Humira: Why is it Expensive in the United States?

Why is Humira Expensive in the United States
Why is Humira Expensive in the United States

Adalimumab, which is sold under the brand name Humira, is a medication used to treat ankylosing spondylitis, rheumatoid arthritis, Crohn’s disease, psoriatic arthritis, psoriasis, and some other forms of arthritis. It is considered a last resort treatment, reserved for individuals who have not improved through other forms of treatment.

Some minor side effects of Humira include pain at the injection site, upper respiratory tract infections, rashes and headaches. More serious side effects include liver failure, heart failure, and cancer. Doctors do not recommend the use of Humira during pregnancy.

Humira works as a TNF inhibitor; it stops the work of the tumor necrosis factor (TNF), which is responsible for several autoimmune and immune-mediated disorders such as rheumatoid arthritis. Individuals with arthritis and related diseases are said to overly produce TNF. Humira is also known as an immunosuppressive drug, meaning it inhibits the functioning of the immune system.

Today, Humira is one of the bestselling medications in the USA, having more than 4 million prescriptions in the United States, making it the 152nd most commonly prescribed medication in 2019. More and more Americans are buying medications (including insulin) from a Canadian supplier to save them thousands a year. 

How Much Does Humira Cost?

A month’s supply of Humira costs approximately $7,400, leading to a yearly cost of around $89,000 per year. This is a hefty price tag for most Americans, where the average income is $32,000 per year.

What are the Reasons Behind this Enormous Amount?

One reason Humira costs so much is that it is an expensive drug to produce. In order to manufacture the drug, DNA technology has to be used. This process cannot be easily replicated, meaning it cannot be produced easily like most synthetic medications.

Humira is also composed of DNA. Such medications need to go through extensive testing in order to meet the FDA’s requirements so that they may be distributed to the public. Testing and trying to meet the FDA’s requirements add to the cost of producing the drug, hiking up the price presented to the consumer.

One more reason why Humira is so expensive is that it is a patented drug; this means that other manufacturers are not allowed to produce it. When there is only one producer of a certain medication, the price can be set at any level as there is only one manufacturer in the market – they face no competition. Alongside this, since Humira, like other medications, is a necessity, consumers will be bound to pay whatever price because their health depends on it. This gives pharmaceutical companies the ability to price their products at whatever level they choose.

Humira BioChem
Such medications need to go through extensive testing in order to meet the FDA's requirements so that they may be distributed to the public. Testing and trying to meet the FDA's requirements add to the cost of producing the drug, hiking up the price presented to the consumer.

Is There A Way To Save Money On Humira?

Insurance

The main way most individuals in the United States save on medical expenses is through medical insurance.

Most insurance plans offered do cover the cost of Humira; however, it varies from plan to plan. Sometimes rather than covering the entire cost, some plans will lower the out-of-pocket cost for the individual, making it cheaper to buy but not necessarily affordable. It is best to check with your insurance provider to receive confirmation.

Individuals who receive medical insurance coverage through their employment contract may be able to receive Humira for completely free. But this is only applicable if you receive private insurance coverage from your employer.

Medicare

Medicare is a national health insurance program offered by the United States federal government. It is available to individuals over 65 years of age and young individuals with disabilities. Before diving into this option, it is important to check if you qualify for Medicare.

Medicare Graphic

Medicare is provided within four parts:

– Part A: Covers most in-patient, nursing, and hospice services.

– Part B: Covers out-patient services and professionally administered prescription drugs

– Part C: More known as Medicare Advantage, provides most services within parts A, B, and D alongside an out-of-pocket expense limit.

– Part D: Covers self-administered prescription drugs.

Medications are categorized into tiers (plans range from having four to six tiers). Humira is categorized into tier five within almost all Medicare plans as it is a specialty drug. This means that if you are looking to cover the costs of Humira, you must have a combination of parts D and C. Although some part C plans may cover Humira entirely without needing part D.

Medicaid

Medicaid is a federal and state-run healthcare program in the United States. It focuses on providing healthcare to individuals who reside with lower income brackets. Alongside the benefits provided in Medicare, Medicaid also covers nursing home and personal services costs. Programs will vary from state to state and by your income.

