Ilumya (tildrakizumab-asmn) is a brand-name subcutaneous injection that’s prescribed for plaque psoriasis in adults. The cost of the drug can depend on several factors, such as whether Ilumya has a savings program.

As with all medications, the cost of Ilumya 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 doses of Ilumya
  • whether Ilumya has a savings program (see the “Financial and insurance assistance” section below)

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

Ilumya contains the active ingredient tildrakizumab-asmn, 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 need financial support to pay for Ilumya, or if you need help understanding your insurance coverage, help is available. For example:

  • The Ilumya Early Access Program is available for Ilumya. This program may help if you’re in the process of getting insurance coverage for Ilumya. For more information and to find out whether you’re eligible for support, call 866-253-6677 or visit the program website.
  • The Ilumya Copay Program is also available for Ilumya. For more information, please call 866-253-6677 or visit the program website.
  • If you don’t have insurance or are underinsured, you may be eligible for the Ilumya Patient Assistance Program. To learn more, please call 855-445-8692 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 Ilumya.

Is Ilumya covered by Medicare?

Typically, Medicare part B plans cover the cost of Iumya because it’s given by a healthcare professional. You can call your Medicare plan provider to learn whether your particular plan covers the cost of this drug. There are many types of Medicare plans, so your coverage and what you pay for prescriptions will be based on your particular plan’s benefits.

The total price you pay for Ilumya may also depend on the cost to receive doses at your doctor’s office or clinic. You may also need to obtain prior authorization before your plan will cover the cost of this medication.

Your doctor may also be able to provide information about your cost for Ilumya if you have Medicare.

How does Ilumya’s cost compare with that of medications such as Skyrizi?

The price you’d pay for Ilumya versus Skyrizi depends on various factors.

For instance, the form of the drug may affect its price. Ilumya and Skyrizi are both available as subcutaneous injections. But Skyrizi may also be given as an intravenous infusion. In some cases, infusions may cost more than injections.

There are additional factors that can affect your prescription cost, including:

  • the length of your treatment
  • whether there are payment assistance programs for your prescribed treatment
  • whether you’re paying out of pocket or have insurance

To learn more about the cost of Ilumya compared with other treatments for your condition, talk with your doctor, pharmacist, or insurance provider.

Below is information you may want to consider if you have insurance and receive Ilumya.

Prior authorization: If you have insurance, your insurance company may require prior authorization before it covers Ilumya. This means the company and your doctor will discuss Ilumya 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 Ilumya requires prior authorization.

Type of insurance coverage: Ilumya is given by your doctor or another healthcare professional. If you have insurance, the price of your Ilumya 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 Ilumya 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.