Tezspire and cost

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

Tezspire contains the active ingredient tezepelumab-ekko,* 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.

* The reason “-ekko” appears at the end of the drug’s name is to show that the drug is distinct from similar medications that may be created in the future.

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 take Tezspire long term, you may be able to lower its cost by getting a 3-month supply. 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.

If you don’t have health insurance, talk with your doctor or pharmacist. They may be able to suggest other options that could work for you.

If you need financial support to pay for Tezspire, or if you need help understanding your insurance coverage, help is available. For example:

• A program called Tezspire Together is available for Tezspire. For more information and to find out if you’re eligible for support, call 888-897-7473 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.

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

Is Tezspire 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 Tezspire may also depend on the cost to receive doses at your doctor’s office or clinic. But note that with the Tezspire prefilled pen, you may be able to self-inject your doses at home. For details about Tezspire forms and dosage, see this article.

Keep in mind that you may need to obtain prior authorization before your plan will cover the cost of this medication. For details about this, see “Insurance considerations” below.

Your doctor may also be able to provide information about your cost for Tezspire if you have Medicare.

What is the cost of Tezspire without insurance?

The price you’ll pay for Tezspire if you don’t have insurance can vary based on several factors. But typically, the cost is higher without insurance. Other factors that could affect what you pay for Tezspire treatment include:

• the quantity you’re prescribed (such as a 90-day supply)
• whether you apply and qualify for any available savings programs
• the pharmacy you use
• the form of the drug you’re prescribed (such as the prefilled syringe, prefilled pen, or vial)
• the cost of the visit to your healthcare professional to receive doses of Tezspire

To learn the exact cost you’d pay for this medication without insurance, ask your doctor or pharmacist. You may also want to contact several pharmacies to compare their prices for Tezspire.

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

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

Type of insurance coverage: Some forms of Tezspire may be given by your doctor or another healthcare professional. If you have insurance, the price of your Tezspire 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 Tezspire 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.

Now that you’ve learned about cost and Tezspire, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance about cost issues related to Tezspire. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you would pay for Tezspire.

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 Tezspire, refer to this article.
• Dosage: Learn about Tezspire and dosage by viewing this article.
• Side effects: For details about Tezspire’s side effects, see this article. You can also look at the Tezspire prescribing information.
• Information about severe asthma: For more information about severe asthma, see our asthma and allergies 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.