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ucb-usa.com Responsibility Affordability Nayzilam Pricing Info
 

How much should I expect to pay for Nayzilam® (midazolam) nasal spray, CIV?

 

Prescription drug prices can be confusing. Two people may pay different prices for the same drug, depending on their insurance situation.

The list price1 of NAYZILAM is $5502 per box. Each box contains two doses. The amount you pay will largely depend on your prescription drug insurance plan. The information below will give you a good idea of what to expect based on your insurance situation.

As a new product, coverage and affordability are still being determined by many health plans. For the most accurate information, talk to your insurance provider who knows the details of your plan.

Full Prescribing Information, including boxed warning regarding concomitant use of benzodiazepines and opioids.

 

 
Which Option Below Best Describes Your Insurance Situation? 

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I Have Insurance Through an Employer or Private Individual Policy and Am Not Covered by Medicare

 

It is anticipated that NAYZILAM prescriptions will cost commercial patients $40 per box.Each box contains two doses.

What you pay for NAYZILAM will depend on your insurance plan and which pharmacy you choose. Each plan has different preferred drug lists and out-of-pocket amounts, and most include an annual deductible. If you haven’t met your deductible, you’ll see higher prices until the deductible is met; then your out-of-pocket cost will likely drop. With the NAYZILAM Savings Card, eligible patients could pay $20 per box. Each box contains two doses. Learn more about the NAYZILAM Savings Card.

 

I Have Medicare Coverage

 

 

If you have Part D coverage and are eligible for the Extra Help (Low Income Subsidy) program, you can expect to pay $3-$9 for each box.4  Each box contains two doses.

If you are unsure whether you qualify for Extra Help, please visit the Social Security Administration website for more information.

If you don’t qualify for Extra Help, your out-of-pocket costs vary. Your out-of-pocket costs can vary throughout the year depending on which phase of the Part D benefit you are currently in.5 It is anticipated that NAYZILAM will cost approximately $150 to $200 per box during the standard benefit phase for Medicare. This may vary from year to year.

 

I Have Medicaid Coverage

 

 

For most people on Medicaid, it is anticipated that NAYZILAM will cost less than $10 per box.6 Each box contains two doses. Some states offer even lower copays, or eliminate the copay requirement altogether.

To find out if you qualify for Medicaid, or for more information about copayments in your state, please visit Medicaid's website

I Don’t Have Insurance or NAYZILAM Is Not Covered By My Insurance Plan

 

 

If you do not have insurance or NAYZILAM is not covered by your insurance plan, please contact our team of compassionate and informed professionals for more information to see what options might be available to you. Contact ucbCARES at 1-844-599-CARE (2273) or visit us online.

 

 

 

 

 

 

References: 
1 List price is also referred to as wholesale acquisition cost or WAC. WAC is the price at which UCB sells its products to wholesalers.

2 Data on File, UCB Inc. Patients may have to pay a higher price than list due to additional pharmacy charges.

3 Data on File, UCB Inc.

4 Social Security Administration (SSA). Extra Help with Medicare Prescription Drug Plan Costs. https://www.ssa.gov/benefits/medicare/prescriptionhelp. Accessed December 2019.

5 Centers for Medicare & Medicaid Services (CMS). Announcement of Calendar Year (CY) 2020 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter. Attachment V Final 2020 Benefit Design Parameters. https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2020.pdf. Accessed on December 2019.

6 IQVIA FIA claims data (Apr 2018 -Mar 2019) and Centers for Medicare & Medicaid Services (CMS). Medicaid and CHIP Overview for Assisters. Maximum Allowable Copayments Determined by Eligible Population’s Household Income. Updated August 2019. **All out-of-pocket charges are based on the specific state’s defined payment amount for that service. Certain groups, including children, terminally ill individuals, and individuals residing in an institution are exempt from cost sharing. Refer to your state agency for details about Medicaid out-of-pocket costs. https://marketplace.cms.gov/technical-assistance-resources/fast-facts-medicaid-chip.pdf. Accessed on December 2019.