Imbruvica® Medicare Coverage

Imbruvica®
Chemical name: Ibrutinib

Typical dosage: 140mg

Typical type: Tablet1

Imbruvica® is a medication typically used to treat mantle cell lymphoma, chronic lymphocytic leukemia, small lymphocytic lymphoma, chronic Graft-Versus-Host-Disease and Waldenström macroglobulinemia. Imbruvica is brand name only and is available as an oral tablet and capsule.

Imbruvica is a prescription medication that contains the active ingredient Ibrutinib. Imbruvica is typically taken once daily and is continued until disease progression or intolerable toxicity.

Imbruvica targets proteins in cancer cells and stops the cancer cells from growing.

The major side effects of Imbruvica include constipation, diarrhea, nausea and vomiting, headache, feeling tired or weak, lack of appetite, stomach pain, muscle or joint pain, muscle spasm, anxiety, signs of a common cold, dry eyes, trouble sleeping and dizziness.

Does Medicare cover Imbruvica?

Yes! 99% of Medicare Advantage plans and Medicare Part D plans cover Imbruvica.1

  • 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.2

  • 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 Imbruvica.

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Average costs for Imbruvica with Medicare drug coverage1

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

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.
$1,131 – $4,678 $999 – $4,619

Additional information

Imbruvica can be used alone or in combination with bendamustine and rituximab, or with obinutuzumab.

Constipation, diarrhea, throwing up and upset stomach are very common with this drug. Talk to your doctor about medication options that can help lower these side effects and improve your quality of life.

You may have an increased chance of getting an infection while taking Imbruvica. Wash your hands often and stay away from sick people.

Imbruvica can increase the risk of serious bleeding. Be careful to avoid injury.

Imbruvica can lead to other problems, including an increased risk of other types of cancer, tumor lysis syndrome, a brain problem called progressive multifocal leukoencephalopathy, kidney problems and liver problems. Talk to your doctor about the risks and benefits of this drug.

This drug is not safe in women who are pregnant and may cause serious harm to an unborn baby. Use birth control to prevent pregnancy while taking this drug and for 1 month after your last dose.

 

 

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.

Copyright © 2019 TZ Insurance Solutions LLC. All rights reserved.

1 GoodRx. Imbruvica. Retrieved May 2019, from www.goodrx.com/imbruvica.

2 Jacobson, Gretchen; et al. A Dozen Facts About Medicare Advantage. (Nov. 13, 2018). Kaiser Family Foundation. Retrieved from www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.