The cost of Cimzia with and without insurance coverage can depend on several factors. Drug savings programs can also lower the price you’ll pay for Cimzia.

As with all medications, the cost of Cimzia can vary. Factors that may affect the price for Cimzia you’ll pay include:

  • your treatment plan
  • your insurance coverage
  • the pharmacy you use
  • the cost of the visit to your healthcare professional to receive doses of Cimzia
  • whether Cimzia has a savings program (see the “Financial and insurance assistance” section below)

Cimzia may need to be purchased through a specialty pharmacy authorized to carry specialty drugs. This type of drug may be costly or require help from healthcare professionals to be taken safely and effectively. For more details about how to obtain Cimzia, talk with your doctor.

To find out what the cost of Cimzia will be for you, talk with your doctor, pharmacist, or insurance provider.

Note: You’ll receive Cimzia doses by subcutaneous injection at your doctor’s office or clinic. However, your doctor may teach you how to self-inject the drug at home.

Here are answers to some frequently asked questions about drug cost and Cimzia.

Is Cimzia covered by Medicare?

Medicare may cover the cost of Cimzia treatment. It depends on your specific coverage. For example, Medicare Part B covers the cost of some drugs that a doctor gives in a healthcare setting. You’ll receive Cimzia doses in your doctor’s office or clinic when you first start treatment.

Medicare Part D provides coverage for prescription drugs that you get at the pharmacy. So ask your doctor whether you’ll continue to receive doses at their office or self-inject the drug at home.

To find out your cost for Cimzia, contact your Medicare representative. You can ask them whether you’ll owe a deductible or coinsurance payment. Your doctor may also be able to provide information about your cost for Cimzia if you have Medicare.

How much does Cimzia cost without insurance?

The price you’ll pay for Cimzia if you don’t have insurance can vary based on several factors. But typically, the cost is higher for those without insurance.

Other factors that could affect what you pay for this drug include:

  • the quantity you’re prescribed (such as a 90-day or 30-day supply)
  • whether you apply and qualify for any available savings programs
  • your dosage
  • the pharmacy you use
  • whether you receive your Cimzia doses at your doctor’s office or self-inject the drug at home

To learn the exact cost you’d pay for this medication without insurance, ask your doctor or pharmacist. You may also want to contact several pharmacies to compare their prices for Cimzia.

Check out Optum Perks for price estimates for several medications. (Optum Perks coupons cannot be used with insurance benefits or copays.)

Optum Perks is owned by RVO Health. By clicking on this link, we may receive a commission. Learn more.

Note: Optum Perks is a sister site of Medical News Today.

Cimzia contains the active ingredient certolizumab pegol, and it’s available only as a brand-name biologic drug. It doesn’t come in a biosimilar version. A biosimilar medication is similar to a brand-name biologic drug (the reference drug). Also, biosimilars tend to cost less than brand-name medications.

WHY ARE COSTS DIFFERENT FOR BIOLOGIC DRUGS VS. BIOSIMILAR DRUGS?

Biologic drugs can be expensive because of the research needed to test their safety and effectiveness. The manufacturer of a biologic drug can sell it for up to 12 years. When the biologic drug’s patent expires, multiple manufacturers can create biosimilar versions. This marketplace competition may lead to lower costs for biosimilars. Also, because biosimilars are very similar to biologic drugs, they don’t require the same costly testing.

If you use Cimzia long term, you may be able to lower how much Cimzia costs per month in the following ways.

Getting a 3-month supply

You may be able to get a 90-day supply of Cimzia. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor, pharmacist, or insurance provider.

Using a mail-order pharmacy

Cimzia may be available through a mail-order pharmacy. Using this type of service may help lower the drug’s cost and allow you to receive your medication without leaving home. Some Medicare plans may help cover the cost of mail-order medications. You may also be able to get a 90-day supply of the drug via mail order.

If you don’t have health insurance, talk with your doctor or pharmacist. They may be able to suggest online pharmacy options that could work for you.

If you need financial support to pay for Cimzia or help to understand your insurance coverage, help is available. For example:

  • Programs called the CIMplicity Savings Program and CIMplicity Covered are available for Cimzia. For more information and to find out if you’re eligible for support, call 844-277-6853 or visit the program website.
  • If you don’t have insurance coverage or can’t afford Cimzia, the UCB Patient Assistance Program may be able to help with Cimzia affordability. You can call 877-785-8906 or visit the program website to learn more.
  • Some websites provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services. Two such websites are:

Optum Perks is owned by RVO Health. By clicking on this link, we may receive a commission. Learn more.

You may want to consider the following information if you have insurance and receive Cimzia.

Prior authorization: If you have insurance, your insurance company may require prior authorization before it covers Cimzia. This means the company and your doctor will discuss Cimzia in regard to your treatment. The insurance company will then determine whether to cover the medication. If a drug requires prior authorization, but you start treatment without the prior approval, you could pay the full cost of the medication. You can ask your insurance company whether Cimzia requires prior authorization.

Type of insurance coverage: Cimzia may be given by your doctor or another healthcare professional. If you have insurance, the price of your Cimzia doses may be billed through your medical coverage instead of the prescription drug portion of your insurance plan. This depends on your specific insurance plan and where you receive your Cimzia doses, such as at your doctor’s office, an infusion clinic, or a hospital. If you have questions about this process, contact your doctor or your insurance provider.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.