PRICING AND INSURANCE
DUPIXENT PRICING
AND INSURANCE
Many patients have questions when it comes to the cost and insurance coverage of DUPIXENT. Use the cost and coverage tool to see whether DUPIXENT may be covered by your insurance plan.
INFORMATION ABOUT THE COST OF DUPIXENT
The amount you pay for DUPIXENT will largely depend on a number of factors, including:
- Whether you have prescription drug insurance
- The type of insurance you have
- Whether your insurance provider considers the medication to be preferred or not preferred
- Whether you’ve met your deductible
Considering these factors, 2 people could pay very different prices for exactly the same prescription medication.
Use the DUPIXENT Cost and Coverage Tool below for more information.
It is recommended to speak with your insurance provider for any outstanding questions you may have about the cost or dispensing of DUPIXENT because they know the full details of your plan.
Select your current prescription insurance to
see possible cost and coverage
Commercial/Employer-Provided Insurance
What do most people with this insurance type pay?
Copay payments vary based on your specific plan. Approximately 68% of commercial/employer-provided insured patients pay between $0-$100 per month for DUPIXENT. Approximately 32%‡ pay $100+3,¶ per month of DUPIXENT.
With the Copay Card, You Could Pay as Little as $0†
The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay® Copay Card.2 Eligible US residents with an FDA-approved prescription for DUPIXENT may pay as little as $0 copay per fill of DUPIXENT (annual maximum of $13,000). Explore your copay eligibility.
†Program has an annual maximum of $13,000. *THIS IS NOT INSURANCE. Not valid for prescriptions paid, in whole or in part, by Medicaid, Medicare, VA, DOD, TRICARE, or other federal or state programs including any state pharmaceutical assistance programs. This program is not valid where prohibited by law, taxed or restricted. DUPIXENT MyWay reserves the right to rescind, revoke, terminate, or amend this offer, eligibility, and terms of use at any time without notice. Additional terms and conditions apply.
‡% of claims based on unprojected data.
¶Out-of-pocket costs were standardized to a 30-day supply period.
Medicaid
What do most people with this insurance type pay?
For most people on Medicaid, prescription drugs like DUPIXENT range from $4-$9 per month.7,† To find out if you qualify for Medicaid, or for more information about copays under Medicaid in your state, visit the Medicaid site.
DUPIXENT MyWay may be able to help
The DUPIXENT MyWay Patient Assistance Program may be able to help. Patients will need to meet the eligibility criteria, including household income, to qualify. The DUPIXENT MyWay team can research each patient's situation and determine eligibility.
†Maximum allowable copayments determined by eligible population’s household income.
Medicare
What do most people with this insurance type pay?
Approximately 71% of Medicare Part D patients can expect to pay between $0-$100 per month for DUPIXENT, and 29% of Medicare Part D patients can expect to pay $100+4,† per month for DUPIXENT.
How much you pay for your prescription drugs may change throughout the year for some people with Part D insurance. You may pay more in the beginning of the year or more later in the year depending on which phase of the Part D benefit you are in.‡
Cost Assistance Options
Some people with Medicare Part D coverage are eligible for the Social Security Administration's Extra Help5 program (also known as the Low-Income Subsidy or "LIS"), and they typically pay $3-$9 for their prescriptions.6 See the program details.
†Payments are averaged across all phases of Medicare coverage, and include coverage gap and catastrophic phase payments. Out-of-pocket costs were standardized to a 30-day supply period.
‡Drug coverage under Medicare Part D is divided into 4 phases: 1) deductible, 2) initial coverage, 3) coverage gap, and 4) catastrophic. Each of these phases has different cost-sharing amounts.
UNINSURED
What do most people who are uninsured pay?
If you do not have insurance that covers your prescription medications, or if your insurance does not cover DUPIXENT, you can typically expect to pay the list price shown below the tool plus any additional pharmacy charges. The price you pay varies from pharmacy to pharmacy.
DUPIXENT MyWay may be able to help
The DUPIXENT MyWay Patient Assistance Program may be able to help. Patients will need to meet the eligibility criteria, including household income, to qualify. The DUPIXENT MyWay team can research each patient's situation and determine eligibility.
