Ibrance Cost in 2025: Discounts and Additional Benefits
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Ibrance, a brand-name drug used to treat certain types of advanced or metastatic breast cancer, can be an expensive treatment option. The cost of Ibrance per month at specialty pharmacy providers typically ranges around £11,000 to £13,000 without insurance coverage. However, the actual patient out-of-pocket cost varies substantially depending on insurance coverage type, formulary tier placement, and whether the patient has Medicare, commercial insurance, or assistance programs.
Insurance Coverage and Ibrance Cost
For patients with Medicare Part D or Medicare Advantage plans, specialty drugs like Ibrance are often categorized in higher tiers such as Tier 4 or Tier 5 (Specialty Tier). The patient cost-share in these tiers often includes coinsurance rates ranging from roughly 15% to 50% or a high fixed copayment, depending on the specific plan formulary details. This can translate to substantial out-of-pocket expenses, given Ibrance’s high cost.
On the other hand, many plans include out-of-pocket maximums or caps on specialty drug costs. However, patients without financial assistance or supplemental coverage may still face several thousands of pounds per month.
Commercial insurance plans and manufacturer copay assistance programs can reduce these costs significantly, but exact amounts vary widely by insurer and patient eligibility.
Finding Financial Support
Pfizer Oncology offers a copay savings card for Ibrance, which can help reduce the cost. Additionally, a Pfizer Patient Assistance Program is available for some uninsured people.
Two websites that provide details about drug assistance programs, ways to make the most of insurance coverage, and links to savings cards are Medicine Assistance Tool and NeedyMeds.
Specialty Pharmacy and Ibrance Availability
Ibrance is available only at specialty pharmacy providers. A pharmacist at a specialty pharmacy can provide the monthly cost of Ibrance. It's essential to note that getting a 90-day supply of Ibrance, if approved by your insurance company, could reduce your number of trips to the pharmacy and help lower the cost.
Other Considerations
There is no generic version of Ibrance, making it an expensive treatment option. However, brand-name drugs are expensive due to the research needed to test their safety and effectiveness, while generics tend to cost less.
If you don't have health insurance, talking with your doctor or pharmacist may help you find online pharmacy options. Whether or not you have insurance, your cost of Ibrance will depend on several factors such as dose and treatment plan, eligibility for an Ibrance savings program, and the pharmacy used.
Before starting treatment with Ibrance, prior authorization may be required by insurance companies. Ibrance is available in oral tablet and oral capsule forms.
In conclusion, while the wholesale cost of Ibrance is high, the actual out-of-pocket cost for patients varies significantly based on insurance coverage. It's essential to discuss your options with your healthcare provider and research available financial assistance programs to help manage the cost of Ibrance.
[1] Medicare Prescription Drug Plans, Drug Coupons and Medicare, and the Medicare drug list. (n.d.). Retrieved from https://www.medicare.gov/drug-coverage-part-d/
[2] Centers for Medicare & Medicaid Services. (n.d.). Part D Costs. Retrieved from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCoverageGenIn/
[3] American Cancer Society. (2021). Ibrance (palbociclib): Uses, dosage, side effects, and more. Retrieved from https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/targeted-therapy/ibrance-palbociclib.html
[4] National Comprehensive Cancer Network. (2021). NCCN Clinical Practice Guidelines in Oncology: Breast Cancer. Retrieved from https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf
[5] Pfizer. (2021). Ibrance (palbociclib) for Invasive Breast Cancer. Retrieved from https://www.pfizer.com/products/cancer/ibrance
- Health insurance, such as Medicare or commercial insurance plans, can significantly influence the out-of-pocket costs for a brand-name drug like Ibrance used to treat certain types of advanced breast cancer.
- Healthcare providers, researchers, and organizations involved in science and medical conditions may collaborate to develop research on cancer treatments, like Ibrance, to ensure their safety and effectiveness.
- Seeking financial support is essential for managing the high cost of treatments like Ibrance, and this can be accomplished through programs like manufacturer copay assistance, patient assistance programs, or by visiting websites like Medicine Assistance Tool and NeedyMeds.
