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Key takeaways
Tremfya is a biologic drug, available by prescription and used as a subcutaneous injection every eight weeks for psoriasis, psoriatic arthritis, and ulcerative colitis.
Coverage for Tremfya varies between insurance plans, with some not covering it and others requiring substantial copays.
Paying for Tremfya without insurance can be intimidating, considering its retail price of $24,000 per 100 mg dose.
SingleCare discount cards and coupons can cut Tremfya’s price in half.
Less expensive biologic drugs and non-biologic alternatives could be cheaper options that are worth discussing with one’s healthcare team.
Tremfya (guselkumab) is a brand-name injectable medication that is prescribed to combat inflammation in the setting of severe plaque psoriasis, psoriatic arthritis, and ulcerative colitis. It is a biologic drug, more specifically a monoclonal antibody, that binds to the inflammatory mediator interleukin-23 (IL-23) to stop the auto-immune cascade fueling these health conditions. Like most biologic drugs, Tremfya carries a hefty price tag. Those hardest hit are people without health insurance. We will examine its expense and ways to save.
Related: Tremfya coupon | Tremfya details
Is Tremfya covered by insurance?
If you have insurance, the best way to know if you have coverage for Tremfya is to check your insurance provider’s formulary. Insurance coverage will vary from plan to plan. For example, Humana Medicare’s formulary lists Tremfya as not covered, while Aetna’s Standard Plan labels the drug as a preferred specialty product. Preferred status often means a lower copay for meds that are covered compared to non-preferred options. These details will determine how much you have to pay out-of-pocket for Tremfya.
How much does Tremfya cost without insurance?
The cost of Tremfya for those with insurance depends on the drug formulary, preference status, and copays. Without insurance, retail prices can differ depending on which pharmacy you use. No generic form exists, and one is not on the horizon either based on Tremfya’s patents.
The retail price of Tremfya is $24,000 for a single-dose 100 mg pen injector. Tremfya is usually given as a 100 mg injection every 8 weeks, except for the first two doses, which are only separated by 4 weeks. That adds up to $168,000 in the first year of treatment and $144,000 annually for each subsequent year.
Tremfya’s expense rightfully sends people in search price comparisons. The drug does not stand alone as an option for treatment of psoriasis, psoriatic arthritis, or ulcerative colitis. Although price is only one factor to consider, it remains one of practical importance.
| Compare Tremfya to related to drugs | |||
|---|---|---|---|
| Drug name | Price without insurance of brand-name drug | SingleCare price | Savings options |
| Tremfya (guselkumab) | $24,000 per 1, 1 mL of 100 mg/mL pen | $11,260 per 1, 1 mL of 100 mg/mL pen of brand-name Tremfya | See updated prices |
| Cosentyx (secukinumab) | $7,800 per 1, 0.5 mL of 75 mg/0.5 mL syringe | $3,780 per 1, 0.5 mL of 75 mg/0.5 mL syringe of brand-name Cosentyx | See updated prices |
| Taltz (ixekizumab) | $8,730 per 1, 1 mL of 80 mg/mL pen | $6,660 per 1, 1 mL of 80 mg/mL pen of brand-name Taltz | See updated prices |
| Bimzelx (bijukizumab) | $17,290 per 2, 1 mL of 160 mg/mL pen | $15,410 per 2, 1 mL of 160 mg/mL pen of brand-name Bimzelx | See updated prices |
| Humira (adalimumab) | $9,280 per 2, 1 auto-injector kits | $5,970 per 2, 1 auto-injector kits of brand-name Humira | See updated prices |
| Idacio (adalimumab-aacf) | $7,890 per 1, 40 mg/0.8 mL auto-injector 2-pack | $920 per 1, 40 mg/0.8 mL auto-injector 2-pack of brand-name Idacio | See updated prices |
| Enbrel (etanercept) | $8,690 per 4, 1 mL of 50 mg/mL syringes | $6,790 for 4, 1 mL of 50 mg/mL syringes of brand-name Humira | See updated prices |
| Cimzia (certolizumab) | $7,370 per 1 prefilled syringe 2-pack | $5,550 per 1 prefilled syringe 2-pack of brand-name Cimzia | See updated prices |
| Simponi (golimumab) | $7,690 per 1, 0.5 mL of 50 mg/0.5 mL pen | $5,950 per 1, 0.5 mL of 50 mg/0.5 mL pen of brand-name Simponi | See updated prices |
| Skyrizi (risankizumab) | $29,660 per 1, 1 mL of 150 mg/mL pen | $19,000 per 1, 1 mL of 150 mg/mL pen of brand-name Skyrizi | See updated prices |
| Stelara (ustekinumab) | $37,050 per 1, 1 mL of 90 mg/mL syringe | $22,670 per 1, 1 mL of 90 mg/mL syringe of brand-name Stelara | See updated prices |
| Xeljanz (tofacitinib) | $6,840 per 60 tablets | $5,200 per 60 tablets of brand-name Xeljanz | See updated prices |
Prescription drug prices often change. These are the most accurate medication prices at the time of publishing. The listed price without insurance references the price of brand-name drugs. The listed SingleCare price references the price of generic drugs if available. Click the link under “Savings options” to see updated drug prices.
