Tecvayli (teclistamab-cqyv) is a brand-name injectable solution that’s prescribed for multiple myeloma. The cost of the drug with and without insurance can depend on several factors, such as whether Tecvayli has a savings program.
Tecvayli is approved to treat multiple myeloma in adults. Tecvayli belongs to a drug class called monoclonal antibodies. It is not available in a biosimilar version.
Read on to learn about Tecvayli and cost, as well as how to save money on prescriptions. If you’d like other information about Tecvayli, refer to this article.
As with all medications, the cost of Tecvayli 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 Tecvayli
- the cost of your hospital stay after each dose of Tecvayli
- whether Tecvayli has a savings program (see the “Financial and insurance assistance” section below)
To find out what the cost of Tecvayli 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 Tecvayli.
Prior authorization. If you have insurance, your insurance company may require prior authorization before it covers Tecvayli. This means the company and your doctor will discuss Tecvayli 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 Tecvayli requires prior authorization.
Type of insurance coverage. Tecvayli is given by your doctor or another healthcare professional. If you have insurance, the price of your Tecvayli 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 Tecvayli 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.
Tecvayli contains the active ingredient teclistamab-cqyv, 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 need financial support to pay for Tecvayli, or if you need help understanding your insurance coverage, help is available. For example:
- The Janssen Compass patient support program is available for Tecvayli. For more information and to find out if you’re eligible for support, call 844-628-1234 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.
Here are answers to some frequently asked questions about drug cost and Tecvayli.
What is the cost of Tecvayli without insurance?
The price you’ll pay for Tecvayli if you don’t have insurance can vary based on several factors. But typically, the cost is higher for those without insurance.
There are other factors that could affect what you pay for this drug. These include:
- your treatment regimen
- whether you apply and qualify for any available savings programs
- your dosage
- the cost of your hospital stay after each Tecvayli injection
To learn the exact cost you’d pay for this medication without insurance, ask your doctor.
Check out Optum Perks* for estimates of Tecvayli’s price when using coupons from the site. (Optum Perks coupons cannot be used with insurance benefits or copays.)
* Optum Perks is a sister site of Medical News Today.
Is Tecvayli covered by Medicare?
It may be. You can call your Medicare plan provider to learn whether your particular plan covers the cost of this drug. There are many types of Medicare plans, so your coverage and what you pay for prescriptions will be based on your particular plan’s benefits.
The total price you pay for Tecvayli may also depend on the cost to receive injections at your doctor’s office or clinic, as well as your hospital stay after each injection. You may also need to obtain prior authorization before your plan will cover the cost of this medication.
Your doctor may also be able to provide information about your cost for Tecvayli if you have Medicare.
Now that you’ve learned about cost and Tecvayli, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance about cost issues related to Tecvayli. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you would pay for Tecvayli.
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 Tecvayli, refer to this article.
- Side effects. For details about Tecvayli’s side effects, see this article. You can also look at the Tecvayli prescribing information.
- Information about multiple myeloma. For more information about multiple myeloma, 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.