Most states offer Medicaid through their own programs; some include:

– Medi-Cal (California)

– BadgerCare (Wisconsin)

– NJ FamilyCare (New Jersey)

– Apple Health (Washington)

– Oregon Health Plan (Oregon)

Even though states must comply with federal law, they will vary in their requirements and eligibility criteria. The state will choose what services and medications it may cover.

Based on your program, you may or may not receive coverage for Humira. It is best to check the website www.medicaid.gov and your state’s website to see if you qualify.

Humira Coupons

The manufacturer of Humira, AbbVie Inc., does provide a ‘Humira Complete Savings Card‘ – but not everyone is eligible for this.

You may be able to receive this benefit if you have private insurance coverage from your employer. However, if you find yourself ineligible for this option, you may use available online coupons, which can reduce your out-of-pocket expense.

Major pharmaceutical services such as Wal-Mart, Walgreens, and CVS Health accept these savings cards and online coupons.

Humira Coupon

Humira (Adalimumab)

2 pens for $2,150.00

Manufacturer Rebates

A rebate is a buying discount whereby the manufacturer will offer you the product at a lower price or may give you a refund for the money you spent on that product at a later time. It is commonly known as ‘cashback.’

You may be able to reduce your costs on Humira through the ‘Humira Complete Prescription Rebate.’ However, much like the savings card, not everyone is eligible.

You may be able to receive a rebate if you are self-insured or receive insurance for commercial prescription medication coverage. In order to receive the rebate, you need to collect the receipts you receive with each purchase of Humira and submit them to Opus Health to receive a check.

The AbbVie Patient Assistance Program

AbbVie, the manufacturer of Humira, has a program that aims to provide Humira free-of-cost to patients.

You will need to apply through their website (applying is free). If you meet the requirements, you may receive your prescription completely free. The requirements are as follows:

– Currently must be being treated by a licensed United States healthcare provider (on an out-patient basis) and have a prescription for an AbbVie medication that is a part of the assistance program.

– Have little to no health insurance coverage

– Must demonstrate financial need that qualifies them for the program

– Must reside in the United States

Generic Versions of Humira

A generic drug is manufactured to be identical to its brand-name counterpart. The generic drug will be the same in safety, strength, dosage form, intended use, quality, performance characteristics, and administration.

Generic drugs tend to cost less as they are not required to repeat the studies/trials, both animal and human (clinical), that brand name companies had to do in order to get FDA approval. The production of generic medications also creates competition within the market, forcing producers to lower their prices to compete for market share and power.

Based on FDA statistics, the reduction in research costs leads to a substantial price reduction within generic drugs. By adding just one generic drug competitor into the market, prices drop by 30%. With five generic drugs competing in the market, prices are expected to drop by 85%. From 2009 to 2019, the generic drug system is said to have saved American healthcare consumers $2.2 trillion.

Currently, there are no biosimilar or generic versions of Humira available. However, the FDA has approved some that will be available in the United States by 2023. They include:

– Abrilada by Pfizer

– Amjevita by Amgen

– Hulio by Mylan

– Hyrimoz by Novartis/Sandoz

Buying Humira from Insulin Outlet
Hundreds of Americans use Insulin Outlet to save thousands on Humira and other medications.

Where Can I find the Cheapest Humira?

Insulin Outlet

Insulin Outlet provides the best prices on Humira. Hundreds of Americans purchase their Humira through Insulin Outlet, as it saves them thousands of dollars per order. The prescription fulfillment service is relatively easy to use, and it is becoming a fan-favorite amongst all users of Humira. For more information about purchasing Humira from Insulin Outlet, please do not hesitate to contact us

 

Conclusion

Unless your insurance plan covers Humira, there is not many options to purchase the medication at a lower rate. Biosimilars to Humira will be available soon, but we have no information about how they will work and how effective they will be.

Humira is a necessity for many; hence, they may never be able to escape the trap of the high cost of their medication. We have come to a point where patients must choose between their health and going into debt to stay alive.

The above-mentioned medical programs aim to provide a better chance of accessibility, but it won’t be enough. American patients need more effective healthcare strategies that help them live their best and fullest life.

The one service that is proven to save Americans thousands of dollars on Humira, is Insulin Outlet. The prescription fulfilment service has become popular amongst many Americans and has changed the finances of many lives. If you are on the many that are struggling to afford Humira (along with insulin products, such as KwikPens and cartridges), visit Insulin Outlet for life-saving prices on life-saving medications.