Orencia (abatacept) is a prescription drug used to treat certain kinds of arthritis and to prevent graft versus host disease. The drug’s cost may depend on your dosage, your health insurance, and the pharmacy you use.
Orencia is used to treat:
- rheumatoid arthritis in adults
- polyarticular juvenile idiopathic arthritis in some children
- psoriatic arthritis in adults
Orencia comes as a powder that’s dissolved in water to form a liquid solution. It’s then given by a healthcare professional as an intravenous (IV) infusion (an injection into your vein given over time).
Orencia is also available as a liquid solution in prefilled syringes or injection pens. With the syringe or pen, you inject the medication under your skin.
Orencia’s active ingredient is abatacept. (An active ingredient is what makes a drug work.)
For more details on Orencia, see this in-depth article.
The price you pay for Orencia can vary. Your cost may depend on your treatment plan, your insurance coverage (if you have it), and the pharmacy you use. If you‘re receiving Orencia by intravenous (IV) infusion, your cost will also depend on how much you have to pay for a clinic visit to receive the infusion.
To find out how much you’ll pay for Orencia, talk with your doctor, pharmacist, or insurance provider.
Note: If you have insurance, you may need to get prior authorization before your insurance provider will cover Orencia. This means your insurer and your doctor will discuss Orencia in regard to your treatment. Then the insurance company will determine whether the drug is covered. If Orencia 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 Orencia requires prior authorization.
Below are answers to some frequently asked questions about Orencia and cost.
Is there a cost difference if you receive Orencia as an injection under your skin vs. as an IV infusion?
It’s possible. How Orencia is given affects the form you’ll use and the location where you’ll typically receive Orencia. These factors may affect the cost.
If Orencia is being injected under the skin, you’ll typically do this yourself. You’ll use single-use prefilled syringes or injection pens that you’ll get from your pharmacy.
If you’re receiving Orencia as an intravenous (IV) infusion, this will usually be given in a clinic. A healthcare professional will use the powder form of Orencia, and this will be mixed with sterile water to form a liquid solution. In this case, you’ll need to consider the cost of the drug and the cost of the visit to the clinic.
To learn more about the cost difference between receiving Orencia as an injection under the skin versus an IV infusion, talk with your doctor or insurance provider.
Does Medicare cover Orencia?
Possibly. Whether Medicare covers Orencia depends on the details of your specific Medicare plan. It may also depend on whether you’re receiving it as an injection or an IV infusion.
When Orencia is given as an IV infusion in a doctor’s office or other healthcare facility, it may be covered by Medicare Part B. This is the part of Medicare that covers outpatient medical services.
To find out if your plan covers Orencia, talk with your plan provider. Your doctor or pharmacist will likely be able to provide more information, too.
Orencia 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. 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 drug manufacturer of a biologic drug can sell it for up to
12 years. When the biologic drug’s patent expires, other drug manufacturers 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 take Orencia long term, you may be able to lower your costs in the following ways:
Look into getting a 90-day supply of your medication. You may be able to get a 90-day supply of Orencia if approved by your insurance company. This could reduce your number of trips to the pharmacy and help lower the cost of Orencia. If you’re interested in getting a 90-day supply of this drug, talk with your doctor, pharmacist, or insurance provider.
Use a mail-order pharmacy to get your medication. Using a mail-order pharmacy might help lower your cost for Orencia. Plus, you could get your medication without leaving home. Some Medicare plans may help cover the cost of mail-order drugs. You may also be able to get a 90-day supply of the drug through mail order. If you don’t have health insurance, talk with your doctor or pharmacist. They may be able to suggest online pharmacy options that could work for you.
If you need help covering the cost of Orencia 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.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist.
If you still have questions about the cost of Orencia, talk with your doctor or pharmacist. They may be able to give you a better idea of what you’ll pay for this treatment. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you’d pay for Orencia.
Examples of questions you may want to ask your doctor or insurance provider include:
- Will it be less expensive for me to inject Orencia at home?
- How much will I have to pay to get Orencia as an intravenous (IV) infusion?
- What are my options if I can’t afford my medication?
To learn more about Orencia, 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.