How Much Does Ocrevus Infusion Cost?

How much Ocrevus infusions cost (with and without insurance) and how patients can lower the cost of their infusions.

Ocrevus (ocrelizumab) is a monoclonal antibody designed to target B lymphocytes. Although a vital part of our immune system, these white blood cells can contribute to nerve damage in patients with multiple sclerosis (MS) by attacking the myelin that surrounds the nerves in the brain.

Ocrevus is prescribed for the treatment of relapsing forms of multiple sclerosis including relapsing-remitting disease (RRMS) and active secondary progressive disease (SPMS). This disease-modifying therapy is the only Food and Drug Administration (FDA)-approved treatment for those with primary progressive multiple sclerosis (PPMS).

As with any FDA-approved intravenous treatment, Ocrevus can be expensive for a few reasons. First and foremost, it’s a biologic medication that’s expensive to produce. But most eligible patients also need regular infusions over long periods of time, which can contribute to higher costs.

Below, we break down how much Ocrevus infusions cost (with and without insurance), along with how patients can lower the cost of their infusions.

How much does Ocrevus cost?

The list price of Ocrevus is, on average, $75,102 per year — but most people will not pay the full drug cost.

How does insurance coverage impact the cost of Ocrevus?

How much the patient pays (aka out-of-pocket costs) is ultimately a function of the insurance plan. Every plan is different, but there are a few concepts that are important to remember:

• Copay: a fixed amount of money that you pay for a healthcare service, which generally totals $0-$50 per visit
  
  
• Coinsurance: a percentage of the total cost of a healthcare service
  
  
• Deductible: an amount of money you must pay before your health insurance plan starts to share costs
  
  
• Or a combination of these options

Those with a private insurance or commercial insurance provider may be eligible for co-pay assistance programs, in which case they’d pay as little as $10 per treatment (with the Ocrevus co-pay card). Those on Medicare will pay between $0 and $14,500 per year, while the cost for those on Medicaid will vary depending on income level and state regulations.

Don’t have insurance or aren’t in-network with your infusion center? It may be possible to bill your insurance company for the medication costs out-of-network.

If out-of-network benefits aren’t available, you may be able to be seen as a self-pay patient.

How does site of care impact the cost of Ocrevus?

The only decision a patient can make to influence the cost of their infusion is to decide where to receive treatment. Generally, there are three options where a patient may receive prescription drug infusion therapy from a healthcare professional:

1. Hospital outpatient
2. Home
3. Office setting (Ambulatory Infusion Center or Specialty Doctor’s Office)

Hospital outpatient is where 50-60% of infusions take place nationally. The cost is generally ~2x what it costs in the home or office. Home infusion has received a lot of press recently, but according to the National Infusion Center Association, it tends to be 50% more expensive than a healthcare provider’s office. The office setting will be the most affordable care setting for patients who have received a referral from their physician for infusion therapy.

How can I lower the cost of Ocrevus infusions?

Manufacturers have copay assistance and financial assistance programs to help offset the cost of biologic treatments to patients, such as the Janssen Carepath Savings Program and Ocrevus Copay Program. Based on eligibility requirements, these programs may cover up to $20,000 per year per patient and significantly reduce, or remove, any financial burden a patient may face for the drug’s administration.

Also, if you’re unable to afford Ocrevus, you may be eligible for additional financial patient assistance through the Genentech Patient Foundation.

How Local Infusion can help

At Local Infusion, each patient is paired 1:1 with a Guide who works with you to determine your out-of-pocket costs and what financial programs you're eligible for. Guides also handle everything related to prior authorization. 

READ MORE: Briumvi vs Ocrevus For MS: What's The Difference?