Nucala savings tips

In this article:

• How much does Nucala cost?
• Can I get Nucala for free?
• How to save money on Nucala
• Is there a cheaper alternative to Nucala?

In this article

• How much does Nucala cost?
• Can I get Nucala for free?
• How to save money on Nucala
• Is there a cheaper alternative to Nucala?

The average person takes 17,000 or more breaths per day, often without even thinking about it. So it’s easy to take them for granted. But for people with severe eosinophilic asthma, breathing isn’t always so simple. This type of asthma increases white blood cells called eosinophils, which can cause inflammation in the respiratory system, triggering attacks. One effective treatment is Nucala (mepolizumab), an add-on prescription drug that can help reduce asthma symptoms and attacks. It is also prescribed to treat chronic rhinosinusitis with nasal polyps, eosinophilic granulomatosis with polyangiitis, and hypereosinophilic syndrome.

Patients only receive this subcutaneous injection once per month, but it can be expensive if you’re paying out of pocket. The good news is there are several ways to save.  

How much does Nucala cost?

Nucala is a specialty drug—meaning it is more complex than most drugs, whether due to the way it needs to be stored or administered, the seriousness of the condition it is used to treat, or other factors. You can only get Nucala from a specialty pharmacy. According to GSK, the drug’s manufacturer, the list price for one dose of Nucala is $3,688.83. But, the list price is the wholesale price charged to pharmacies, not to patients. If prescribed Nucala without insurance, you will likely pay the list price plus an additional amount charged by the specialty pharmacy dispensing it. Each injection contains 100 mg/mL of reconstituted solution and lasts for 30 days. Over an entire year, someone paying completely out of pocket could pay as much as $44,266. Biologic drugs like Nucala cost a lot to research and develop, and their prices often reflect that.

But not everyone has to pay that much. One of the most reliable ways to save money on prescription drugs is through insurance or Medicare coverage. Not every plan will cover Nucala, but some will. Medicare Part D plans, for example, spent a cumulative $193 million in 2022 covering it for beneficiaries, up from around $132 million in 2021. Some private insurance plans may provide coverage as well, so it’s worth checking your plan’s formulary or contacting the insurance company.

This coverage might also depend on how it’s administered. For example, “Medicare Part B can sometimes cover drugs like Nucala when administered in a healthcare provider’s office, under the Durable Medical Equipment category, although it generally falls under Part D when prescribed for home use,” said Sazan Sylejmani, Pharm.D., a pharmacist in Westmont, Illinois. So, if you plan on using an autoinjector or prefilled syringe at home, the coverage would need to come from a prescription drug plan, from Medicare or otherwise.

Even when it’s covered, the patient might need to pick up the tab on copays, coinsurance, or other out-of-pocket expenses. Certain health insurance companies and plans might also require prior authorization. According to Michael O. McKinney, MD, a primary care physician at Healthy Outlook, “Often there are certain criteria like showing evidence of severe persistent asthma despite the use of standard treatments of eosinophilic asthma that patients must satisfy before being covered.” 

But those aren’t the only price-influencing factors. “Prices can vary due to different pharmacy purchasing costs, regional pricing strategies, and the competitive landscape in specific areas,” Dr. Sylejmani said.

Can I get Nucala for free?

Even better than saving on Nucala is getting it for free—and it’s possible for people who meet certain eligibility requirements. GSK has a patient assistance program called GSKForYou, which provides medications (including Nucala) at no cost to qualifying applicants. Whether you have no insurance or your plan doesn’t cover Nucala, you’re eligible for enrollment if you’re below a certain income threshold.

That threshold varies based on the number of people in your household and which state you live in. For the 48 contiguous states, the District of Columbia, and the U.S. Virgin Islands, here are the income limits per month:

• One-person household: $6,275.00
• Two-person household: $8,516.67
• Three-person household: $10,758.33
• Four-person household: $13,000.00

*For each additional person, add $2,241.67.

On top of that, the patient can’t be receiving assistance from any government assistance programs like Medicaid, the VA, or TriCare.

