Key takeaways:
Vumerity (diroximel fumarate) is an oral capsule used to treat relapsing forms of multiple sclerosis in adults. Without insurance, it can cost more than $7,000 per month. A manufacturer copay card or patient assistance program may help lower your cost.
Most Medicaid, Affordable Care Act marketplace, and commercial insurance plans cover Vumerity. But prior authorization or step therapy is often required before coverage is approved. Medicare coverage is limited.
Vumerity is usually filled through a specialty pharmacy. Your specialty pharmacy team can help you understand your insurance coverage and find savings options.
Save on related medications
Vumerity (diroximel fumarate) is an oral capsule that treats relapsing forms of multiple sclerosis in adults. It’s a limited distribution drug, which means that you’ll need to receive it from a specialty pharmacy instead of your local pharmacy. Vumerity may also come at a higher cost than a typical prescription medication.
Here’s what you should know about how much Vumerity costs without insurance, as well as how likely it is that your plan will cover it. We’ll also review ways to save on the cost of your prescription.
How much does Vumerity cost without insurance?
The recommended Vumerity dosage is 462 mg (two 231 mg capsules) twice daily, which comes to 120 capsules per month. Vumerity was launched at a wholesale acquisition cost of $88,000 per year (over $7,000 a month). The average retail price is typically even higher because of wholesaler and pharmacy markups.
Vumerity is available only as a brand-name medication. A lower-cost generic for Vumerity was FDA approved in November 2025. But it isn’t available yet because of patent restrictions.
Which factors affect the cost of Vumerity?
Several factors can affect the cost of Vumerity, including:
Location: Where you live can affect the cost of your medication. For example, according to GoodRx research, medications are typically more affordable in Denver than in New Orleans.
Pharmacy: Vumerity is typically filled by a specialty pharmacy. But prices can vary depending on the pharmacy you choose. Your prescriber and insurance plan can help you find the most affordable location to fill your prescription.
Insurance coverage: You’ll typically pay less for Vumerity if your prescription insurance covers it. But your copay may vary based on your plan’s formulary (more on that next).
Does insurance cover Vumerity?
Medicaid plans cover Vumerity for almost all enrollees. It’s also covered for most people enrolled in a commercial insurance plan and almost 75% of those enrolled in an Affordable Care Act (ACA) marketplace plan. Medicare covers Vumerity for only about 24% of enrollees.
A prior authorization is required for almost all Medicaid plans and about 70% of ACA and commercial insurance plans. This means your prescriber needs to submit information explaining why Vumerity is medically necessary before your plan will cover it.
Step therapy is required for about 66% of Medicaid plans, about 40% of ACA plans, and over 20% of commercial plans. This means you’re required to try other treatments (or explain why you aren’t able to take them) before they’ll cover Vumerity.
If Vumerity is covered by your insurance, the amount you’ll pay depends on where it falls within your plan’s formulary (list of covered medications). Medications are often classified into different tiers within a formulary — a lower tier typically means a lower copay. You can access your plan’s formulary online or by calling the customer service number on your prescription insurance card.
How different insurance plans cover Vumerity
The table below breaks down the percentage of enrollees who have coverage for Vumerity by insurance type. It also shows the likelihood of having prior authorization and step therapy requirements.
Insurance type | Enrollees covered for Vumerity | Enrollees required to get prior authorization | Enrollees required to do step therapy |
72.9% | 67.6% | 39.5% | |
Commercial plans (excluding ACA plans) | 85.6% | 69.9% | 23.2% |
Medicare (Medicare Advantage and Part D plans) | 23.9% | 18.8% | 3.7% |
Medicaid, including state-run and managed care plans | 99.9% | 91.2% | 65.8% |
Source: Managed Markets Insight & Technology, LLC™, as of January 10, 2026 (See methodology below.)
If your insurance doesn’t cover Vumerity, try these options:
Lower your cost with a patient assistance program or a free medication discount program, such as GoodRx. (See below for details.)
Ask your insurance plan to cover Vumerity by submitting a formulary exception request. Your prescriber may need to provide documentation and a letter of medical necessity explaining why this medication is required for your condition.
