Aprepitant (Emend) Medicare Coverage

Aprepitant
Chemical name: Aprepitant

Brand name: Emend

Typical dosage: 40mg

Typical type: Capsule1

Aprepitant is a medication used to prevent nausea. It is available as a brand name drug or a generic and comes as an oral capsule, IV injection or an oral liquid.

Aprepitant is a medication used to prevent chemotherapy-induced nausea and vomiting, as well as postoperative nausea and vomiting. The brand name equivalent of Aprepitant is called Emend.

Aprepitant inhibits substances from forming in the body that lead to nausea and vomiting. It is typically given prior to the event that will cause nausea, and it may be administered after as well.

Common side effects of Aprepitant include fatigue, diarrhea, constipation, loss of appetite, stomach pain, heartburn, dizziness, headache and burping.

Does Medicare cover Aprepitant or Emend?

Some Medicare Advantage plans and Medicare Part D plans may cover Aprepitant.

  • Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.1

  • Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Aprepitant.

Find Medicare Advantage plans with drug coverage

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

 

You can also compare Part D prescription drug plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Average costs for Aprepitant with Medicare drug coverage

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in and the Medicare drug plan you have.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.
After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.

Additional information

If you take Aprepitant to prevent nausea and vomiting due to chemotherapy, your first dose should be taken one hour prior to chemotherapy on day one. You will then take it once daily on days 2 and 3, after chemotherapy treatment. This helps prevent delayed nausea and vomiting.

If you take Aprepitant to prevent nausea and vomiting due to surgery, you should take one dose within 3 hours before you are given anesthesia. Aprepitant can be taken with or without food, but check with your doctor and follow their instructions, especially before surgery.

Infection can rarely happen after taking Aprepitant. Infection symptoms include fever, chills, sore throat, ear or sinus pain, cough, increased sputum, change in color of sputum, pain with passing urine, mouth sores or wounds that will not heal.

This medication may affect how well birth control pills and other hormone-based birth control works. It is best to use a second form of birth control if needed after taking Aprepitant.

 

 

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

 

Written by Hayden Gharibyar, Pharm.D.