Tarceva Medicare Coverage

Tarceva is a prescription medication that contains the active ingredient Erlotinib. Tarceva is usually taken once daily by mouth until disease progression or unacceptable toxicity.

Tarceva is an antineoplastic cancer medication that interferes with the growth of cancer cells, which are eventually destroyed.

The major side effects of Tarceva include feeling tired or weak, itching, acne, skin irritation, nausea, diarrhea, loss of appetite, mouth irritation or mouth sores, headache, back pain, muscle or joint pain, change in hair or nails and dry skin.

How much does Erlotinib cost with Medicare?

Erlotinib 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 Erlotinib?

According to GoodRx, 100% of Medicare Advantage plans and Medicare Part D plans covered Erlotinib, the generic form of Tarceva, in 2023.¹

• Medicare Advantage plans or Part D plans that cover Erlotinib 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 Erlotinib. 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

This medication should be taken on an empty stomach 1 hour before or 2 hours after meals.

Do not take cimetidine, famotidine, nizatidine, ranitidine, or any antacids at the same time as this drug. Keep taking Tarceva even if you begin to feel better.

Tarceva is indicated as first line, maintenance, or as second or greater line treatment after progression following at least 1 prior chemotherapy regimen in metastatic non-small cell lung cancer.

It is used in tumors with epidermal growth factor receptor Exon 19 deletions or exon 21 substitution mutations.

Tarceva is also used as first-line treatment with gemcitabine for locally advanced, unresectable or metastatic pancreatic cancer. Tarceva should not be used with any platinum-based chemotherapy regimens.

Tarceva may be given with other medications to minimize the incidence of side effects such as nausea.

Some vaccines may not be compatible with this drug regimen or may not work. Talk to your doctor about vaccines before you get any.

Bleeding risk is increased in patients who are also taking warfarin.

You may be more susceptible to sun damage while taking Tarceva. Avoid sun, sunlamps and tanning beds. Use sunscreen, protective clothing and protective eyewear when using this medication.

This medication may put you at a higher risk of holes in the GI tract, as well as lung, liver and kidney problems.

This drug is not indicated for use in pregnant or breastfeeding women because of harm it can cause to the baby. Use birth control to prevent pregnancy while taking this drug and for 1 month after.

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.