Tzield (teplizumab-mzwv) is a brand-name infusion that’s prescribed to slow the progression of type 1 diabetes. The cost of the drug with and without insurance can depend on several factors.
Tzield is approved to slow the progression of type 1 diabetes in certain adults and children ages 8 years and older. Tzield belongs to a drug class called CD3 blockers. It isn’t available in a biosimilar version.
Read on to learn about Tzield and cost, as well as how to save money on prescriptions. If you’d like other information about Tzield, refer to this article.
As with all medications, the cost of Tzield 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 Tzield
- whether Tzield has a savings program (see the “Financial and insurance assistance” section below)
To find out what the cost of Tzield 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 Tzield.
Prior authorization. If you have insurance, your insurance company may require prior authorization before it covers Tzield. This means the company and your doctor will discuss Tzield 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 Tzield requires prior authorization.
Type of insurance coverage. Tzield is given by your doctor or another healthcare professional. If you have insurance, the price of your Tzield 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 Tzield 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.
Tzield contains the active ingredient teplizumab-mzwv 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 receive Tzield 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 Tzield, or if you need help understanding your insurance coverage, help is available. For example:
- A program called COMPASS is available for Tzield. For more information and to find out whether you’re eligible for support, call 844-778-2246, 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 Tzield, you may still have some questions. Talk with your doctor who can provide personalized guidance about cost issues related to Tzield. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you would pay for Tzield.
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 Tzield, refer to this article.
- Information about diabetes. For more information about type 1 diabetes, see our diabetes 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.