Keytruda® Medicare Coverage

Keytruda is an immunotherapy used to treat several types of cancers. It works by stimulating the immune system to attack cancer cells.

Keytruda is administered intravenously at a doctor’s office or infusion center over 30 minutes usually every 3 weeks. Because this medication works on the immune system, it can attack normal organs and tissues in the body during treatment or even after treatment ends, which can be severe or life-threatening.

Common side effects of this medication include fatigue, pain, diarrhea, constipation, decreased appetite, nausea and rash.

Does Medicare cover Keytruda?

No. Medicare Advantage plans and Medicare Part D plans do not typically cover Keytruda.¹

You may be able to find Medicare Advantage plans or Part D plans that cover other cancer treatment drugs.

• 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.

Or call 1-800-557-6059 1-800-557-6059 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 Keytruda with Medicare drug coverage¹

Because Medicare Advantage plans and Medicare Part D plans do not typically cover Keytruda, you will likely be responsible for all costs for this drug if you have one of these types of Medicare coverage.

Additional information

Keytruda is indicated to treat several types of advanced cancers and is not a chemotherapy drug, but an immunotherapy drug.

This immunotherapy agent has been shown to significantly shrink tumors, reduce disease progression and even help patients extend their life.

Keytruda has been labeled as breakthrough therapy in certain advanced cancers and has received accelerated approval by the FDA in certain cancers because of the significant benefit of this medication seen in clinical trials.

Keytruda should be used with caution in patients with immune problems, organ transplant, stem cell transplant, liver or lung problems.

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.