Xiaflex (collagenase clostridium histolyticum) is a brand-name prescription medication. The Food and Drug Administration (FDA) has approved it to treat certain tissue conditions in some adults. These include:
For more information about Xiaflex’s uses, refer to this article.
Here are some details about Xiaflex, which is a biologic:
- How it’s given: injected into affected areas by your doctor or another healthcare professional
- Biosimilar version: none available
Read on to learn about Xiaflex injections and cost, as well as how to save money on prescriptions.
As with all medications, the cost of Xiaflex can vary. Factors that may affect the price you’ll pay include:
- your treatment plan
- the condition Xiaflex is being used to treat
- your insurance coverage
- the cost of the visit to your healthcare professional to receive doses of Xiaflex
- whether Xiaflex has any savings programs (see the “Financial and insurance assistance” section below)
To find out what the cost of Xiaflex 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 Xiaflex.
Prior authorization. If you have insurance, your insurance company may require prior authorization before it covers Xiaflex. This means the company and your doctor will discuss Xiaflex in regard to your treatment. The insurance company will then determine whether the medication is covered. If a drug requires prior authorization and you start treatment without the prior approval, you could pay the full cost of the medication. You can ask your insurance company whether Xiaflex requires prior authorization.
Type of insurance coverage. Xiaflex is given by your doctor or another healthcare professional. If you have insurance, the price of your Xiaflex doses may be billed through your primary health insurance instead of the prescription drug portion of your insurance. This depends on your insurance coverage and where you receive your Xiaflex 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.
Here are answers to some frequently asked questions about drug cost and Xiaflex.
How can I determine the cost of Xiaflex with Medicare?
The cost of Xiaflex with Medicare depends on your individual Medicare plan and benefits. Since Xiaflex is given by your doctor or another healthcare professional, you may have two separate costs for your treatment. This includes the cost of the medication and the cost to receive doses of Xiaflex at a doctor’s office, clinic, or hospital.
Different parts of Medicare offer different benefits. These include benefits for the cost of drugs and the cost of the visit to your doctor to receive Xiaflex injections.
Your cost with Medicare may also depend on any deductibles you need to meet for your specific plan. And if your Medicare plan has a prior authorization requirement, this would need to be met before the drug cost is covered. (For more details about prior authorization, see the “Xiaflex cost” section above.)
To learn about what Xiaflex may cost with your particular Medicare plan, reach out to your plan provider. For more information about Medicare plans and coverage, see the “Next Steps” section below.
What’s the cost of Xiaflex with insurance?
The cost of Xiaflex with insurance depends on your specific insurance plan and benefits. For example, your cost could vary based on whether:
- you have a set copay
- you’ll need to pay a percentage of the total cost of Xiaflex
- your insurance company requires prior authorization (to learn more, see the “Xiaflex cost” section above)
- there are additional fees for receiving Xiaflex injections at a doctor’s office, clinic, or hospital
- there are any cost savings programs available (for more details, see the “Financial and insurance assistance” section below)
Other factors can also affect your Xiaflex cost with insurance. These include the condition being treated and your treatment plan for Xiaflex.
Talk with your insurance provider to find out more about the cost of Xiaflex with insurance.
Xiaflex contains the active ingredient collagenase clostridium histolyticum. 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 Xiaflex, or if you need help understanding your insurance coverage, help is available. For example:
- A copay assistance program is available for Xiaflex. For more information and to find out whether you’re eligible for support, call 877-XIAFLEX (877-942-3539). You can also visit the program websites for Peyronie’s disease and Dupuytren’s contracture.
- 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 Xiaflex, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance about cost issues related to Xiaflex. However, if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you would pay for Xiaflex.
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 Xiaflex, refer to this article.
- Dosage. Learn about Xiaflex and dosage by viewing this article.
- Side effects. For details about Xiaflex’s side effects, see this article. You can also look at the Xiaflex prescribing information.
- Information about your condition. For more information about Peyronie’s disease, see our list of men’s health 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.