How much is Xeljanz without insurance?

Is Xeljanz covered by insurance? | How much does Xeljanz cost without insurance? | How to get Xeljanz without insurance

Xeljanz is a brand-name prescription drug that treats inflammatory diseases such as arthritis and ulcerative colitis after other medications don’t work. The FDA has approved the drug to treat moderate to severe rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, polyarticular juvenile idiopathic arthritis, and ulcerative colitis. Tofacitinib, the active ingredient in Xeljanz, blocks enzymes called cytokines that provoke and regulate the immune system’s inflammatory response. People prescribed Xeljanz will take immediate-release tablets, extended-release tablets (Xeljanz XR), or an immediate-release oral solution. All versions are premium-priced, but there are ways to save money.

Related: Xeljanz dosage

What is the generic for Xeljanz?

Xeljanz and Xeljanz XR are premium-priced medications with no lower-priced generic version. The earliest a generic version will appear may be in 2034. 

Is Xeljanz covered by insurance?

The conditions treated by Xeljanz are serious medical problems, so people with health insurance, Medicare Part D drug insurance, or Medicaid are usually covered, but not always. Talk to an insurance company representative about Xeljanz coverage before filling a prescription. Because Xeljanz is FDA-approved for use only after other drugs have failed, insurance companies usually require prior authorization before approval. They also frequently classify it as a specialty drug in their highest copay tiers, so the out-of-pocket cost may be high.

How much does Xeljanz cost without insurance?

At an average monthly cost of $6,700 for 60, 240 mg immediate-release tablets or 30 extended-release tablets, Xeljanz is one of the highest-priced prescription medications on the market. The average daily cost for either Xeljanz or Xeljanz XR works out to $22 at that price. The good news is that Xeljanz is only used for active flare-ups. People will not need to take it when in remission. Still, flare-ups and remission are unpredictable, so the total yearly cost is difficult to predict.

The bad news is that there aren’t many lower-cost alternatives. Xeljanz is FDA-approved for treatment, usually after patients have unsuccessfully responded to other drugs called TNF blockers. These biologic drugs—Enbrel (etanercept), Remicade (infliximab), Simponi (golimumab), and Humira (adalimumab)—are even higher in price than Xeljanz. These drugs are probably unsuitable as Xeljanz substitutes. That may apply equally to lower-priced generic immunosuppressants such as cyclosporine and methotrexate. Because of the side effects of Xeljanz, it is typically a last-step treatment for moderate and severe inflammatory disease. These side effects include serious infections, skin cancer, lymphoma, lung disease, hepatitis B reactivation, blood clots, cardiovascular events, and death.

Other drugs similar to Xeljanz, called Janus kinase inhibitors (JAK inhibitors), are also premium-priced. These include Rinvoq (upadacitinib) and Olumiant (baricitinib). They, too, are FDA-approved treatments typically employed after TNF blockers have failed because of their risks.

A SingleCare prescription discount card may provide uninsured patients with the best cost savings. The lowest SingleCare price for a 30-day supply of Xeljanz immediate-release tablets is only $4800, almost $2,000 less than the average retail price.

RELATED: Xeljanz alternatives: What can I take instead of Xeljanz?

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 link under “Savings options” to see the latest drug prices.

How to get Xeljanz without insurance

For people without health insurance coverage, the cost of Xeljanz may be a barrier to getting treatment. Because Xeljanz is a specialty drug used when other treatments have failed, switching to a lower-priced generic drug is rarely an option. One way to save money is to take advantage of Pfizer’s patient assistance program, but that isn’t a sure thing. Some people may not be able to meet the stringent eligibility criteria. Instead, here are a few strategies for getting needed treatment at a lower cost. 

1. Start with a SingleCare savings card

A SingleCare prescription discount card can reduce the price of a 30-day Xeljanz prescription by as much as $2,000. Xeljanz savings will vary by participating pharmacy, so browse available discounts on SingleCare’s Xeljanz coupon page or Xeljanz XR coupon page. 

2. Compare pharmacy prices 

The lowest price for Xeljanz is $4,000 lower than the highest pharmacy price. That’s a lot of savings, but comparing prescription drug prices is difficult. Instead, use SingleCare’s average price history table for Xeljanz to find the best price for Xeljanz at local pharmacies quickly.

3. Compare your current costs to health insurance costs

Health insurance may be more affordable than treatment costs for many of the inflammatory diseases treated by Xeljanz. Start by researching the costs and benefits of health insurance plans on your state’s health insurance marketplace. Talk to an agent or expert to help determine the best value and ensure that Xeljanz and other needed medications are included in their benefits.

4. Enroll in Medicaid or Medicare Low Income Subsidy

If treatment and health insurance are difficult to overcome, you may qualify for Medicaid. Medicare LIS is the equivalent of Medicaid for older adults regarding drug coverage. Research Medicaid eligibility requirements, enrollment instructions, and additional information on your state’s Medicaid website.