Copaxone (Glatiramer Acetate) Medicare Coverage

Copaxone
Chemical name: Glatiramer Acetate

Brand name: Copaxone

Typical dosage: 40mg/ml

Typical type: Injection1

Copaxone is a medication used to treat multiple sclerosis. Copaxone is available as a brand name drug or a generic and comes as an injection.

Copaxone is a medication that contains the active ingredient Glatiramer Acetate. It is used to treat relapsing forms of multiple sclerosis. This includes relapsing-remitting disease, clinically isolated syndrome and secondary progressive disease.

Copaxone is believed to prevent the production of immune cells that target and attack an important part of nerve cells called myelin. It is typically taken either once daily or 3 times per week.

Common side effects of Copaxone include irritation where you give the injection, upset stomach, vomiting, fatigue and back pain.

Does Medicare cover Copaxone or Glatiramer Acetate?

Some Medicare Advantage plans and Medicare Part D plans may cover Copaxone or the generic form, Glatiramer Acetate.

  • 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 Copaxone.

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 Copaxone 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 use Copaxone 3 times per week, each injection should be administered at least 48 hours apart.

Copaxone should be stored in the refrigerator. If stored at room temperature, it must be thrown away after 30 days.

Inject Copaxone into fatty skin. It can be given in the stomach, thigh, outer hip or the upper arm if someone else is administering the shot. Choose a new spot to inject the medicine each time you use it. Always use new needles for injection.

Copaxone can increase your risk for getting an infection. Signs of infection include sore throat, ear or sinus pain, cough, fever or chills. Talk to your doctor if you experience any of these side effects.

 

 

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.