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
$5508 – $6117
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
$1377 – $6054
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$1856 – $2778
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
$275 – $309
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.
Lower Cost 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 MedicareRx Preferred (PDP) $2365
AARP MedicareRx Saver Plus (PDP) $1490
AARP MedicareRx Walgreens (PDP) $1480
Aetna Medicare Rx Saver (PDP) $1478
Anthem Blue Cross MedicareRx Plus (PDP) $1845
Anthem MediBlue Essential (HMO) $1754
CareMore Value Plus (HMO) $3275
Cigna-HealthSpring Preferred (HMO) $1685
EnvisionRxPlus (PDP) $1463
Express Scripts Medicare - Choice (PDP) $1502
Express Scripts Medicare - Value (PDP) $1444
First Health Part D Value Plus (PDP) $1951
Humana Enhanced (PDP) $1839
Humana Preferred Rx Plan (PDP) $1393
Humana Walmart Rx Plan (PDP) $1393
Kaiser Permanente Medicare Plus Std w/Part D (AB) (Cost) $2018
MedicareBlue Rx Standard (PDP) $1457
SilverScript Plus (PDP) $1992
Symphonix Value Rx (PDP) $1492
TexanPlus Classic (HMO) $5039
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). They are accurate as-of January 2017 and the information may be updated. If you encounter any issues, please let us know.
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