Rituxan and cost

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

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

Insurance considerations

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

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

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

Is there a cost difference for Rituxan depending on the strength of infusion you receive, such as 1,000-mg?

It’s possible that a 1,000-milligram (mg) infusion may have a different cost than other strengths of Rituxan. The cost of your Rituxan infusion depends on many factors, including your insurance coverage and where you get your infusion.

If you have questions about your cost of Rituxan, contact your insurance plan administrator.

Does Medicare cover Rituxan?

Certain Medicare plans may cover Rituxan. Medicare Part B covers some medications that you receive at your doctor’s office.

For more information, contact your Medicare provider to find out if Rituxan is covered for you.

The active ingredient of Rituxan is rituximab. It’s available as these biosimilar drugs:

• rituximab-pvvr (Ruxience)
• rituximab-abbs (Truxima)
• rituximab-arrx (Riabni)

A biosimilar medication is a drug that’s similar to a brand-name biologic drug (the parent drug). Rituxan is a biologic medication, which is also called a biologic. Biologic drugs are made from living cells. It’s not possible to copy these drugs exactly. Biosimilars are considered to be as safe and effective as their parent drug. And like generics, biosimilars tend to cost less than brand-name medications.

If your doctor has prescribed Rituxan and you’re interested in using Ruxience, Truxima, or Riabni instead, talk with your doctor. They may have a preference for one version or the other. You’ll also need to check with your insurance provider, as it may only cover one or the other.

To find out how the cost of these biosimilar drugs compare with the cost of Rituxan, talk with your doctor, pharmacist, 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 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 Rituxan, or if you need help understanding your insurance coverage, help is available. For example:

• A program called Rituxan Immunology Co-pay Program is available for Rituxan. For more information and to find out whether you’re eligible for support, call 877-436-3683 or visit the program website.
• If you don’t have insurance coverage, a program called the Genentech Patient Foundation is available for Rituxan. For more information, call 888-941-3331 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 Rituxan, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance about cost issues related to Rituxan. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you would pay for Rituxan.

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 Rituxan, refer to this article.
• Dosage. Learn about Rituxan and dosage by viewing this article.
• Side effects. For details about Rituxan’s side effects, see this article. You can also look at the Rituxan prescribing information.
• Information about cancer and rheumatoid arthritis. For more information about some of the conditions Rituxan is prescribed to treat, see our cancer hub and arthritis hub. You can also refer to our lists of articles about rheumatology, lymphoma, and leukemia.

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.