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Is Baqsimi covered by Medicare?

Medically reviewed by Carmen Fookes, BPharm. Last updated on June 15, 2020.

Official Answer

by Drugs.com
  • For most people, Medicare does not fully cover the cost of Baqsimi.
  • 71% of people with Medicare Part D coverage can expect to pay between zero and $100 per device.
  • The average cost for the other 29% is around $260 per device.
  • Some Medicare patients can qualify for financial support through the Extra Help program bringing the cost of Baqsimi down to between $3 and $9 each prescription.
  • Without any insurance coverage, Baqsimi costs around $303 for a single-dose, single-use, nasal powder spray, according to the Drugs.com price guide.
  • People with commercial drug insurance coverage that covers Baqsimi may be eligible for the Baqsimi Got Your BAQ™ program and pay as little as $25 for up to two Baqsimi devices.
  • There is currently no generic form of Baqsimi.

Baqsimi (glucagon nasal powder) may be used to treat severe hypoglycemia (low blood sugar/glucose levels) in adults and children over the age of four. Glucagon is a hormone that increases blood glucose levels by stimulating the release of glucose from the liver. It also slows digestion.

Medicare is the federal health insurance program for people aged 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). Different parts of Medicare help cover specific services with Medicare Part D covering prescription drug coverage.

  • Medicare-eligible beneficiaries can enroll in a Medicare Part D Prescription Drug plan from a private insurance company.
  • Out of pocket costs for Baqsimi depend on your insurance company and what phase of the Part D benefit you are currently in.
  • For the majority of people, Medicare does not fully cover the cost of Baqsimi.
  • Overall, 71% of Baqsimi prescriptions for people with Medicare part D coverage cost between zero and $100 per device.
  • The remaining 29% cost an average of $260 per device.
  • Some Medicare patients can qualify for financial support through the Extra Help program. This will bring the cost of Baqsimi down to between $3 and $9 each prescription.

The Lilly Diabetes Solution Center (1-833-808-1234) can offer advice on the most affordable option for each individual.

People with commercial drug insurance coverage that covers Baqsimi may be eligible for the Baqsimi Got Your BAQ™ program. They may pay as little as $25 for up to two BAQSIMI devices (1 two-pack or 2 one-packs) with a maximum of 12 fills per year. This offer is capped and for a limited time until 12/31/2020. The patient is responsible for any taxes, fees, or amounts exceeding monthly or annual caps.

According to the Drugs.com price guide which bases its price on the Drugs.com discount card which is accepted at most U.S. pharmacies, the cost for a single-dose Baqsimi nasal powder 3mg is approximately $303 depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.

Baqsimi is a dry nasal spray that is given for low blood sugar emergencies to people who cannot eat, have passed out, or are having a seizure due to low blood sugar levels (hypoglycemia). Hypoglycemia needs to be treated as quickly as possible because having low blood sugar levels for too long can cause seizures, coma, or death.

Each Baqsimi device contains 1 dose of glucagon nasal powder and cannot be reused There is currently no generic version of Baqsimi.

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