Vabysmo cost

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

To find out what the cost of Vabysmo will be for you, talk with your doctor, pharmacist, or insurance provider.

Insurance considerations

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

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

Type of insurance coverage. Vabysmo is given by your doctor or another healthcare professional. If you have insurance, the price of your Vabysmo 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 Vabysmo 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.

Vabysmo contains the active ingredient faricimab-svoa, 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 take Vabysmo long term, you may be able to lower its cost in the following ways.

Using a mail-order pharmacy

Vabysmo 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.

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 Vabysmo, or if you need help understanding your insurance coverage, help is available. For example:

• The drug manufacturer offers two assistance programs for Vabysmo:
  • The Genentech Ophthalmology Co-pay Program and may be an option for you if you have health insurance. To learn more about this program, call 855-218-5307 or visit the program’s website.
  • The Genentech Patient Foundation and may be an option for you if you don’t have insurance. For more information to find out whether you’re eligible, call 888-941-3331 or visit the program’s 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 Vabysmo.

How does Vabysmo’s cost compare with that of medications such as Eylea?

The price you’d pay for Vabysmo versus that of Eylea depends on various factors, 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 Vabysmo compared with other treatments for your condition, talk with your doctor, pharmacist, or insurance provider.

How much does Vabysmo cost with insurance?

If you have insurance, your cost for Vabysmo depends on factors such as:

• your particular plan benefits, including your drug copay amount
• your dosage of the drug
• whether you apply and qualify for a savings program

To find out how much Vabysmo will cost you with insurance, contact your insurance provider or doctor.

You can also visit Optum Perks* for price estimates for Vabysmo when using coupons from the site. However, Optum Perks coupons cannot be used with any insurance benefits or copays.

* Optum Perks is a sister site of Medical News Today.

Vabysmo is approved by the Food and Drug Administration (FDA) for wet age-related macular degeneration and diabetic macular edema in adults.

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

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 Vabysmo, refer to this article.
• Dosage. Learn about Vabysmo and dosage by viewing this article.
• Side effects. For details about Vabysmo’s side effects, see this article. You can also look at the Vabysmo prescribing information.
• Information about macular degeneration. For more information 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.