How to get Tremfya without insurance
The use of biologic medications has taken off, and their price can seem sky-high. Insurance may or may not cover the cost. To help patients navigate through insurance, pharmacy, and pricing aspects to get Tremfya, the drug’s manufacturer Johnson and Johnson has created the Tremfya with Me program. When it comes to savings, eligibility requirements for manufacturer patient assistance programs may need to be met. There are discount options that are more readily available.
Get a SingleCare discount card
Free and easy to use, the SingleCare discount card can lower the price of Tremfya by just showing it to the pharmacist. The price of a 100 mg pen of the medication can drop from $24,000 to $11,260. Taken every 8 weeks, the nearly $13,000 savings per dose amounts to almost $80,000 saved in a year.
Shop around at different pharmacies
Over 35,000 pharmacies in the United States take SingleCare coupons. The discount price will differ between establishments. Depending on which pharmacy you use, a 100 mg Tremfya pen could cost between $11,260 and $12,500 with a Singlecare coupon. Shopping around between pharmacies can pay off, to the tune of saving over a thousand dollars per dose.
Look into other biologics
From the table above, you can see that there is no shortage of options for biologic treatment of psoriasis, psoriatic arthritis, and ulcerative colitis. Generics are not available within the class because biologic drug development has been fairly recent, and manufacturing a generic for these complex molecules is expensive. Humira has been around long enough that biosimilars of it, like Idacio, are available.
The biosimilars represent some of the least expensive options. With a SingleCare discount, Idacio costs $920 for a one-month supply. A patient could spend $1840 for two months of Idacio therapy or pay $11,260 for a two-month supply of Tremfya.
The details of dosing will be important to consider when comparing options. Cosentyx is listed above as having a discounted price of $3,780 for a 75 mg syringe, and while this looks cheaper than Tremfya, Cosentyx dosing for plaque psoriasis is often 300 mg every four weeks. Likewise, Stelara’s price is eye-popping at $22,000 per 90 mg dose, even when discounted, but this dose may only need to be given every 12 weeks for plaque psoriasis.
Get the medical advice of your dermatologist, rheumatologist, or gastroenterologist about alternatives to Tremfya. Your healthcare provider can review differences in efficacy and side effects with you in order to factor these aspects, as well as price, into your decision making.
Ask about alternatives to biologics
With biologics, considerable efficacy comes at a sizable cost. Other treatment options could be effective too, and at a fraction of the cost. For example, methotrexate can be effective for plaque psoriasis. It can cost as little as $230 for 72, 2.5mg tablets, enough for three months of treatment when dosed as 15 mg once weekly. Discuss non-biologic treatment options with your doctor to determine if their lower efficacy or side effects make them unattractive alternatives despite their price.
Sources
- Tremfya drug patent profile, DrugPatentWatch (2024)
- Tremfya drug label, NIH DailyMed (2024)
- Humana Medicare drug pricing app, Humana (2024)
- Aetna Standard Control Plan formulary, Aetna (2024)
- Tremfya with Me program, Johnson and Johnson, Inc (2024)
