How Much Is Tezspire Without Insurance?

Biosimilar availability

As mentioned, Tezspire is a biologic medication. Biologics don’t have traditional generics. Instead, a biologic can have biosimilars, which are highly similar (but not identical) to the original (reference) medication.

Tezspire is currently only available as a reference (“brand-name”) product. This can play a role in its high price, since a biosimilar could help you access the medication at a lower cost.

Dosage form

Tezspire comes in three different dosage forms:

• A single-dose prefilled syringe

• A single-dose injection pen

• A single-dose vial

The cost of Tezspire may depend on what dosage form you’re prescribed. For example, the injection pen tends to cost more than the other forms. But it’s the only form you can inject on your own at home.

Both the vial and prefiled syringe are injected by a healthcare professional. So there may be extra costs beyond the medication itself, such as administration fees.

Location

Medication prices often vary by geographic location. Different states, cities, and regions may have different pricing for the same treatments. For instance, prices for prescription medications are generally lower in Tampa, Florida, than in New York City.

Pharmacy

Tezspire is considered a specialty medication. This means you’ll likely need to get it from a specialty pharmacy. Different specialty pharmacies may offer different pricing and savings opportunities. But your insurance plan may prefer a specific location. Researching your options in advance can help you find the best price.

Insurance coverage

Whether you have insurance plays a big role in your out-of-pocket costs. If you do, your plan may cover Tezspire outright. But some plans may require prior authorization or step therapy. A prior authorization requirement means your prescriber will need to provide information to your insurer before they’ll cover the medication. Doing step therapy requires you to try one or more lower-cost treatments before moving to Tezspire.

Your out-of-pocket costs also depend on your plan's coverage rules. Factors that can affect what you pay include:

• Where Tezspire is placed within your plan’s formulary (list of covered medications)

• Your deductible

• Your copays or coinsurance

Checking your insurance plan's formulary and looking into coverage requirements in advance can help you estimate your costs before starting treatment. You can usually access this information online or by calling the customer service number on the back of your prescription insurance card.

Good to know: Tezspire may be covered under your medical insurance instead of your prescription insurance if you’re receiving it in a medical office rather than injecting it yourself at home. In this case, your prescriber’s office can help you navigate the expected treatment costs.

1. See if you qualify for a copay savings card

The Tezspire Together Co-Pay Program may help you pay as little as $0 per dose if you have commercial insurance coverage. It can also take up to $100 per month off any administration costs for in-office injections (except if you live in Massachusetts or Rhode Island). 

To qualify for this program, you must:

• Have commercial insurance coverage

• Not have government-funded insurance, such as Medicare or Medicaid

• Live in the U.S., Puerto Rico, or another U.S. territory

You can enroll in the program online or call 1-800-818-1770 for more information. 

2. Check if you’re eligible for the manufacturer’s patient assistance program

If you're uninsured or underinsured, you may qualify for the Tezspire Together patient assistance program, which offers the medication at no cost to eligible applicants.

To qualify, you must:

• Be uninsured or have government-funded insurance with a copay of more than $100 for Tezspire

• Be a resident of the U.S., Puerto Rico, or another U.S. territory for at least 6 months

• Have a household income at or below 500% of the federal poverty level

Your prescriber will need to enroll you in this program. But you can call 1-888-897-7473 to get more information and determine your eligibility.

3. Look into independent patient assistance programs

Several nonprofit organizations also offer patient assistance programs that could help lower your costs. These are often catered to people living with a specific health condition, and each program has its own eligibility criteria. Examples of organizations that offer these programs include:

• The Assistance Fund

• Patient Access Network (PAN) Foundation

• Patient Advocate Foundation

• HealthWell Foundation

Keep in mind that you may need to join a wait list if a program isn’t currently accepting new applicants.

4. Tap into your HSA, FSA, or HRA

If you have a health savings account (HSA), a flexible spending account (FSA), or a health reimbursement arrangement (HRA), you can use it to help cover your out-of-pocket costs for Tezspire. These tax-advantaged healthcare accounts let you pay for eligible expenses with tax-free dollars.

Pay directly with your HSA or FSA card at the pharmacy, or cover the cost yourself and submit a request for reimbursement. The funds in HSAs roll over annually. But you typically have to use FSA dollars before a certain deadline or they’ll expire.

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Written by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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