Syfovre (pegcetacoplan) is a brand-name eye injection that’s prescribed for geographic atrophy. The cost of the drug with and without insurance can depend on several factors, such as whether Syfovre has a savings program.
Syfovre is approved to treat geographic atrophy, which is a late stage of age-related macular degeneration. It belongs to a drug class called complement inhibitors. Syfovre isn’t available in a generic version.
Read on to learn about Syfovre and cost, as well as how to save money on prescriptions. If you’d like other information about Syfovre, refer to this article.
As with all medications, the cost of Syfovre 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 Syfovre
- whether Syfovre has a savings program (see the “Financial and insurance assistance” section below)
To find out what the cost of Syfovre will be for you, talk with your doctor or insurance provider.
Below is information you may want to consider if you have insurance and receive Syfovre.
Prior authorization. If you have insurance, your insurance company may require prior authorization before it covers Syfovre. This means the company and your doctor will discuss Syfovre 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 Syfovre requires prior authorization.
Type of insurance coverage. Syfovre is given by your doctor or another healthcare professional. If you have insurance, the price of your Syfovre 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 Syfovre doses, such as at your doctor’s office or a hospital. If you have questions about this process, contact your doctor or your insurance provider.
Syfovre is only available as a brand-name drug. It doesn’t come 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 receive Syfovre 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 Syfovre, or if you need help understanding your insurance coverage, help is available. For example:
- A program called Apellis Assist is available for Syfovre. For more information and to find out whether you’re eligible for support, call 888-APELLIS (888-273-5547) 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.
Now that you’ve learned about cost and Syfovre, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance about cost issues related to Syfovre. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you would pay for Syfovre.
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 Syfovre, refer to this article.
- A look at your condition. For more information about geographic atrophy, see this article. To learn more about age-related macular degeneration, see our eye health 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.