Galsulfase
Specialty Drug

Naglazyme

GALSULFASE is an enzyme replacement. It is used to treat the symptoms of mucopolysaccharidosis VI (also known as MPS VI or Maroteaux-Lamy syndrome). This medicine is not a cure. Compare enzyme replacement therapies.

Galsulfase Medicare Coverage

Overview

Does Medicare cover Naglazyme?

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

How much is my Naglazyme 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
$1751 – $1947
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
$438 – $1919
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$625 – $881
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
$88 – $98
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 Galsulfase

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

Patient Assistance Program
Contact BioMarin Patient & Physician Support (BPPS) by phone or email to get more information on how they can financially assist you with your prescription.
Lower Cost Alternative
Less expensive drugs that work the same way may be available.

Find Your Galsulfase 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 (5ml) of Naglazyme 5mg/5ml

Medicare Plan Name Average Co-Pay
AARP MedicareRx Preferred (PDP) $751
AARP MedicareRx Saver Plus (PDP) $473
AARP MedicareRx Walgreens (PDP) $469
Aetna Medicare Rx Saver (PDP) $472
Anthem Blue Cross MedicareRx Plus (PDP) $609
Anthem MediBlue Essential (HMO) $572
CareMore Value Plus (HMO) $1039
Cigna-HealthSpring Preferred (HMO) $530
EnvisionRxPlus (PDP) $464
Express Scripts Medicare - Choice (PDP) $479
Express Scripts Medicare - Value (PDP) $461
First Health Part D Value Plus (PDP) $623
Humana Enhanced (PDP) $583
Humana Preferred Rx Plan (PDP) $442
Humana Walmart Rx Plan (PDP) $442
Kaiser Permanente Medicare Plus Std w/Part D (AB) (Cost) $641
MedicareBlue Rx Standard (PDP) $487
SilverScript Plus (PDP) $642
Symphonix Value Rx (PDP) $473
TexanPlus Classic (HMO) $1598
Don't see your Medicare plan above?

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Galsulfase Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

Some Medicare plans have restrictions on coverage of Naglazyme 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 Naglazyme typically on?

Tier 5

Medicare plans typically list Naglazyme 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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