Benlysta (belimumab) is a brand-name drug prescribed for lupus in adults and some children. It comes as an intravenous (IV) infusion and subcutaneous injection. Benlysta’s cost with and without insurance can depend on several factors.

Benlysta is approved by the Food and Drug Administration (FDA) to treat systemic lupus erythematosus (SLE) (also known as lupus) and lupus nephritis in adults and children ages 5 years and older.

As with all medications, the cost of Benlysta can vary. Factors that may affect the price you’ll pay include:

  • your treatment plan
  • your insurance coverage
  • the pharmacy you use
  • whether Benlysta has a savings program (see the “Financial and insurance assistance” section)
  • the form of Benlysta your doctor prescribes
  • the cost of the visit to your healthcare professional to receive doses of Benlysta*

To determine the cost of Benlysta for you, talk with your doctor, pharmacist, or insurance provider.

* This will depend on the form of Benlysta your doctor prescribes. With Benlysta for subcutaneous injection, you may self-inject the drug at home. To learn more, see this article about Benlysta forms and dosage.

Benlysta contains the active ingredient belimumab and is available only as a brand-name biologic drug. It doesn’t come in a biosimilar version. A biosimilar medication is similar to a brand-name biologic drug (the parent drug). Also, biosimilars tend to cost less than brand-name medications.

WHY ARE COSTS DIFFERENT FOR BIOLOGIC DRUGS VS. BIOSIMILAR DRUGS?

Biologic drugs can be expensive because of the research needed to test their safety and effectiveness. The manufacturer of a biologic drug can sell it for up to 12 yearsTrusted Source. When the biologic drug’s patent expires, multiple manufacturers can create biosimilar versions. This marketplace competition may lead to lower costs for biosimilars. Also, because biosimilars are very similar to biologic drugs, they don’t require the same costly testing.

If you take Benlysta long term, you may be able to lower its cost in the following ways.

Getting a 3-month supply

You may be able to get a 90-day supply of Benlysta. If approved by your insurance company, getting a 90-day supply of the drug could reduce your trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor, pharmacist, or insurance provider.

Using a mail-order pharmacy

Benlysta may be available through a mail-order pharmacy. Using this type of service may help lower the drug’s cost and allow you to receive your medication without leaving home. Some Medicare plans may help cover the cost of mail-order medications. You may also be able to get a 90-day supply of the drug via mail order.

If you don’t have a health insurance plan, talk with your doctor or pharmacist. They may be able to suggest online pharmacy options that could work for you.

Support is available if you need financial support to pay for Benlysta or need help understanding your insurance coverage. For example:

  • A program called the Benlysta Copay Program is available. For more information and to determine your eligibility for support, call 800-741-0375 or visit the program website.
  • Some websites provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services. Two such websites are:

Here are answers to some frequently asked questions about drug cost and Benlysta.

How much does Benlysta cost with insurance versus without it?

What you pay for Benlysta if you have insurance compared to what you’d pay without it depends on several factors.

Factors that could affect how much this drug costs without insurance may include:

  • your dosage and treatment plan
  • the form of the drug you’re prescribed, such as the IV infusion or subcutaneous injection
  • the quantity you’re prescribed, such as a 90-day or 30-day supply
  • the pharmacy you use
  • whether you apply and qualify for any available savings programs

These same factors may affect the price you pay for Benlysta if you have insurance. The drug’s cost with insurance will also depend on your specific plan benefits and any prior authorization requirements you have for drug coverage. For details about this, see the “Insurance considerations” section.

To learn more about what you’d pay for Benlysta with or without insurance, talk with your doctor, pharmacist, or insurance provider if you have one.

Is Benlysta covered by Medicare?

It may be. You can call your Medicare plan provider to learn whether your particular plan covers the cost of this drug. There are many types of Medicare plans, so your coverage and what you pay for prescriptions will derive from your particular plan’s benefits.

The total price you pay for Benlysta may also depend on the cost of receiving infusions at your doctor’s office or clinic. You may also need to obtain prior authorization before your plan will cover the cost of this medication.

Your doctor may also provide information about the price you pay for Benlysta if you have Medicare.

Below is information to consider if you have insurance and receive Benlysta.

Prior authorization: If you have insurance, your insurance company may require prior authorization before covering Benlysta. This means the company and your doctor will discuss Benlysta regarding your treatment. The insurance company will then determine whether to cover the medication.

If a drug requires prior authorization but you start treatment without it, you could pay the full cost of the medication. You can ask your insurance company whether Benlysta requires prior authorization.

Type of insurance coverage: Benlysta IV infusion is given by your doctor or another healthcare professional. If you have insurance, the price of your infusion may be billed through your medical coverage instead of the prescription drug portion of your insurance plan. This depends on your specific insurance plan and where you receive your Benlysta doses, such as at your doctor’s office, an infusion clinic, or the hospital.

Contact your doctor or insurance provider if you have questions about this process.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.