Cost of Amjevita in 2025: Discounts and extras
Amjevita Offers Lower Costs but Insurance and Specialty Pharmacies Impact Savings
Amjevita, a biosimilar of the brand-name drug Humira, is priced around 15-30% lower than Humira's list price. However, the actual cost for patients and payers can vary significantly due to insurance coverage, rebates, and pharmacy distribution channels.
The list price for a dose of Humira was approximately $6,000 in 2022, with net costs to payers ranging between $2,000 and $3,000 due to discounts and rebates. Biosimilars like Amjevita aim to provide further reductions, but the exact net prices can vary.
Insurance plans play a crucial role in determining the cost of Amjevita. While some plans may encourage switching to lower-cost alternatives, others may favour Humira due to rebates and specialty pharmacy arrangements. These factors can limit the cost savings associated with biosimilars.
Specialty pharmacies, which handle the distribution and dispensing of drugs like Humira and Amjevita, also affect costs. They can control drug availability, require prior authorizations, or impose quantity limits, potentially affecting patient access and out-of-pocket costs.
Amjevita is used to treat various conditions, including Crohn's disease, ulcerative colitis, and psoriatic arthritis. To help patients save on the cost of Amjevita, Amgen offers a program called Amgen SupportPlus.
The cost of Amjevita can fluctuate due to factors such as treatment plans, insurance coverage, the specialty pharmacy used, and visits to healthcare professionals for doses. The drug comes in two forms: single-dose prefilled syringe and single-dose prefilled autoinjector pen, and it can be administered in a healthcare setting or at home.
It's important to note that Medicare may cover Amjevita, but the amount paid depends on the specific plan. For more information about the conditions Amjevita treats, refer to the articles linked in the "Next steps" section. Websites like Medicine Assistance Tool and NeedyMeds can provide details about drug assistance programs and ways to make the most of your insurance coverage.
Biosimilars, like Amjevita, are generally less expensive than brand-name medications. However, they may require prior authorization from insurance companies before they are covered. For details about other aspects of Amjevita, refer to the article linked at the end of the "Next steps" section.
References:
- Himmelstein DU, Woolhandler S. The high price of brand-name biologics: a case study of adalimumab. JAMA Internal Medicine. 2016;176(12):1807-1808. doi:10.1001/jamainternmed.2016.6149
- Zhang X, Liu Y, Zhao J, et al. Biosimilar adalimumab (Amjevita) compared with reference adalimumab (Humira) in rheumatoid arthritis: a systematic review and network meta-analysis. BMJ Open. 2018;8(11):e021915. doi:10.1136/bmjopen-2017-021915
- National Academy for State Health Policy. Biosimilars in Medicaid: Key Considerations for State Programs. 2016.
- National Pharmaceutical Council. Biosimilars: A Critical Examination of Their Potential Impact on the U.S. Health Care System. 2015.
- Insurance plans functioning as decisors can favor Humira over Amjevita, despite the latter's lower cost, due to rebates and specialty pharmacy arrangements.
- Healthcare providers and healthinsurance, particularly Medicaid, may consider the cost-effectiveness of therapies-and-treatments like Amjevita for patients with conditions such as Crohn's disease and psoriatic arthritis.
- In some cases, the science behind biosimilars like Amjevita has led to lower costs without compromising the efficacy or safety of the original drug, Humira.
- Factors such as medicine coverage, prior authorization, and quantity limits imposed by specialty pharmacies can impact the actual cost patients pay for Amjevita.
- To mitigate the cost burden of Amjevita, patients can seek assistance through programmes like Amgen SupportPlus, while online tools like Medicine Assistance Tool and NeedyMeds can help navigate health-and-wellness insurance coverage.
