Ultomiris (ravulizumab-cwvz) is a brand-name drug that’s prescribed for certain rare blood disorders. The cost of Ultomiris with and without insurance can depend on several factors, such as whether the drug has a savings program.
Ultomiris is approved by the Food and Drug Administration (FDA) to treat the following in adults and children ages 1 month and older:
- paroxysmal nocturnal hemoglobinuria
- atypical hemolytic uremic syndrome. For this use, Ultomiris is given to help prevent blood clots and damage to the small blood vessels from occurring.
Ultomiris is also FDA approved to treat adults with anti-acetylcholine receptor antibody-positive generalized myasthenia gravis.
As with all medications, the cost of Ultomiris 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 an intravenous (IV) infusion of Ultomiris
- whether Ultomiris has a savings program (see the “Financial and insurance assistance” section below)
To find out what the cost of Ultomiris will be for you, talk with your doctor, pharmacist, or insurance provider. Or look below in the next section to learn how much you can save by using an Optum Perks coupon.
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Ultomiris contains the active ingredient ravulizumab-cwvz,* 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 “-cwvz” appears at the end of the drug’s name is to distinguish it from current or future biosimilar versions.
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 Ultomiris long term, you may be able to lower its cost in the following ways.
Getting a 3-month supply
You may be able to get a 90-day supply of Ultomiris. 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.
Using a mail-order pharmacy
Ultomiris may be available through a mail-order pharmacy. Using this type of service may help lower the drug’s cost and allow you to receive your medication without leaving home. Some Medicare plans may help cover the cost of mail-order medications. You may also be able to get a 90-day supply of the drug via mail order.
If you don’t have health insurance, talk with your doctor or pharmacist. They may be able to suggest online pharmacy options that could work for you.
If you need financial support to pay for Ultomiris, or if you need help understanding your insurance coverage, help is available. For example:
- A program called the Alexion OneSource CoPay Program is available for Ultomiris. For more information and to find out if you’re eligible for support, call 888-765-4747 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 Ultomiris.
How does Ultomiris’s cost compare with that of medications such as Soliris?
The price you’ll pay for Ultomiris versus that of Soliris depends on various factors.
For instance, the form of the drug may affect its price. Soliris (eculizumab) and Ultomiris are both available as IV infusions. Ultomiris is also available as a subcutaneous injection. Depending on your insurance, IV infusions may cost more than subcutaneous injections because they are given by a healthcare professional at a hospital or infusion clinic.
There are additional factors that can affect your prescription cost, including:
- the length of your treatment
- whether there are payment assistance programs for your prescribed treatment
- whether you’re paying out of pocket or have insurance
To learn more about the cost of Ultomiris compared with other treatments for your condition, talk with your doctor or insurance provider.
How much does Ultomiris cost with insurance vs. without it?
What you pay for Ultomiris if you have insurance compared to what you’d pay without it depends on several factors.
Factors that could affect what you pay for this drug without insurance include:
- the length of treatment you’re prescribed (such as a 90-day or 30-day supply)
- whether you apply and qualify for any available savings programs
- your dosage and treatment plan
- the pharmacy you use
- the form of the drug you’re prescribed (such as the subcutaneous injection or IV infusion)
These same factors may affect your price for Ultomiris if you have insurance. But the price you pay with insurance will also depend on:
- your specific plan benefits
- any prior authorization requirements you have for drug coverage
To learn more about what you’d pay for Ultomiris with or without insurance, talk with your doctor, pharmacist, or insurance provider (if you have one).
You can also visit Optum Perks* for price estimates for this drug when using coupons from their site. However, Optum Perks coupons cannot be used with insurance benefits or copays.
* Optum Perks is a sister site of Medical News Today.
Below is information you may want to consider if you have insurance and receive Ultomiris.
Prior authorization: If you have insurance, your insurance company may require prior authorization before it covers Ultomiris. This means the company and your doctor will discuss Ultomiris 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 Ultomiris requires prior authorization.
Type of insurance coverage: Ultomiris IV infusion is given by your doctor or another healthcare professional. If you have insurance, the price of your Ultomiris 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 Ultomiris 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 Ultomiris, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance about cost issues related to Ultomiris. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you would pay for Ultomiris.
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 Ultomiris, refer to this article.
- Dosage: Learn about Ultomiris and dosage by viewing this article.
- Side effects: For details about Ultomiris’s side effects, see this article. You can also look at the Ultomiris prescribing information.
- Information about your condition: For more information about blood disorders, see our list of blood and hematology articles.
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.