCare prescription discount card<\/span><\/a> can help you save money on your Cyltezo prescription when presented at a participating retail pharmacy, lowering your cost of Cyltezo from $7,580 to $6,557 for a two-pen injector kit (a one-month supply). Discounts vary from pharmacy to pharmacy, but you can use your SingleCare prescription discount card to shop for the cheapest price on Cyltezo in your area. <\/span><\/p>\n

    2. Ask about generic adalimumab-adbm<\/span><\/h3>\n

    We mentioned that sometimes you will be given a prescription labeled adalimumab-adbm instead of Cyltezo, and that this is the exact same medication (and equally safe and effective to use). Adalimumab-adbm is much cheaper than Cyltezo, with an average retail price of $1,582 before insurance. And with a SingleCare prescription discount card, you could lower that cost even further to around $812. You could ask your healthcare provider or pharmacy about receiving adalimumab-adbm in place of Cyltezo to save money.<\/span><\/p>\n

    3. Enroll in BI Solutions Plus <\/span><\/h3>\n

    BI Solutions Plus<\/span><\/a> is the patient support program for Cyltezo’s manufacturer, Boehringer Ingelheim. If you have commercial or private insurance, you may qualify for free Cyltezo with its copay card. If you don’t qualify, there are other resources available to many patients through BI Solutions Plus, including insurance specialists that can help you find the best way to access your medication and lower your out-of-pocket costs.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

    Cyltezo (adalimumab-adbm) is a prescription injectable drug that reduces inflammation that’s caused by a substance called tumor necrosis factor (TNF). It’s used to treat autoimmune conditions like rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and inflammatory bowel disease.  It’s a biosimilar of the drug Humira, which is a biologic drug approved by the Food and Drug […]<\/p>\n","protected":false},"author":149,"featured_media":628503,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[4343,15103],"coauthors":[8860],"class_list":["post-628502","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-brand-name-drugs","tag-drug-pricing","wpautop"],"acf":[],"yoast_head":"\nHow much does Cyltezo cost without insurance?<\/title>\n<meta name=\"description\" content=\"Cyltezo without insurance costs about $7,500 per month, but there are ways to save.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, 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