1‑844‑DUPIXENT (1-844-387-4936), option 1
Monday-Friday, 8 am - 9 pm EST
of U.S. patients with [insurance type] insurance are covered nationally.
Does my insurance cover DUPIXENT® (dupilumab)?
Enter the insured patient’s ZIP Code below.
If you can't find your recommended plan, enter the ZIP Code of the insured patient's employer.
All prescription medications have a list price.1 Very few patients pay the list price, which is a price set by the manufacturer. The list price* of DUPIXENT is $3,203.39 USD per carton, but most people will not pay the list price.
*List price is also referred to as wholesale acquisition cost or WAC. WAC is the price at which Sanofi sells its products to wholesalers. A monthly supply of DUPIXENT (300 mg or 200 mg) is defined as 2 injections per month. List price as of 1/3/2021.
WORKING WITH SPECIALTY PHARMACIES TO GET DUPIXENT
Once DUPIXENT is approved, a specialty pharmacy may work with you to schedule shipments of DUPIXENT to your home or preferred location.
- Be sure to answer calls from your specialty pharmacy! You cannot receive DUPIXENT until you speak with your specialty pharmacy to schedule your DUPIXENT shipments.
- Store your specialty pharmacy’s name and phone number in your phone’s contacts.
See how DUPIXENT goes from being prescribed
to being delivered
to your doorstep.
Transcript
DUPIXENT® (dupilumab)—a medicine with special storage requirements—is what’s known as a specialty medicine.
That means it may be delivered to you by a specialty pharmacy instead of your local pharmacy.
That also means you can expect the process for getting your prescription filled to be different from other medicines you may pick up from your local pharmacy.
It will go something like this:
First, your doctor writes a prescription for DUPIXENT. Be sure to ask your doctor about enrolling in DUPIXENT MyWay®, which can provide additional support for you. You or your doctor can download the enrollment form on DUPIXENT.com or call 1-844-DUPIXENT, Option 1 to enroll.
Next, your prescription may have to be authorized by insurance. This is called prior authorization and is common for specialty medicines.
Your insurance company will work with your doctor to get any additional medical information they need.
It might feel like this part takes a while, but hang in there.
If you have enrolled in DUPIXENT MyWay, you will receive a welcome call from a nurse educator while your insurance benefits are being confirmed. Once DUPIXENT is approved by your insurer, a specialty pharmacy works with you to schedule the shipments of DUPIXENT to your home or other preferred location, so be sure to answer their calls to prevent delays.
They will not ship your medicine without first confirming delivery details with you.
And while everyone’s working through the details, look to DUPIXENT MyWay for additional support.
You can connect with DUPIXENT MyWay nurse educators by phone 24/7 to receive supplemental injection training, help scheduling deliveries and prescription refills, or help navigating financial support options, such as copay assistance.
As a reminder, with all of these folks helping to get you off to good start with DUPIXENT, you may receive phone calls from your doctor’s office, specialty pharmacy, and a DUPIXENT MyWay Nurse Educator.
Remember to quickly respond to these calls to avoid delays in receiving DUPIXENT. So, now you know what to expect from prescription to delivery.
For more information on how to properly store DUPIXENT after delivery, please review the DUPIXENT Instructions for Use at DUPIXENT.com.
THE DUPIXENT MyWay® COPAY CARD
The DUPIXENT MyWay Copay Card may help eligible patients cover the out-of-pocket cost of DUPIXENT. If you’re eligible, you can enroll and download your copay card on the site. Terms & Restrictions Apply.
check copay eligibilityFREQUENTLY ASKED QUESTIONS
Notify your pharmacy. In fact, when you take medications that require refills regularly over time, it’s always good to periodically check that your pharmacy has your most up-to-date insurance information on file. This can help you avoid potential delays in getting your prescription.
Contact 1-844-DUPIXENT (1-844-387-4936) to speak to a DUPIXENT MyWay® Nurse Educator if you have additional questions.
