How Much is Xofluza Without Insurance Coverage?
Unfortunately, Xofluza is very expensive without insurance, costing around $150 for each one-time pill. Despite its high cost and lack of generic alternative currently, Xofluza provides such significant therapeutic value that the price may balance out financially depending on your situation.
Weighing the Benefits of Quick Flu Treatment
Shelling out $150+ for a single pill seems outrageous, but considering even one bout of flu costs $300+ in doctor visits, testing, and missed work, Xofluza can provide net savings. Avoiding 7-10 grueling days of illness with a single fast dose improves outcomes too.
Pricing Breakdown of Xofluza Packages
Xofluza currently comes in 2 dosage packages without insurance:
- 40mg package (two 20mg tablets): $150
- 80mg single tablet: $150
So paying out-of-pocket gives you only package options of $150 that provide the full recommended dosing amount for patients age 12+.
Affording Xofluza by Bringing Down the Cost
Despite the seemingly high cash price, you still have ways to get Xofluza more affordably to reap its benefits while recovering from the flu:
Apply for the Genentech Patient Assistance Program
Americans with lower incomes below certain thresholds can get Xofluza at low cost or even free by completing paperwork showing financial need to qualify.
Order from an International Online Pharmacy
Purchasing from vetted pharmacies in Canada or abroad often cuts costs significantly for expensive medications compared to US prices.
Utilize a Prescription Savings Card
Various discount cards and coupons can take 10-15% or more off the retail price. Look for Xofluza-specific savings cards online.
Buy the Generic Once Available
When Xofluzas patent expires in a few years, cheaper generic versions will arise, significantly reducing cost.
Will Insurance Cover Xofluza at All?
Because Xofluza qualifies as Tier 4 specialty self-administered medication for most plans, coverage depends on your specific policy. Affordability through insurance breaks down as follows:
Medicare
Currently Medicare Part D and Medicare Advantage Plans do not cover brand name Xofluza. Some plans may cover generics once released.
Medicaid
State Medicaid programs have their own drug formularies, so some may include Xofluza coverage already or make exceptions through prior authorization.
Private Health Insurance
Tier 4 medications often have co-pays averaging 30% or more. But exceptions through prior authorization may enable $0 or reduced co-pay.
Weighing the Value: Is Xofluza Worth the Cost?
Considering the barriers of expensive pricing but extreme convenience as the first and only oral single-dose flu treatment, determining value means weighing several factors:
Your Personal Flu Risk
If at higher risk for flu complications due to age, pregnancy, or chronic conditions, more cost warrants avoidance.
Your Disposable Income
If affording occasional $150 treatment expense is no hardship, value tilts towards yes.
Flu Activity in Your Area
If flu season is ramping up locally, cost for quick effective treatment balances out.
Your Eligibility for Discounts
If qualified for programs making Xofluza low-cost or free, this minimizes barriers to access.
Weighing these personal factors helps determine if entering flu season with a direct Xofluza prescription for onset of illness provides individual value despite lack of universal coverage currently.
The Outlook: Will Xofluza Get More Affordable?
Despite its current high cost, as technology advances and oral antiviral options expand, market competition will likely make prompt flu relief more financially accessible in coming years by:
- Driving down costs as new medications compete with Xofluza
- Speeding generic development making single-dose treatment affordable to all
- Increasing insurance coverage with cheaper alternatives available
- Expanding discount programs and patient assistance opportunities
So while Xofluza remains costly today, its convenient effectiveness helps pave the way for a new era of rapid relief from seasonal influenza at prices accessible regardless of coverage status.
FAQs
How much does Xofluza cost without insurance?
The out-of-pocket cost for Xofluza is about $150 for a one time, single dose pill. Both the 40mg and 80mg packages cost around $150 without insurance coverage.
Does Medicare or Medicaid cover the cost of Xofluza?
Currently, Medicare Part D and Medicare Advantage plans do not cover the brand name version of Xofluza. Medicaid coverage varies by state, so check your state's formulary for inclusion and prior authorization rules.
What if I still can't afford Xofluza at $150 per dose?
You may qualify for discounted or free Xofluza through the Genentech patient assistance program if you meet certain income requirements. You can also use prescription savings cards to lower the cost.
When will Xofluza become more affordable?
Once Xofluza's patent expires in the next few years, cheaper generic versions will become available which should significantly lower the cost and improve insurance coverage rates.
Is paying $150 for a single dose of Xofluza worth it?
It depends on your personal flu risk, income level, access to discounts, and how widely flu is circulating in your area. Compare costs of flu treatment and potential missed work without Xofluza.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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