Monjuvi and cost

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

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

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

Insurance considerations

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

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

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

Monjuvi contains the active ingredient tafasitamab-cxix, 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 Monjuvi long term, you may be able to lower its cost.

If you don’t have health insurance, talk with your doctor. They can advise whether you qualify for certain financial assistance options.

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

• A program called My Mission Support is available for Monjuvi. For more information and to find out whether you’re eligible for support, call 855-421-6172 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.

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

How does Monjuvi’s cost compare with that of medications such as Revlimid?

Monjuvi and Revlimid (lenalidomide) are both drugs that a doctor may prescribe for certain types of blood cancers. The cost of each drug can depend on various factors.

For instance, the form of the drug may affect its price. Monjuvi is available as an intravenous (IV) infusion that’s given by a healthcare professional. In contrast, Revlimid is available as an oral capsule. Typically, infusions cost more than capsules.

Additionally, Revlimid is available in the generic version lenalidomide, and Monjuvi isn’t available as a biosimilar. Generics and biosimilars typically cost less than the brand-name versions.

The cost of each drug can also depend on the length of your treatment, whether you have insurance, and whether the drug has a savings program.

To learn more about the cost of Monjuvi compared with other treatments for your condition, talk with your doctor, pharmacist, or insurance provider. To learn more about the cost of Revlimid, see this article.

How much does Monjuvi cost with insurance vs. without it?

The cost of Monjuvi with and without insurance can depend on several factors. These include your dosage, treatment plan, and whether you qualify for any savings programs.

In addition, if you have insurance, the cost of Monjuvi may also depend on your specific insurance plan. Your insurance provider may also require prior authorization before they cover this drug. To learn more about prior authorization, see the “Monjuvi cost” section above.

To learn more about Monjuvi‘s cost with and without insurance, talk with your doctor or insurance provider (if you have one).

You can also visit Optum Perks* for price estimates for this drug when using coupons from their site. However, Optum Perks coupons cannot be used with insurance benefits or copays.

* Optum Perks is a sister site of Medical News Today.

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

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 Monjuvi, refer to this article.
• Dosage. Learn about Monjuvi and dosage by viewing this article.
• Information about lymphoma. For more information about lymphoma, see our cancer hub.

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.