You may be eligible for the DUPIXENT MyWay Copay Card if you:
- Have commercial insurance
- Have a DUPIXENT prescription for an FDA-approved condition
- Are a resident of the 50 United States, the District of Columbia, or Puerto Rico
Program has an annual maximum of $13,000. *THIS IS NOT INSURANCE. Not valid for prescriptions paid, in whole or in part, by Medicaid, Medicare, VA, DOD, TRICARE, or other federal or state programs including any state pharmaceutical assistance programs. This program is not valid where prohibited by law, taxed or restricted. DUPIXENT MyWay reserves the right to rescind, revoke, terminate, or amend this offer, eligibility, and terms of use at any time without notice. Additional terms and conditions apply.
Commercial health insurance plans are operated by privately owned companies and are available7:
- Through your employer or a union
- Purchased on your own from an insurance company or through a state or federal exchange established under the Affordable Care Act
The following types of plans are considered commercial health plans:
- Health Maintenance Organization (HMO)
- Point of Service (POS)
- Exclusive Provider Organization (EPO)
- Preferred Provider Organization (PPO)
- High-Deductable Health Plan (HDHP)
People with commercial health plans can contribute to a Health Care Flexible Spending Account (FSA) offered by their employer to pay for certain medical, pharmacy, dental, and vision costs.8 Money is deducted from your paycheck before taxes, but your employer can keep any money not spent by the end of the year.8
Part D is an optional benefit that helps pay for outpatient prescription drugs only and is run by private health plans contracted by Medicare.
Part D is included in most Medicare Advantage (Part C) plans and can be added separately if you have Original Medicare (Parts A and B).9
If you have any other questions, DUPIXENT MyWay can help you understand the process.
1‑844‑DUPIXENT (1-844-387-4936), option 1
Monday-Friday, 8 am - 9 pm EST
Insurance plans may require additional medical information from your doctor, like chart notes or other treatments you’ve tried, prior to authorizing a DUPIXENT prescription. This is typical for a specialty drug like DUPIXENT.
The decision about whether to cover a drug usually begins with whether the drug is on the plan’s drug formulary. Commercial and Medicare health plans both use formularies.
Even if a medication is on the drug formulary, health plans may have policies you and your doctor must follow before the drug is approved. Two of these common policies are called prior authorization and step edits.
If you have any other questions about these policies DUPIXENT MyWay can help you understand the process.
1‑844‑DUPIXENT (1-844-387-4936), option 1
Monday-Friday, 8 am - 9 pm EST
If you do not have insurance that covers your prescription medications, or if your insurance does not cover DUPIXENT, you can typically expect to pay the list price shown above plus any additional pharmacy charges. The price you pay varies from pharmacy to pharmacy.
If you need help paying for your prescription, the DUPIXENT MyWay Patient Assistance Program may be able to help. Patients will need to meet the eligibility criteria, including household income, to qualify. The DUPIXENT MyWay team can research each patient’s situation and determine eligibility.
If you have any additional questions about this pricing information, please call DUPIXENT MyWay at 1-844-DUPIXENT (1-844-387-4936).
- Analy$ource
- IQVIA FIA data; Jan 2019-Dec 2019
- IQVIA FIA data; Jan 2019-Dec 2019
- Extra Help with Medicare Prescription Drug Plan Costs. https://www.ssa.gov/benefits/medicare/prescriptionhelp. Accessed on February 20, 2019.
- Announcement of Calendar Year (CY) 2019 Medicare Advantage capitation rates and Medicare Advantage and Part D payment policies and final call letter. Centers for Medicare and Medicare website. https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2019.pdf. Accessed onFebruary 20, 2019.
- Medicaid and CHIP overview for assisters. https://marketplace.cms.gov/technical-assistance-resources/fast-facts-medicaid-chip.pdf. Accessed on March 6, 2019.
- Barnett JC, Berchick ER. Health insurance coverage in the United States: 2016. Current population reports. Publication 60-260. https://www.census.gov/content/dam/census/library/publications/2017/demo/p60-260.pdf. Published September 2017. Accessed July 24, 2020.
- What's an FSA and how do I use it? Blue Cross Blue Shield Blue Care Network of Michigan website. https://www.bcbsm.com/index/health-insurance-help/faqs/plan-types/health-spending-accounts/fsa.html. Accessed July 15, 2020.
- Centers for Medicare & Medicaid Services. Medicare & You 2020. Baltimore, MD: Centers for Medicare and Medicaid Services; 2019. CMS product no. 10050-40.