Otezla (apremilast) and cost

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

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

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

To save money on your Otezla prescription, explore coupons and saving options from the drug manufacturer.

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

How much does Otezla cost with insurance vs. without insurance?

Your Otezla cost, with or without insurance, varies based on many factors. These include what pharmacy you use and your dose of Otezla. The best way to determine how much Otezla may cost you, with or without insurance, is to talk with your pharmacist.

The manufacturer of Otezla has a copay card for people with private or commercial insurance. This card can decrease the copay of your medication. Sometimes, you may need prior authorization through your insurance to get coverage for Otezla. If your insurance has denied coverage, you may still be eligible to use the copay card. To learn more about this copay card program, call 844-468-3952 or visit the program website.

You cannot use the copay card if you do not have insurance. However, you may be eligible for other programs through the manufacturer, such as the Amgen Safety Net Foundation. You can find more information on the program website. You can also see the “Financial and insurance assistance section below.”

What’s Otezla’s cost with Medicare?

Otezla’s cost with Medicare may vary based on your Medicare plan and your prescription drug coverage. You can talk with your pharmacist to find out how much Otezla may cost with your Medicare plan. They can determine how much Otezla may cost through your individual insurance plan.

Also, if you have questions about getting Otezla through your Medicare plan, you can call Otezla insurance specialists at 844-468-3952.

How much does Otezla cost per month?

Your monthly cost of Otezla may vary based on many factors, including:

• your insurance coverage
• your Otezla dose
• the pharmacy you use
• if you qualify for the copay savings card or other programs

The best way to find out your cost of Otezla is by talking with your pharmacist. They can help determine how much Otezla may cost you per month based on the factors above. If you need help paying for Otezla, see the “Financial and insurance assistance” section below.

Otezla is only available as a brand-name drug. It is not available 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 Otezla 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 Otezla. 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

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

• An Otezla copay card is available for people with private or commercial insurance. For more information and to find out if you’re eligible for support, call 844-468-3952 or visit the program website.
• If you do not have insurance, the drug manufacturer has a nonprofit organization that may help with Otezla’s cost. This is called the Amgen Safety Net Foundation. You can get more information on 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 have learned about cost and Otezla, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance about cost issues related to Otezla. However, if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you would pay for Otezla.

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 Otezla, refer to this article.
• Dosage: Learn about Otezla and dosage by viewing this article.
• Side effects: For details about Otezla’s side effects, see this article. You can also look at the Otezla prescribing information.
• Interactions: You can find out more about what Otezla interacts with by visiting this article.
• Information about your condition: For details about your condition, see our:
  • psoriasis hub and list of psoriasis articles
  • arthritis hub and list of psoriatic arthritis 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.