How Much Should I Expect to Pay for BIMZELX® (bimekizumab-bkzx)?
Prescription drug prices can be confusing. Two people may pay different prices for the same drug, depending on their insurance situation.
The list price1 of BIMZELX is $7,552.802 per 1 mL autoinjector or syringe, but the amount you pay will largely depend on your prescription drug insurance plan. The information below will give you a good idea of what to expect based on your insurance situation.
For the most accurate information, talk to your insurance provider, as they know the details of your plan.
Which Option Below Best Describes Your Insurance Situation?
I Have Insurance Through an Employer or Private Individual Policy
BIMZELX prescriptions will cost the majority of patients between $0 and 26% of drug cost every two months based on their benefit design.3
What you pay for BIMZELX will depend on your insurance plan. Each plan has different preferred drug lists and out-of-pocket amounts, and most include an annual deductible. If you haven’t met your deductible, you’ll see higher prices until the deductible is met; then your out-of-pocket cost will likely drop. Commercially insured patients with approved coverage may pay as little as $5 per dose utilizing the BIMZELX Navigate® Savings Program. If you have additional questions about affordability, you can reach out to one of our BIMZELX Navigate Nurse Navigators at 1-833-931-6877.
I Have Medicare Coverage
If you have Part D coverage and are eligible for the Extra Help4 program, you can expect to pay $4.50- $11.20 for each prescription.5
If you are unsure whether you qualify for Extra Help, please visit the Social Security Administration website for more information.
If you don’t qualify for Extra Help, your out-of-pocket costs may vary throughout the year depending on which phase of the Part D benefit you are currently in.
I Have Medicaid Coverage
For most people on Medicaid, prescription drugs like BIMZELX range from $4.95-$9.85 per month.6 Some states eliminate the copay requirements altogether.
To find out if you qualify for Medicaid, or for more information about copayments in your state, please visit Medicaid's website.
I Don’t Have Insurance or BIMZELX Is Not Covered By My Insurance Plan
If you do not have insurance or your insurance plan does not cover BIMZELX, please contact our team of compassionate and informed professionals for more information to see what options might be available to you. Contact UCBCares® at 1-844-599-CARE (2273) or visit us online at https://www.ucb-usa.com/patients/patients.
References:
- AnalySource powered by First Data Bank. Accessed July 2024. List price is also referred to as wholesale acquisition cost or WAC. WAC is the price at which UCB sells its products to wholesalers. A dose of BIMZELX is defined as 320 mg (given as two subcutaneous injections of 160 mg each) every four weeks until week 16, and every eight weeks thereafter.
- AnalySource accessed July 2024. AnalySource will publish a Wholesale Unit Cost (2 prefilled syringes/autoinjectors) and Extended Unit Cost (1 prefilled syringe/autoinjector).
- Based on Commercial Insurance benefit design (Kaiser Foundation 2023 Employer Health Benefits Survey (https://www.kff.org/health-costs/report/2022-employer-health-benefits-survey/) and the most common Tier coverage of Specialty Biologics. Accessed January 2024.
- Social Security Administration (SSA). Extra Help with Medicare Prescription Drug Plan Costs. https://www.medicare.gov/basics/costs/help/drug-costs. Accessed January 2024.
- Centers for Medicare & Medicaid Services (CMS). Announcement of Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies. https://www.cms.gov/files/document/2024-announcement-pdf.pdf. Accessed January 2024.
- Centers for Medicare & Medicaid Services (CMS). Medicaid and CHIP Overview. Maximum Allowable Copayments Determined by Eligible Population’s Household Income. Updated August 2023. All out-of-pocket charges are based on the specific state’s defined payment amount for that service. Certain groups, including children, terminally ill individuals, and individuals residing in an institution, are exempt from cost sharing. Refer to your state agency for details about Medicaid out-of-pocket costs. https://marketplace.cms.gov/technical-assistance-resources/medicaid-chip-overview.pdf. Accessed January 2024.
BIMZELX®, BIMZELX Navigate®, and UCBCares® are registered trademarks of the UCB Group of Companies.
US-BK-2400156
November 2024