{"id":628880,"date":"2024-07-08T17:38:21","date_gmt":"2024-07-08T21:38:21","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=628880"},"modified":"2024-10-25T09:51:51","modified_gmt":"2024-10-25T13:51:51","slug":"nucala-savings","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/nucala-savings\/","title":{"rendered":"Nucala savings tips"},"content":{"rendered":"

The average person takes <\/span>17,000 or more breaths per day<\/span><\/a>, often without even thinking about it. So it’s easy to take them for granted. But for people with severe eosinophilic asthma, breathing isn’t always so simple. This type of asthma increases white blood cells called eosinophils, which can cause inflammation in the respiratory system, triggering attacks. One effective treatment is <\/span>Nucala<\/span><\/a> (mepolizumab), an add-on prescription drug that can help reduce asthma symptoms and attacks. It is also prescribed to treat chronic rhinosinusitis with nasal polyps, eosinophilic granulomatosis with polyangiitis, and hypereosinophilic syndrome.<\/span><\/p>\n

Patients only receive this subcutaneous injection once per month, but it can be expensive if you’re paying out of pocket. The good news is there are several ways to save.  <\/span><\/p>\n

How much does Nucala cost?<\/span><\/h2>\n

Nucala is a <\/span>specialty drug<\/span><\/a>—meaning it is more complex than most drugs, whether due to the way it needs to be stored or administered, the seriousness of the condition it is used to treat, or other factors. You can only get Nucala from a specialty pharmacy. <\/span>According to GSK<\/span><\/a>, the drug’s manufacturer, the list price for one dose of Nucala is $3,688.83. But, the list price is the wholesale price charged to pharmacies, not to patients. If prescribed Nucala without insurance, you will likely pay the list price plus an additional amount charged by the specialty pharmacy dispensing it. Each injection contains 100 mg\/mL of reconstituted solution and lasts for 30 days. Over an entire year, someone paying completely out of pocket could pay as much as $44,266. Biologic drugs like Nucala cost a lot to research and develop, and their prices often reflect that.<\/span><\/p>\n

But not everyone has to pay that much. One of the most reliable ways to save money on prescription drugs is through insurance or Medicare coverage. Not every plan will cover Nucala, but some will. Medicare Part D plans, for example, <\/span>spent a cumulative $193 million in 2022<\/span><\/a> covering it for beneficiaries, up from around $132 million in 2021. Some private insurance plans may provide coverage as well, so it’s worth checking your plan’s formulary or contacting the insurance company.<\/span><\/p>\n

This coverage might also depend on how it’s administered. For example, “Medicare Part B can sometimes cover drugs like Nucala when administered in a healthcare provider’s office, under the Durable Medical Equipment category, although it generally falls under Part D when prescribed for home use,” said <\/span>Sazan Sylejmani, Pharm.D.<\/span><\/a>, a pharmacist in Westmont, Illinois. So, if you plan on using an autoinjector or prefilled syringe at home, the coverage would need to come from a prescription drug plan, from Medicare or otherwise.<\/span><\/p>\n

Even when it’s covered, the patient might need to pick up the tab on copays, coinsurance, or other out-of-pocket expenses. Certain health insurance companies and plans might also require prior authorization. According to Michael O. McKinney, MD, a primary care physician at <\/span>Healthy Outlook<\/span><\/a>, “Often there are certain criteria like showing evidence of severe persistent asthma despite the use of standard treatments of eosinophilic asthma that patients must satisfy before being covered.” <\/span><\/p>\n

But those aren’t the only price-influencing factors. “Prices can vary due to different pharmacy purchasing costs, regional pricing strategies, and the competitive landscape in specific areas,” Dr. Sylejmani said.<\/span><\/p>\n

Can I get Nucala for free?<\/span><\/h2>\n

Even better than saving on Nucala is getting it for free—and it’s possible for people who meet certain eligibility requirements. GSK has a patient assistance program called <\/span>GSKForYou<\/span><\/a>, which provides medications (including Nucala) at no cost to qualifying applicants. Whether you have no insurance or your plan doesn’t cover Nucala, you’re eligible for enrollment if you’re below a certain income threshold.<\/span><\/p>\n

That threshold varies based on the number of people in your household and which state you live in. For the 48 contiguous states, the District of Columbia, and the U.S. Virgin Islands, here are the <\/span>income limits<\/span><\/a> per month:<\/span><\/p>\n