Hemlibra (emicizumab) is a brand-name injectable solution that’s prescribed for hemophilia A with or without factor VIII inhibitors. The cost of the drug with and without insurance can depend on several factors, such as whether Hemlibra has a savings program.
As with all medications, the cost of Hemlibra 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 your Hemlibra injection (if you or a caregiver do not give your dose at home)
- whether Hemlibra has a savings program (see the “Financial and insurance assistance” section below)
In addition, you may need to purchase needles and syringes to use Hemlibra.
To find out what the cost of Hemlibra will be for you, talk with your doctor, pharmacist, or insurance provider.
Hemlibra contains the active ingredient emicizumab, 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 Hemlibra 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 Hemlibra. 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
Hemlibra 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 Hemlibra, or if you need help understanding your insurance coverage, help is available. For example:
- A copay program called Hemlibra Co-pay Assistance is available for Hemlibra. For more information and to find out if you’re eligible for support, call 844-436-2672 or visit the program website.
- A program called Genentech Patient Foundation is also available for people taking Hemlibra. You may be eligible for this program if you don’t have insurance or you meet other eligibility criteria.
- 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 Hemlibra.
Why is Hemlibra so expensive?
Hemlibra is a medication used to treat a rare bleeding disorder called hemophilia A. Any drug that’s approved by the FDA can be expensive due to the research needed to ensure its safety and effectiveness. In the case of rare diseases, including hemophilia, it’s even more costly to do clinical trials and the testing needed to determine a drug’s safety.
If you’re having trouble affording Hemlibra treatment, see the resources above in the “Financial and insurance assistance” section. The manufacturer of Hemlibra offers a few programs that you may qualify for to help alleviate some of the costs of Hemlibra.
Is Hemlibra a cost-effective treatment option for hemophilia A?
Yes, Hemlibra may be a cost-effective treatment option for people with hemophilia A. Although it may have a higher cost than other drugs, it does prevent bleeds in the majority of people with hemophilia A taking the drug. In addition, a report by the Institute for Clinical and Economic Review states that using Hemlibra does decrease costs overall in people with hemophilia A.
If you’re interested in using Hemlibra but are concerned about the costs, talk with your doctor or pharmacist. You may also wish to see the resources above in the “Financial and insurance assistance” section.
Below is information you may want to consider if you have insurance and receive Hemlibra.
Prior authorization: If you have insurance, your insurance company may require prior authorization before it covers Hemlibra. This means the company and your doctor will discuss Hemlibra 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 Hemlibra requires prior authorization.
Type of insurance coverage: Hemlibra may be given by your doctor or another healthcare professional. If you have insurance, the price of your Hemlibra 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 Hemlibra 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.
For more information on this medication, including its dosage, its side effects, or how Hemlibra works, see this article. You can also discuss any questions that you have with your doctor or pharmacist.
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.