You might also get one dose of Nucala for free if your insurance plan requires prior authorization. GSK has a program called Gateway to Nucala that offers the first Nucala injection at no cost if the patient’s prior authorization process takes longer than five days.

How to save money on Nucala

Those aren’t the only ways to reduce the cost of Nucala, though. Here’s additional information on a few other reliable options.

1. Nucala copay program

“Nucala’s manufacturer offers a savings card that can help eligible patients reduce their out-of-pocket costs, something we assist with regularly at our pharmacy,” Dr. Sylejmani said. This copay program is for patients who have a private health insurance plan that covers some (but not all) of their Nucala costs. The maximum amount it will cover is $9,450 for the year or $15,000 for people who have a high-deductible health plan. To qualify, you must be based in the United States and ineligible for any government-funded prescription assistance programs, including Medicare Part B, Medicare Part D, and Medicaid.

2. Ask for a 90-day supply

Buying anything in bulk is usually more cost-effective than buying a little at a time, and prescription drugs are no exception. Some studies have shown that patients who got 90-day supplies saved more on average than those who got 30-day supplies. Plus, these prescriptions only require a copay every three months instead of every month.

3. Consult your healthcare provider

Your healthcare provider not only knows the ins and outs of your medical condition, but they also know a lot about drug alternatives and ways to save. Don’t be shy about asking them how to get Nucala, or a similar drug, for cheaper. They might have tips on assistance programs, affordable pharmacies, and other ways to cover your out-of-pocket costs.

4. Research other assistance programs

GSKForYou is a great resource for most, but it’s not the only patient assistance program out there. There are also government and nonprofit sources. For Medicare beneficiaries who meet the eligibility requirements, Medicare Extra Help can help cover Part D expenses. Each state also has its own pharmaceutical assistance programs, and the Patient Advocate Foundation’s Co-Pay Relief program can be a solid resource for people with private insurance plans.

5. Shop around

Medications are products, and just like any other product, they’re sold for different prices at different pharmacies. Even pharmacies in the same vicinity can charge significantly different amounts for prescription drugs like Nucala. Price shopping for medications within a small geographic area can yield considerable cost savings.

Is there a cheaper alternative to Nucala?

For biologic drugs like Nucala, the most common cheaper alternatives are biosimilars. These are like the generic version of biologics—almost identical and FDA-approved for the same conditions. But as a newer drug, Nucala doesn’t have a biosimilar counterpart yet, so what’s the next best option? 

There are a few other treatments available. “However, each of these substitutions has its mode of action distinct from the others and could fit different groups of patients,” Dr. McKinney said. “The choice of another treatment option should depend on individual patient features, preferences, and aims of therapy, so patients must communicate their challenges with care providers.” 

Other biologics

Studies have concluded that Fasenra (benralizumab) and Dupixent (dupilumab) have efficacy and safety similar to Nucala. Cinqair (reslizumab) and Xolair (omalizumab) are other popular substitutes, but all of these are also biologic drugs, so they might not be any less expensive.

RELATED: Nucala vs. Dupixent │Fasenra vs. Nucala

Corticosteroids

The most prominent nonbiologic alternatives to Nucala are inhaled corticosteroids, which help decrease inflammation, allowing the patient to breathe normally. Plus, they’re often a lot cheaper. Flovent (fluticasone propionate HFA), for example, costs an average of $447.60 for a one-month supply, and a Pulmicort Flexhaler costs an average of $359.34.

Leukotriene modifiers

Eosinophils usually work in conjunction with chemicals called leukotrienes, which can also cause airway swelling. Leukotriene modifiers like Singulair and Accolate alter the actions of these chemicals, reducing their effects. Singulair costs around $334.49 per month on average.

Rescue inhalers

Healthcare professionals also often recommend that individuals with eosinophilic asthma also have a fast-acting rescue inhaler. During sudden asthma attacks, these medications can quickly open the airway, letting the patient breathe. Rescue inhalers aren’t standalone treatments, though. They’re a just-in-case medication you can use alongside a corticosteroid, biologic, or other drug.