Gemtesa and cost

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

• your treatment plan
• your insurance coverage
• the pharmacy you use
• whether Gemtesa has a savings program (see the “Financial and insurance assistance” section below)

To find out what the cost of Gemtesa 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 Gemtesa. This means the company and your doctor will discuss Gemtesa 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 Gemtesa requires prior authorization.

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

Is Gemtesa covered by Medicare?

It’s possible. Whether Medicare covers Gemtesa depends on your specific plan because each plan has different coverage levels. To find out your cost for Gemtesa, call your plan administrator. You can also ask your doctor or pharmacist about Medicare coverage for Gemtesa.

To learn more about Medicare, see the “Next steps” section below.

Does Gemtesa cost less than Myrbetriq?

The cost of Gemtesa compared with the cost of Myrbetriq depends on certain factors. These include:

• your prescription drug insurance coverage
• the pharmacy you use
• drug savings programs
• whether a generic version is available

Similar to Gemtesa, Myrbetriq is a brand-name drug prescribed for overactive bladder. A generic version of Myrbetriq has been approved by the Food and Drug Administration (FDA), but it’s not available yet. There is no generic version of Gemtesa. Generic drugs typically cost less than brand-name drugs. To learn more, see the “Brand-name vs. generic drugs” section just below.

If you have insurance, ask your plan provider how Gemtesa and Myrbetriq costs compare. You can also talk with your pharmacist and doctor. They may be able to help determine the cost differences. For information about Gemtesa savings programs, see the “Financial and insurance assistance” section below.

To find out which drug is best for your condition, talk with your doctor.

Gemtesa is available only as a brand-name drug. It doesn’t come in a generic version. A generic drug is an exact copy of the active drug in a brand-name medication.

Generics tend to cost less than brand-name drugs.

WHY ARE COSTS DIFFERENT FOR BRAND-NAME DRUGS VS. GENERIC DRUGS?

Brand-name drugs can be expensive because of the research needed to test their safety and effectiveness. The manufacturer of a brand-name drug can sell it for up to 20 years. When the brand-name drug’s patent expires, multiple manufacturers can create generic versions. This marketplace competition may lead to lower costs for generics. Also, because generics contain the same active ingredients as brand-name drugs, they don’t require the same costly testing.

If you take Gemtesa 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 Gemtesa. 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

Gemtesa 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 Gemtesa, or if you need help understanding your insurance coverage, help is available. For example:

• A program called the Gemtesa Simple Savings Program is available for Gemtesa. For more information and to find out whether you’re eligible for support, call 833-876-8268 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:
  • Medicine Assistance Tool
  • NeedyMeds

To learn more about saving money on prescriptions with or without insurance, check out this article.

Now that you’ve learned about cost and Gemtesa, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance about cost issues related to Gemtesa. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you would pay for Gemtesa.

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 Gemtesa, refer to this article.
• Dosage. Learn about Gemtesa and dosage by viewing this article.
• Side effects. For details about Gemtesa’s side effects, see this article. You can also look at the Gemtesa prescribing information.
• Information about your condition. For more information about overactive bladder (OAB), see this list of OAB articles.

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.