Arexvy and cost

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

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

Arexvy contains the active ingredient respiratory syncytial virus vaccine, adjuvanted, 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 BRAND-NAME 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 Arexvy, or if you need help understanding your insurance coverage, help is available. For example:

• 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 Arexvy.

What is the cost of Arexvy without insurance?

The price you’ll pay for Arexvy if you don’t have insurance can vary based on several factors. But typically, the cost is higher for those without insurance.

There are other factors that could affect what you pay for this drug. These include:

• whether you apply and qualify for any available savings programs
• your dosage
• the pharmacy you use

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 Arexvy.

Check out Optum Perks* for price estimates for several medications. (Optum Perks coupons cannot be used with insurance benefits or copays.)

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

How does Arexvy’s cost compare with that of Abrysvo?

Arexvy and Abrysvo are vaccines that are given to prevent lung infections due to RSV. The price you would pay for Arexvy or Abrysvo depends on various factors, including:

• 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 Arexvy compared with other RSV vaccines, talk with your doctor, pharmacist, or insurance provider.

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

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

Type of insurance coverage: Arexvy is given by your doctor or another healthcare professional. If you have insurance, the price of your Arexvy 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 Arexvy, such as at your doctor’s office or pharmacy.

If you have questions about this process, contact your doctor or your insurance provider.

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.