Fabrazyme
Specialty Drug

Agalsidase Beta

AGALSIDASE BETA is used to replace an enzyme that is missing in patients with Fabry disease. It is not a cure. Compare enzyme replacement therapies.

Fabrazyme Medicare Coverage

Overview

Does Medicare cover Fabrazyme?

Yes.
100% of Medicare Part D and Medicare Advantage plans cover this drug.

How much is my Fabrazyme co-pay with Medicare?

It depends. Which coverage stage are you in? Click on a tab below…

Deductible
Typical
Donut Hole
Post-Donut Hole
Co-Pay Range
$5376 – $5980
In the Deductible co-pay stage, you are responsible for the full cost of your prescriptions. Your Medicare deductible cannot exceed $360 in 2016.
Co-Pay Range
$1344 – $2249
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$2419 – $3067
In the Donut Hole (also called the Coverage Gap) stage, you’ll pay more for your prescriptions. In 2016, the Donut Hole begins once you’ve spent $3,310 in one year.
Co-Pay Range
$15 – $299
In the Post-Donut Hole (also called Catastrophic Coverage) stage, Medicare will cover most of your drug costs. In 2016, this stage begins once you have spent $4,850.
Want an exact price for your co-pay?

Ways to Save on Fabrazyme

Here are some ways that may lower the cost of your Fabrazyme prescription.

Patient Assistance Program
Receive your prescription at no charge if you are eligible.
Cheaper Alternative
Less expensive drugs that work the same way may be available.

Find Your Fabrazyme Medicare Co-Pay

Here are average co-pays for some of the most popular Medicare plans. Be sure to add your plan to see your specific co-pay. If a price is shown in red, GoodRx has found discount prices that are lower than your Medicare co-pay.

Average Co-Pay for 1 vial of Fabrazyme 35mg

Medicare Plan Name Average Co-Pay
AARP MedicareComplete (HMO) $1536
AARP MedicareComplete Plan 1 (HMO) $1614
AARP MedicareComplete SecureHorizons (HMO) $1490
AARP MedicareRx Preferred (PDP) $1793
AARP MedicareRx Saver Plus (PDP) $1401
Aetna Medicare Rx Saver (PDP) $1419
Cigna-HealthSpring Preferred (HMO) $1721
Cigna-HealthSpring Rx Secure (PDP) $1379
Cigna-HealthSpring Rx Secure-Extra (PDP) $1490
EnvisionRxPlus Silver (PDP) $1406
Express Scripts Medicare - Value (PDP) $1408
First Health Part D Value Plus (PDP) $1873
Humana Enhanced (PDP) $1841
Humana Preferred Rx Plan (PDP) $1395
Humana Walmart Rx Plan (PDP) $1395
Kaiser Permanente Senior Advantage (HMO) $2249
MedicareBlue Rx Standard (PDP) $1401
SilverScript Choice (PDP) $1913
Symphonix Value Rx (PDP) $1404
WellCare Classic (PDP) $1459
Don't see your Medicare plan above?

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Fabrazyme Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

Some Medicare plans have restrictions on coverage of Fabrazyme that may include:

Prior Authorization

Most Medicare plans will require you to obtain their authorization before they will provide coverage for this prescription. You’ll need to contact your plan and they may require you to have your doctor fill out paperwork indicating why you need this prescription. If you do not receive authorization or don’t want to go through this process, you may want to consider using a GoodRx discount instead of Medicare to find the best price for this prescription.

What drug tier is Fabrazyme typically on?

Tier 5

Medicare plans typically list Fabrazyme in Tier 5 of their formulary. Tier 5 drugs are usually non-preferred brand-name drugs. Tier 5 drugs cost more than Tier 1, 2, 3 and 4 drugs.

Does your plan have restrictions?

See discount prices that can save you money when your Medicare plan doesn't work for you.

Medicare prices are provided by the Centers for Medicare and Medicaid Services (CMS). If you encounter any issues, please let us know.
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