If you’re looking at treatment options for certain kinds of cancer, you may want to learn more about Opdivo (nivolumab). It’s a prescription drug used in adults to treat certain kinds of:
- lung cancer
- skin cancer
- bladder cancer
- classic Hodgkin’s lymphoma
- colorectal cancer
- esophageal cancer
- head and neck cancer
- kidney cancer
- liver cancer
- stomach cancer
It’s also approved to treat a form of colorectal cancer in certain children.
Opdivo comes as a liquid solution that’s given as an intravenous (IV) infusion. This is an injection into a vein given over time by a healthcare professional.
Keep reading for details on Opdivo and cost, and how to save money on prescriptions.
Note: For more details on Opdivo, see this in-depth article.
The price you pay for Opdivo can vary. It may depend on your treatment plan, your insurance coverage (if you have it), and the pharmacy you use. It’ll also depend on how much you have to pay for a clinic or doctor’s office visit to receive Opdivo.
To find out how much you’ll pay for Opdivo, including your cost per month or per year, 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 Opdivo. This means your insurer and your doctor will discuss the drug in regard to your treatment. Then the insurance company will determine whether it’s covered. If Opdivo requires prior authorization and you don’t receive it before you start treatment, you could pay the full cost of the drug.
Be sure to ask your insurance company whether Opdivo requires prior authorization.
Opdivo is a biologic drug, which means it’s made from parts of living organisms. It doesn’t come in a biosimilar form. Biosimilars are like generic drugs. But unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologics.
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 drugmaker 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 need help covering the cost of Opdivo or understanding your insurance, check out these resources:
On these sites, you can find insurance information, details on drug assistance programs, and links to savings cards and other services.
The maker of Opdivo has several cost savings options available for those who qualify. See the BMSSupport website or call 800-861-0048 for more details.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist.
Below are answers to some frequently asked questions about Opdivo and cost.
Is Opdivo covered by Medicare Part B?
Medicare Part B covers 80% of the cost of approved services, such as a doctor’s visit. But you’ll still have other out-of-pocket costs you’ll need to pay for Opdivo treatment. If you have supplemental Medicare plan benefits, these could help cover the remaining costs of the drug. (These costs include deductibles, copayments, and coinsurance for eligible services, as well as the cost to receive each dose of Opdivo.)
To learn more about your cost for Opdivo with Medicare Part B, call your Medicare plan provider. They can tell you how much you can expect to pay out of pocket.
Does the cost of Opdivo vary with insurance coverage?
Yes. Your cost for Opdivo may vary depending on whether you have insurance, and if so, what your particular plan’s benefits are. For example, you may have a set copay (your share of the cost) for Opdivo, or you may have to pay a percentage of the total cost of the drug.
Your cost with insurance coverage can also depend on:
- whether you obtain any required prior authorization for the drug
- the condition Opdivo is being used to treat
- your treatment plan
Your cost may also depend on whether you qualify for any cost savings programs. You can learn more about cost savings programs available through the drugmaker in the “Can I get help paying for Opdivo?” section above.
To find out more about the cost of Opdivo with insurance, reach out to your plan provider for details.
If you still have questions about the cost of Opdivo, talk with your doctor or pharmacist. They may be able to give you a better idea of what you’ll pay for this drug. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you’d pay for Opdivo.
Examples of questions you may want to ask your doctor or insurance provider include:
- Does my cost for Opdivo depend on the condition I’m using it to treat?
- Could my cost of Opdivo change if my dosage is increased?
- Would my cost for Opdivo be higher if I receive my treatment at a clinic versus a doctor’s office?
To learn more about Opdivo, see 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.