Neulasta® Medicare Coverage

Neulasta is a prescription medication that contains the active ingredient Pegfilgrastim. Neulasta is given once per chemotherapy cycle for prevention of cancer-induced neutropenia, and once weekly for patients who have been exposed to high doses of radiation (called hematopoietic radiation syndrome).

Neulasta stimulates the production, maturation and activation of neutrophils to improve the immune system.

The most common side effects with Neulasta include bone pain, muscle pain and pain in the arms or legs.

How much does Neulasta cost with Medicare?

Neulasta coverage and costs may vary based on the specific plan you have, as well as what coverage stage you're in.

Contact your plan carrier or consult your plan formulary for more cost information.

Does Medicare cover Neulasta?

According to GoodRx, 35% of Medicare Advantage plans and Medicare Part D plans covered Neulasta in 2023.¹

• Medicare Advantage plans or Part D plans that cover Neulasta include copay amounts that can range widely from one plan to another. Plan members may also be responsible for meeting a deductible before the plan’s drug coverage kicks in.
  
  
• Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). 89% of 2023 Medicare Advantage plans included prescription drug coverage.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 Neulasta. We represent carriers such as Humana, UnitedHealthcare^®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

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.

Additional information

Neutropenia is when your white blood cell count is so low, your body is not able to adequately protect you from infections.

Neulasta is administered by a licensed healthcare provider in a healthcare setting.

Neulasta should be used with caution in patients with sickle cell anemia and may cause a condition called capillary leak syndrome. Capillary leak syndrome may lead to a heartbeat that is not normal, chest pain or pressure, heart attack, lung or breathing problems, bleeding or low blood flow in the stomach or bowel, swelling or feeling confused.

Talk to your doctor about the risks of infant exposure when using Nuelasta during pregnancy or while breastfeeding.

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.