Remicade and cost

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

To find out what the cost of Remicade 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 Remicade.

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

Type of insurance coverage. Remicade is given by your doctor or another healthcare professional as an intravenous infusion. If you have insurance, the price of your Remicade 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 Remicade 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.

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

Does Medicare cover Remicade?

Possibly. If you have Medicare, the amount you’ll pay for Remicade depends on your specific plan. For example, Medicare Part B covers the cost of some drugs given in a healthcare setting. You receive Remicade doses at your doctor’s office or an infusion center.

To find out your cost for Remicade, contact your Medicare representative. You can also ask your doctor or pharmacist about Medicare coverage for Remicade. For more information about Remicade and Medicare, see the “Next steps” section below.

Is the cost of Remicade similar to the cost of Humira?

It depends. As with Remicade, doctors may prescribe Humira (adalimumab) for certain autoimmune conditions. However, the cost of Remicade and Humira can differ for several reasons, including how the drug is given and insurance considerations.

For example, Remicade’s cost depends on the cost of the visit to your doctor to receive doses of the drug. (Remicade is given by intravenous infusion.) Humira is given by subcutaneous injection, but your doctor can show you how to self-inject the drug at home.

If you have insurance, ask your plan provider how the costs of Remicade and Humira compare. To find out which medication is best for your condition, talk with your doctor.

The active ingredient of Remicade is infliximab. It’s available as the following biosimilar drugs:

• Avsola (infliximab-axxq)
• Inflectra (infliximab-dyyb)
• Renflexis (infliximab-abda)

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. The four letters at the end of the drug name show that it’s distinct from similar medications that may be created in the future.

If your doctor has prescribed Remicade and you’re interested in a biosimilar drug instead, talk with your doctor. They may prefer one version over another. You’ll also need to check with your insurance provider, as it may cover only one version.

To find out how the cost of this biosimilar drug compares with the cost of Remicade, talk with your doctor or insurance provider.

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

• A program called Janssen CarePath is available for Remicade. For more information and to find out whether you’re eligible for support, call 877-CarePath (877-227-3728) 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 Remicade, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance about cost issues related to Remicade. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you would pay for Remicade.

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 Remicade, refer to this article.
• Dosage. Learn about Remicade and dosage by viewing this article.
• Side effects. For details about Remicade’s side effects, see this article. You can also look at the Remicade prescribing information.
• Interactions. You can find out more about what Remicade interacts with by visiting this article.
• Information about your condition. For more information about the conditions Remicade treats, refer to the following:
  • Rheumatoid arthritis (RA): See our RA hub.
  • Ankylosing spondylitis: See our arthritis hub.
  • Psoriatic arthritis (PsA): See this list of PsA articles.
  • Plaque psoriasis: See our psoriasis hub.
  • Crohn’s disease: See this list of Crohn’s disease and inflammatory bowel disease articles.
  • Ulcerative colitis: See this list of UC 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.