Will insurance pay for the cost of Ibrance?

Ibrance (palbociclib) is an expensive medicine used to treat breast cancer, but most people do not pay the full price for this drug. Your insurance, the manufacturer of Ibrance, or patient assistance programs may be available to help you pay for this medication.

Contact your insurance plan to determine if Ibrance is a covered medication. Most insurance companies cover some portion of the cost of Ibrance. Based on your benefits, they should be able to tell you the out-of-pocket cost for your treatment, which may involve copays, deductibles or co-insurance.

If you have commercial insurance, check with Pfizer, the manufacturer of Ibrance, to determine if you may be eligible for the $0 copay card. Savings may be available for other types of insurance or if you have no insurance. Call 1-844-9-IBRANCE (Monday–Friday 8 AM–8 PM ET).

Related: Ibrance Prices, Coupons and Patient Assistance Programs

Ibrance (palbociclib) is used as part of a treatment regimen in men and women to treat HR-positive, HER2-negative breast cancer that has spread to other parts of the body.

Does insurance pay for Ibrance?

Your Ibrance prescription cost may be lower if you have commercial insurance (for example, private insurance through your employer or the Affordable Care Act).

• As of June 2022, Ibrance is covered by 98% of commercial insurance plans.
• You still may be responsible for other costs, such as copays, coinsurance, or a deductible based on your insurance plan and formulary restrictions.
• Ibrance is only available as a brand name drug at this time. A generic version is not yet available on the U.S. market.

Pfizer Oncology Together Co-Pay Savings Program

Pfizer, the manufacturer of Ibrance, offers the Pfizer Oncology Together Co-Pay Savings Program. Patients with commercial, private, employer or marketplace insurance may be eligible to use a copay card to lower their out-of-pocket costs for Ibrance. Offer is not valid for cash-paying patients.

With this card, you will pay as little as a $0 co-pay per monthly prescription, with a maximum amount of $25,000 per calendar year that can be applied toward your copay.

The amount of any benefit is the difference between your co-pay and $0. After the annual maximum of $25,000 is reached, you will be responsible for the remaining monthly out-of-pocket costs.

This card can be used once every 30 days, but there are no restrictions on how many times you use it as long as the program is in effect.

You will most likely fill your Ibrance prescription through a specialty pharmacy, and they may accept your copay card. Specialty drugs are often expensive and may need special handling, shipping, storage or pharmacist safety reviews. The offer will be accepted only at participating pharmacies.

There are no income requirements, forms, or faxing to enroll. You can get your card online. For live support, you can call 1-844-9-IBRANCE (Mon-Fri, 8 AM to 8 PM ET).

Related Questions

• Is Verzenio better than Ibrance?
• Can you take Verzenio after Ibrance fails?
• How long can you take Ibrance?

Will Medicare pay for Ibrance?

You are not eligible to use the commercial copay card if you are enrolled in a state or federally funded insurance program (for example, Medicare, Medicare Part D, Medicaid, Veteran Affairs, Tricare, others), or if you are paying cash.

• As of June 22, Ibrance is covered by 100% of Medicare Part D plans. However, your out-of-pocket cost may vary depending on your specific plan and benefit coverage.
• Financial assistance through Extra Help, a Medicare Part D Low-Income Subsidy (LIS) program from Pfizer, may also be an option.
• Pfizer Oncology Together can help identify financial support resources if you have these forms of insurance and still cannot afford your medication. Call 1-844-9-Ibrance (Monday–Friday 8 AM–8 PM ET).

What if I don’t have insurance to cover Ibrance?

If you do not have insurance or cannot otherwise afford your medication, you may be eligible for free medicine through the Pfizer Patient Assistance Program or at a lower cost through the Pfizer Savings Program.

Pfizer has a program that can check to see if you are eligible for Medicaid. Independent charitable foundations may also be able to provide support.

To learn more about how an Ibrance savings program may benefit you, call Pfilzer at 1-844-9-IBRANCE (Monday–Friday 8 AM–8 PM ET).

Is there a generic for Ibrance?

Ibrance is only available as a brand name drug at this time. A generic version, which is typically more affordable, may not be available commercially until 2027. A generic has been tentatively approved by the FDA but is not yet available on the U.S. market.

Ibrance (palbociclib) is classified as a CDK 4/6 inhibitor. It is used as part of a treatment regimen in men and women to treat HR-positive, HER2-negative breast cancer that has spread to other parts of the body.

Bottom Line

Ibrance is an expensive medicine used to treat breast cancer, but most people do not pay the full price for this drug

Your final cost will depend upon your insurance coverage, either private or government-sponsored, or any copay cards, online coupons or cash discounts you may have.

Pfizer, the manufacturer of Ibrance offers a $0 co-pay program for eligible patients with commercial insurance and can provide advice on other options to lower your cost of Ibrance. Call 1-844-9-Ibrance (Monday–Friday 8 AM–8 PM ET).

This is not all the information you need to know about Ibrance (palbociclib) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.