Enbrel patient assistance program

In this article:

• How much does Enbrel cost?
• Enbrel patient assistance
• Other ways to save money on Enbrel
• Is there a cheaper alternative to Enbrel?
• Key takeaways:

In this article

• How much does Enbrel cost?
• Enbrel patient assistance
• Other ways to save money on Enbrel
• Is there a cheaper alternative to Enbrel?
• Key takeaways:

Enbrel (etanercept), is a brand-name biologic drug that blocks the activity of tumor necrosis factor (TNF), a substance in the body that can cause inflammation and lead to immune system diseases. It is taken as an injection under the skin once or twice a week as prescribed by a healthcare provider to treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, and plaque psoriasis. Like other biologics, it can be expensive, but there are several reliable ways to reduce that cost—particularly the Amgen Safety Net patient assistance program.

How much does Enbrel cost?

Without insurance coverage, discounts, or other financial support, Enbrel’s typical cash price is $8,430.54 for four 1 mL pre-filled syringes. That’s $2,107.64 per dose and could add up to over $100,000 per year.

That price comes largely from how the drug is developed. “Biologic medications are different from those that are synthesized in the lab. They are derived from living cells and biological processes, not from chemicals and nonliving processes,” said Tanya Feke, MD, a health policy analyst for Medicareresources.org. “This can make the process to produce them more difficult and, unfortunately, more expensive.”

Although Enbrel may seem expensive, it’s important to remember that some health insurance plans, Medicare Part D, and Medicaid plans might cover it. Amgen Inc., Enbrel’s manufacturer, says that 67% of patients with commercial insurance coverage paid $10 or less per month, while the other 33% paid an average of $341 per month.

When it comes to whether Medicare covers Enbrel, it gets a little complicated. Some Part D plans may require prior authorization or step therapy, where you must first try lower-cost medication options before stepping up to more expensive therapies,” according to Dr. Feke.

Medicare may instead cover infusible drugs that are administered via intravenous route. “Most Medicare Advantage (Part C) plans exclude self-injectable biologics or tablets such as Janus kinase (JAK) inhibitors,” said board-certified rheumatologist Stella Bard, MD. 

However, some Medicare Part D plans might cover Enbrel. According to the Centers for Medicare & Medicaid Services, Part D plans dispersed over $612 million in 2022 to cover Enbrel. And Amgen Inc. says 76% of Medicare Part D beneficiaries paid $50 or less per month, while 24% paid around $395 per month. Among Medicaid beneficiaries, 93% paid $10 or less per month, and the other 7% paid around $293 per month.

Enbrel patient assistance

Not everyone has insurance, and not every insurance plan covers Enbrel. Enbrel patient assistance is available through the Amgen Safety Net Foundation, which provides free Enbrel to eligible patients.

The program has specific eligibility requirements. To qualify, patients must:

• Have lived in the United States or one of its territories for six months or longer.
• Have an income of $45,180 or less for one person or $61,320 or less for two people. (Add $16,140 for each additional member of the household.)
• Have no insurance or have an insurance plan that doesn’t cover Enbrel or viable biosimilar drugs. This includes Medicare Part D beneficiaries whose plans cover Enbrel but don’t qualify for other financial support.

The first enrollment step is checking your eligibility on the Amgen Safety Net Foundation website. Once you do this, the site will direct you to apply online. You can also download, complete, and fax a paper form. Qualifying applicants will receive Enbrel free for 12 months, at which point they can re-enroll in the program, as long as they still meet all the requirements.

Other ways to save money on Enbrel

If you don’t qualify for the Enbrel patient assistance program, there are other ways to save. 

1. Free Enbrel coupons

SingleCare has coupons available for thousands of prescription and over-the-counter drugs, including Enbrel. Using a SingleCare Enbrel coupon could take nearly $2,000 off the drug’s average price—taking it from $8,430.54 to $6,507.50 for four 1 mL of 50 mg/mL syringes. Just keep in mind that SingleCare prices can vary by quantity, strength, form, and pharmacy location. Anyone can sign up for free and use the coupons at more than 35,000 participating pharmacies.

2. Enbrel copay card

While the Amgen Safety Net Foundation is for patients who don’t have insurance, Amgen Patient SupportPlus offers an Enbrel Co-pay Program for eligible commercially insured patients. If you have private health insurance and a valid Enbrel prescription, you can enroll in the program, and anyone who qualifies could potentially get Enbrel for free. However, you won’t qualify if you have Medicare, Medicaid, or other government-sponsored financial support. This program also includes support services like nurse partners, who provide one-on-one support. Learn more about the Enbrel Co-Pay Program.

RELATED: Enbrel copay card: Eligibility & more

3. Government assistance

For some people, Medicare Part D coverage might not cut it. Fortunately, government prescription assistance programs don’t end there. The Medicare Extra Help program provides Medicaid coverage, plus additional benefits. Each state also has its own assistance programs, but the eligibility requirements vary.

4. Nonprofit programs

The Patient Advocate Foundation’s Co-pay Relief Program may offer reimbursements or help pay for drugs directly, and the PAN Foundation provides grants for people with certain conditions. Enrolling in these programs usually means meeting specific income requirements, but if you’re accepted, you could save money on Enbrel.

5. Comparing prices

Medication prices vary from pharmacy to pharmacy—even between locations in the same city. So even though the pharmacy down the road might be convenient, one across town might have Enbrel for cheaper, making it worth the drive.

Is there a cheaper alternative to Enbrel?

Enbrel doesn’t have a generic version, but the Food and Drug Administration approved a biosimilar called Erelzi in 2016. Biosimilar drugs are nearly biologically identical to their biologic drug counterparts but often cost much less. Unfortunately, a 2020 federal circuit court decision made Erelzi unavailable in the United States until 2029—and the Supreme Court upheld the decision. “This gives Enbrel brand exclusivity through that time, and will likely keep costs up until there is competition in the market,” Dr. Feke said.

But that doesn’t mean Enbrel patients have no alternatives. “Cheaper alternatives to Enbrel might be the Humira biosimilars—and there are currently many on the market,” Dr. Bard said. “They target the same molecule but look very different to the immune system.” 

RELATED: Enbrel vs. Humira: Differences, similarities, and which is better for you

Depending on your medical condition, your healthcare provider may recommend Enbrel alternatives such as:

• Otrexup (methotrexate): A disease-modifying antirheumatic drug (DMARD) that costs $886 on average
• Arava (leflunomide): Another DMARD that costs an average of $1,744
• Orencia (abatacept): A selective T-cell costimulatory modulator that costs an average of $5,632 per 3, 250 mg solution.
• Xeljanz (tofacitinib): Another DMARD that costs $7,005 for 60 tablets, on average.
• Cimzia (certolizumab): A TNF blocker that costs an average of $6,461 per kit.

These medications aren’t completely interchangeable, since they may treat different conditions and affect the body in different ways. Consult a healthcare provider to see which might be a good match for your condition.

Key takeaways:

• Enbrel is a TNF blocker commonly prescribed to treat moderate-to-severe plaque psoriasis, various types of arthritis, and ankylosing spondylitis.
• Without insurance or other financial assistance, Enbrel’s average price is $8,430.54 for four pre-filled syringes.
• Commercial health insurance, Medicare, and Medicaid may help pay for Enbrel, but it depends on the specific plan.
• Amgen’s Safety Net Foundation is a patient assistance program that helps uninsured patients pay for the drug.