What is the cost of Kymriah?
Kymriah (tisagenlecleucel) is an expensive CAR-T cell cancer therapy costs over $612,000 for one treatment infusion, but most people do not pay this amount. In addition, the Centers for Medicare & Medicaid Services (CMS) states that CAR-T cell therapy would be covered for eligible people with Medicare.
- Kymriah is a chimeric antigen receptor T cell (CAR-T) therapy for use in pediatric and young adult patients (up to age 25) with relapsed or refractory (r/r) B-cell acute lymphoblastic leukemia (ALL).
- It is also approved to treat relapsed or refractory large b-cell lymphoma in adults after two or more therapies. It is not used for treatment of patients with primary central nervous system lymphoma.
- It is used to treat adult patients with relapsed or refractory follicular lymphoma (FL) after two or more therapies.
Kymriah is usually given by a health care provider in a clinic or hospital and is not found in a traditional pharmacy. The cost for this medicine may be covered by your insurance but you may have a deductible, copay and / or coinsurance. It is given as one single treatment infusion but involves hospitalization and close monitoring by healthcare providers for several weeks or months.
Kymriah Cares, a support program from Novartis, offers assistance to eligible patients to help them gain access to treatment. Your questions related to the medicine and administration, treatment center locations, or insurance coverage can be directed to Kymriah Cares at 1-844-459-6742 8AM to 8PM ET.
View the Drugs.com Kymriah Price Guide to learn more about costs, copay programs and patient financial assistance.
Related Questions
- How is Kymriah administered?
- What type of drug is Kymriah (tisagenlecleucel)?
- How does Besponsa work to treat Acute Lymphoblastic Leukemia (ALL)?
Does Medicare pay for Kymriah?
In August 2019, the Centers for Medicare & Medicaid Services (CMS) announced that CAR-T cell therapy would be covered for all patients with Medicare. You still may have deductibles, copays, coinsurance or other costs. Ask your physician for more information.
Most people do not pay out-of-pocket for the full price of Kymriah. Your cost will vary based on your insurance coverage or other financial assistance. Novartis may be able to provide this drug for free if you have been denied coverage or do not have insurance.
If you have more questions about Kymriah treatment, treatment center locations, Medicare / Medicaid, or other insurance coverage, you can contact Novartis at 1-844-4KYMRIAH (1-844-459-6742), 8AM to 8PM ET for more information.
This is not all the information you need to know about Kymriah and does not take the place of your doctor’s directions. Prices and savings programs are subject to change. Discuss any medical questions you have with your doctor or other health care provider.
References
- Support Resources for Kymriah. Kymriah.com. Accessed April 11, 2024 at https://www.us.kymriah.com/acute-lymphoblastic-leukemia-children/patient-support/support-resources-for-kymriah/
- Novartis Can Provide CAR-T Therapy for Free, OIG Says. WCG FDANews. March 30, 2021. Accessed April 11, 2024 at https://www.fdanews.com/articles/202098-novartis-can-provide-car-t-therapy-for-free-oig-says
- Medicare to Cover CAR-T Cell Therapy. Cancer Today. Dec. 23, 2019. Accessed April 11, 2024 at https://www.cancertodaymag.org/Pages/Winter2019-2020/Medicare-to-Cover-CAR-T-Cell-Therapy.aspx
- Centers for Medicare and Medicaid Services (CMS). CMS.gov. Accessed April 11, 2024 at https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=N&NCAId=291
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Drug information
- Kymriah Information for Consumers
- Kymriah prescribing info & package insert (for Health Professionals)
- Side Effects of Kymriah (detailed)
Related support groups
- Kymriah (3 questions, 3 members)
- Acute Lymphoblastic Leukemia (21 questions, 15 members)
- Follicular Lymphoma (11 questions, 15 members)
- B Cell Lymphoma (2 questions, 3 members)