Empaveli (pegcetacoplan) is a brand-name liquid solution that’s prescribed for a rare blood disorder called paroxysmal nocturnal hemoglobinuria. The cost of the drug with and without insurance can depend on several factors.
Empaveli is given as an infusion under your skin. You’ll typically get your first infusion at a healthcare professional’s office. However, your doctor can also teach you or a caregiver how to give these infusions at home.
Read on to learn about Empaveli and cost, as well as how to save money on prescriptions. If you’d like other information about Empaveli, refer to this article.
As with all medications, the cost of Empaveli can vary. Factors that may affect the price 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 your first dose of Empaveli
- whether you or a healthcare professional gives your later doses of Empaveli
- whether Empaveli has a savings program (see the “Financial and insurance assistance” section below)
In addition, you may need to purchase needles to use Empaveli.
To find out what the cost of Empaveli will be for you, talk with your doctor, pharmacist, or insurance provider.
Note: If you have insurance, your insurance company may require prior authorization before it covers Empaveli. This means the company and your doctor will discuss Empaveli in regard to your treatment. The insurance company will then determine whether the medication is covered. 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 Empaveli requires prior authorization.
Empaveli contains the active ingredient pegcetacoplan, and it’s available only as a brand-name biologic drug. It doesn’t come in a biosimilar version. A biosimilar medication is a drug that’s similar to a brand-name biologic drug (the parent 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 take Empaveli long term, you may be able to lower its cost in the following ways.
Getting a 3-month supply
You may be able to get a 90-day supply of Empaveli. 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
Empaveli 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 Empaveli, or if you need help understanding your insurance coverage, help is available. For example:
- A program called ApellisAssist is available for Empaveli. For more information and to find out if you’re eligible for support, call 866-MY-APL-ASSIST (866-692-7527) or visit the program website.
- 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:
To learn more about saving money on prescriptions with or without insurance, check out this article.
Here are answers to some frequently asked questions about drug cost and Empaveli.
How does the cost of Empaveli compare with the cost of Ultomiris?
Your doctor can teach you or a caregiver how to give your Empaveli doses at home. However, Ultomiris doses can only be injected by a healthcare professional. This difference may affect the cost of each drug.
In addition, the price of either drug also depends on whether you have insurance, as well as your specific insurance plan.
It’s important to note that each drug has a program that offers financial assistance for those who qualify. For details on Empaveli’s financial assistance program, see “Financial and insurance assistance” above.
To find out how much you’ll pay for Empaveli versus Ultomiris, talk with your doctor, pharmacist, or insurance provider.
Will Empaveli cure paroxysmal nocturnal hemoglobinuria?
No, there are currently no medications to cure PNH.
With PNH, your bone marrow creates abnormal red blood cells. Empaveli stops your immune system from destroying these red blood cells in a process called hemolysis. However, it doesn’t stop your body from making abnormal red blood cells in the first place.
Currently, the only cure for PNH is a bone marrow transplant.
To find out more about what to expect from taking Empaveli, talk with your doctor.
Now that you’ve learned about cost and Empaveli, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance about cost issues related to Empaveli. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you would pay for Empaveli.
Here are some other resources you may find helpful:
- Medicare drug coverage. To learn about Medicare coverage for drugs, see these articles about Medicare prescription drug plans, drug coupons and Medicare, and the Medicare drug list.
- More details. For details about other aspects of Empaveli, refer to this article.
- A look at your condition. For more information about paroxysmal nocturnal hemoglobinuria, see this article.
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.