If the formulary exception request is denied, file an appeal.
Ask your prescriber about switching to a Vumerity alternative, such as Tecfidera (dimethyl fumarate), that your insurance may cover. A lower-cost generic for Vumerity was FDA approved in November 2025. Your prescriber can let you know when it’s available.
Compare insurance plans during the next open enrollment period to find one that offers coverage for Vumerity.
Ways to save on Vumerity
Here are some ways to save on Vumerity.
1. See if you qualify for a copay savings card
If you have commercial insurance, you may be able to pay as little as $0 per month for Vumerity using a savings card from the manufacturer.
To qualify for the Vumerity copay savings card, you must:
Have private or commercial insurance.
Not be enrolled in a government health insurance program, such as Medicare, Medicaid, or Tricare.
Be at least 18 years old
Be prescribed Vumerity by a U.S.-licensed prescriber for an FDA-approved use
Live in the U.S. or a U.S. territory (Massachusetts and California residents are excluded)
You can enroll in the Vumerity copay program online or call 1-800-456-2255 for assistance.
2. Check if you’re eligible for a patient assistance program
Vumerity’s manufacturer doesn’t offer a patient assistance program. But you can apply for financial support through other programs, such as the PAN Foundation.
If you have Medicare insurance and a limited income, you may be eligible for the “Extra Help” program. This low-income subsidy assists with deductible and copay costs related to your medications.
3. Ask about a 90-day supply
In some cases, your insurance plan may offer a lower copay if you fill a 90-day supply of your medication instead of a 30-day supply. This option may also save you time and shipping costs.
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 Vumerity. These tax-advantaged health accounts let you pay for eligible expenses with tax-free dollars.
You pay for your medication directly with your HSA or FSA card or cover the cost yourself and submit a request for reimbursement. The funds in an HSA or an HRA typically roll over annually, but you have to use your FSA dollars before your plan’s deadline.
The bottom line
Vumerity (diroximel fumarate) is an oral capsule that treats relapsing forms of multiple sclerosis in adults. Without insurance, Vumerity can cost over $7,000 per month. A manufacturer copay savings card or patient assistance program can help make your Vumerity prescription more affordable.
Almost all Medicaid plans cover Vumerity, as do most Affordable Care Act marketplace and commercial insurance plans. But prior authorization or step therapy is often required. Vumerity is typically filled by a specialty pharmacy. Don’t hesitate to ask your specialty pharmacy team for help with insurance coverage and savings opportunities.
Why trust our experts?
Methodology
We obtained national prescription coverage data for each medication from Managed Markets Insight & Technology (MMIT). The data reflects health insurance coverage as of January 2026.
We calculated the percentage of enrollees in plans that cover each medication by dividing the number of enrollees covered for the medication within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel.
We determined the percentage of enrollees in plans with a prior authorization requirement by calculating the proportion of enrollees in plans that required prior authorization for the medication within each channel.
Finally, we measured the percentage of enrollees in plans with a step therapy requirement by calculating the proportion of enrollees in plans that imposed step therapy requirements for the medication in each channel.
These estimates, derived from national MMIT coverage data, provide insight into health insurance coverage for each medication. They take into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total number of enrollees covered by various insurance channels, including ACA plans, commercial (excluding ACA) plans, Medicare, and Medicaid (both state-run and managed care plans).
References
Biogen. (n.d.). Biogen copay program.
Biogen. (2025). Vumerity- diroximel fumarate capsule.
HealthCare.gov. (n.d.). Appealing a health plan decision. Centers for Medicare & Medicaid Services.
Inacio, P. (2025). FDA approves generic version of Vumerity for relapsing MS. MS Views and News.
Medicaid.gov. (n.d.). Managed care. Centers for Medicare & Medicaid Services.
Patient Access Network Foundation. (n.d.). Multiple sclerosis (MS).
Parsons, L. (2019). Biogen under fire over $88,000 Vumerity annual price. PMLive.
U.S. Food and Drug Administration. (2026). First generic drug approvals.
Vumerity. (n.d.). Vumerity copay program. Biogen.
