If you’re looking at treatment options for inflammatory bowel disease (IBD), you may want to learn more about Entyvio (vedolizumab). It’s a prescription drug used to treat the following forms of moderate to severe IBD in adults:
Entyvio is a biologic (a drug made in a laboratory using living cells). It works with your immune system to treat your IBD. Entyvio contains the active ingredient vedolizumab. (An active ingredient is what makes a drug work.)
Entyvio comes as a liquid solution in a vial. It’s given by a healthcare professional as an intravenous (IV) infusion (an injection into a vein given over time).
Keep reading for details on Entyvio and cost, and how to save money on prescriptions.
Note: For more details on Entyvio, see this in-depth article.
The price you pay for Entyvio infusions can vary. The cost may depend on your treatment plan, your insurance coverage (if you have it), and the pharmacy you use. It will also depend on how much you have to pay for an office visit with your doctor to receive Entyvio.
To find out how much you’ll pay for Entyvio, talk with your doctor or insurance provider.
Note: If you have insurance, you may need to get prior authorization before your insurance provider will cover Entyvio. This means your insurer and your doctor will discuss Entyvio in regard to your treatment. Then the insurance company will determine whether to approve coverage for the drug. If you start treatment before the prior authorization is approved (or if coverage is denied), you might be charged the full cost of Entyvio.
Be sure to ask your insurance company whether Entyvio requires prior authorization.
Below are answers to some frequently asked questions about Entyvio and cost.
How much does Entyvio cost with insurance and without insurance?
If you have private insurance, the cost of Entyvio will depend on your specific plan’s benefits and coverage. Depending on your insurance plan, you may pay the full cost, a set cost, or a percentage of the cost of each dose of Entyvio.
Check with your doctor or insurer to find out if your plan covers Entyvio (some insurance plans may not). If it doesn’t, the drugmaker offers an assistance program called the Start Program* that can help you begin treatment with Entyvio. This allows time for your doctor and insurance plan to go through an appeal process, if possible, to get the drug covered.
Also, the maker of Entyvio offers a copay savings program* that may help pay for the drug if you have private insurance.
If you don’t have insurance, you may pay more for Entyvio. The drugmaker offers assistance through the Bridge Program,* which may be able to help you get Entyvio while you’re temporarily without insurance coverage.
Talk with your doctor or insurance provider (if you have insurance) to see what Entyvio will cost you.
* See the FAQ just below and the “Can I get help paying for Entyvio?” section of this article for more details on the various cost-saving programs available for this drug.
Is there a copay card or savings program available to help lower Entyvio’s price?
Yes, there is a copay savings program available to help with the cost of Entyvio if you have private insurance. If you’re eligible, you may pay as little as $5 per dose of the drug. With this program, you could get up to $20,000 of Entyvio coverage per year.
The maker of Entyvio offers additional assistance programs that may be able to help you:
- The Start Program. This is for people who have private insurance, but their insurer has denied their claim for coverage. The Start Program may provide up to 1 year of Entyvio at no cost to you while the manufacturer and your doctor work to get Entyvio covered by your insurance.
- The Bridge Program. This is for people who have had private insurance but are temporarily without it. The Bridge Program may provide up to 6 months of Entyvio at no cost to you. After 6 months, the manufacturer and your doctor will help find other assistance options that could help with the cost of the drug.
Talk with your doctor or an Entyvio representative to see if you qualify for any of these programs. If you do, they can help you enroll. You can call 855-368-9846 for more information.
Will Medicare cover Entyvio’s cost?
It depends. If you have Medicare that covers drug costs (not all Medicare plans do), your cost for Entyvio will depend on your specific plan’s benefits. And the copay for brand-name prescription drugs is different if you have Medicare Advantage versus Medicare Part D.
Talk with your doctor or a Medicare representative to find out if your plan covers Entyvio and what the cost will be.
If you need help covering the cost of Entyvio or understanding your insurance, check out these websites:
On these sites, you can find insurance information, details on drug assistance programs, and links to savings cards and other services.
A program called EntyvioConnect may also be available for this drug. See the “Is there a copay card or savings program available to help lower Entyvio’s price?” in the FAQs section above for information about EntyvioConnect’s Start Program and Bridge Program.
If you have questions about how to pay for your prescription, talk with your doctor.
Entyvio only comes as a brand-name drug. It’s a biologic drug, which means it’s made in a laboratory using living cells. It comes in several biosimilar forms. Biosimilars are like generic drugs. But unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs.
Why is there such a cost difference between biologic drugs and biosimilar drugs?
Biologic drugs can be expensive because of the research and testing needed to ensure their safety and effectiveness. The manufacturer of a biologic drug can sell it for up to
12 years. When the biologic drug’s patent expires, other drugmakers can create biosimilar versions. This competition in the market may lead to lower costs for biosimilars. And because biosimilars are very similar to biologic drugs, they don’t need to be studied again. This can also lead to lower costs for biosimilars.
If you still have questions about the cost of Entyvio, talk with your doctor. They may be able to give you a better idea of what you’ll pay. But if you have health insurance, you’ll need to talk to your insurer to learn the actual cost you’d pay for Entyvio.
Examples of questions you may want to ask your doctor or insurance provider include:
- What do I do if my insurance denies the prior authorization for Entyvio coverage?
- Are there other lower-cost drugs that could treat my condition?
- What are my options if I can’t afford Entyvio?
To learn more about Entyvio, check out these articles:
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.