Cyltezo (adalimumab-adbm) is a brand-name drug prescribed for certain inflammatory conditions. It’s available as an injection pen and a single-dose prefilled syringe. The cost of Cyltezo with and without insurance can depend on several factors.
Cyltezo belongs to a drug class called tumor necrosis factor-alpha (TNF-alpha) blockers. Cyltezo is a biosimilar version of the drug Humira.
Read on to learn about Cyltezo and cost, as well as how to save money on prescriptions. If you’d like more information about Cyltezo, refer to this article.
As with all medications, the cost of Cyltezo 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 Cyltezo
- whether Cyltezo has a savings program (see the “Financial and insurance assistance” section below)
In addition, you may need to purchase needles to use the single-dose prefilled syringe form of Cyltezo.
To find out what the cost of Cyltezo will be for you, talk with your doctor, pharmacist, or insurance provider.
Insurance considerations
Below is information you may want to consider if you have insurance and receive Cyltezo.
Prior authorization. If you have insurance, your insurance company may require prior authorization before it covers Cyltezo. This means the company and your doctor will discuss Cyltezo 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 Cyltezo requires prior authorization.
Type of insurance coverage. Cyltezo can be given by your doctor or another healthcare professional. If you have insurance, the price of your Cyltezo 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 Cyltezo 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.
Cyltezo contains the active drug adalimumab-adbm. It’s a biosimilar version of the brand-name biologic drug Humira (adalimumab). 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.
Cyltezo is approved to treat the same conditions as Humira.
If your doctor has prescribed Cyltezo and you’re interested in taking Humira instead, talk with your doctor. They may prefer one version or the other for your condition. In addition, your insurance provider may only cover one or the other.
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 Cyltezo 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 Cyltezo. 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
Cyltezo 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 Cyltezo or help to understand your insurance coverage, help is available. For example:
- The Cyltezo Copay Program is available for this drug. For more information and to find out if you’re eligible for support, call 833-CYLTEZO (833-295-8396) or visit the program website.
- 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 Cyltezo.
Is the cost of Cyltezo similar to the cost of Humira?
Cyltezo and Humira (adalimumab) are both drugs that doctors may prescribe for certain inflammatory conditions. Specifically, both drugs may be used to treat:
- Crohn’s disease
- ulcerative colitis
- rheumatoid arthritis
- plaque psoriasis
- uveitis
- ankylosing spondylitis
- juvenile idiopathic arthritis
- psoriatic arthritis
- hidradenitis suppurativa
Cyltezo is a biosimilar of the brand-name biologic drug Humira. A biosimilar medication is a drug that’s similar to a brand-name biologic drug (the parent drug). Also, biosimilars typically cost less than brand-name medications.
The cost of Cyltezo or Humira depends on many factors, including your insurance coverage.
It’s important to note that each drug has a program that offers financial assistance for those who qualify. For details on Cyltezo’s financial assistance program, see the “Financial and insurance assistance” section above.
To find out how much you’ll pay for Cyltezo versus Humira, talk with your doctor, pharmacist, or insurance provider.
Is Cyltezo a long-term treatment?
If your doctor has recommended Cyltezo, you’ll likely take it long term. Most inflammatory conditions do not have a cure. However, taking a drug like Cyltezo may significantly reduce symptoms of your condition.
If you’re having trouble paying for Cyltezo, you may qualify for their financial assistance program. For more details, see “Financial and insurance assistance” above.
To learn more about what you can expect while on Cyltezo treatment, talk with your doctor or pharmacist.
Now that you’ve learned about cost and Cyltezo, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance about cost issues related to Cyltezo. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you’d pay for Cyltezo.
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 Cyltezo, refer to this article.
- A look at your condition. Cyltezo is prescribed to treat several conditions. For more information about each, view our hubs on:
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.