Hizentra 的价格是多少？定价、保险和自付额援助完整指南

If you or a family member has been prescribed Hizentra (immune globulin subcutaneous), understanding the cost is one of the first concerns. Specialty medications like Hizentra carry significant price tags, but the amount you actually pay depends on your insurance plan, available copay programs, and where you fill your prescription.

This guide breaks down Hizentra’s pricing by vial size, explains how insurance and Medicare cover the drug, and outlines every copay assistance option available so you can make informed decisions about your treatment.

什么是 Hizentra？

Hizentra is a subcutaneous immunoglobulin (SCIG) therapy manufactured by CSL Behring. It is FDA-approved for the treatment of 原发性免疫缺陷（PI） in patients aged 2 and older, and for the maintenance treatment of 慢性炎症性脱髓鞘性多发性神经病（CIDP） 在成年人中。

不像 静脉注射免疫球蛋白 (IVIG) therapies that require clinic-based infusions, Hizentra is self-administered at home via subcutaneous injection. This home-based administration model can reduce both direct medical costs and indirect expenses like travel and lost work time.

Hizentra is available in four vial sizes, each designed for different dosing needs based on the patient’s weight and prescribed regimen.

Hizentra Cost Breakdown by Vial Size

The following table reflects approximate wholesale acquisition costs (WAC) for Hizentra without insurance. Actual retail prices may vary by pharmacy.

Monthly treatment costs vary widely depending on body weight and the prescribed dose. A typical PI patient weighing 70 kg on a standard dose of 0.2 g/kg per week may require approximately 56 g per month, which would cost roughly $14,000 per month without insurance.

These numbers underscore why insurance coverage and copay assistance programs are critical components of affording Hizentra therapy.

Insurance Coverage for Hizentra

Most major commercial insurance plans cover Hizentra for FDA-approved indications. Coverage typically requires:

• Prior authorization confirming the medical necessity of immunoglobulin therapy
• Diagnosis documentation of Primary Immunodeficiency or CIDP
• Step therapy requirements may apply, depending on the insurer
• Specialty pharmacy dispensing through an approved network

As a specialty pharmacy that works directly with insurance providers, AmeriPharma handles the prior authorization process and communicates with your prescriber’s office to gather the required clinical documentation.

What Affects Your Out-of-Pocket Cost

Your actual copay depends on several factors specific to your insurance plan:

• Plan tier placement: Hizentra is typically placed on a specialty tier, which may carry higher copays or coinsurance
• Deductible status: You may pay full cost until your annual deductible is met
• Out-of-pocket maximum: Once reached, your plan covers 100% of covered services
• Coinsurance rate: Common specialty tier coinsurance ranges from 20% to 50%

Medicare Coverage and Rates

Medicare Part B covers Hizentra for patients with a confirmed diagnosis of Primary Immunodeficiency when administered in the home setting. Key Medicare coverage details include:

• HCPCS Code: J1559 (Injection, immune globulin [Hizentra], 100 mg)
• Medicare Allowable Rate: Approximately $14.88 per billing unit
• Patient Coinsurance: Standard 20% after the Part B deductible is met
• Part B Deductible (2027): $292.00 annually

For a patient requiring 56 g (560 billing units) per month, the Medicare-allowed amount would be approximately $8,332.80 per month. After the deductible, the patient’s 20% coinsurance would be roughly $1,666.56 per month.

Medicare Supplement (Medigap) plans may cover part or all of the 20% coinsurance. Patients with both Medicare and Medicaid (dual eligible) typically have minimal out-of-pocket costs.

共付额援助计划

Several programs exist to reduce out-of-pocket costs for Hizentra, and most patients qualify for at least one.

CSL Behring Copay Assistance (Commercially Insured Patients)

The manufacturer offers 共同支付援助 covering up to $20,000 per year in out-of-pocket costs. Eligibility requirements include:

• Active commercial (private) insurance coverage
• A valid prescription for Hizentra
• U.S. residency
• Not covered by any government-funded insurance (Medicare, Medicaid, Tricare, VA)

Patient Assistance Program (PAP) for Uninsured Patients

CSL Behring’s Patient Assistance Program provides Hizentra at no cost to eligible patients who are uninsured or underinsured. To apply:

• 称呼 1-800-676-4266
• Provide proof of income and insurance status
• Work with your prescriber to complete the application

Hizentra Connect Nurse Support

Hizentra Connect provides one-on-one nurse training for home administration, ongoing injection-site support, and help navigating insurance or financial barriers. Contact Hizentra Connect at 1-877-355-4447.

Independent Copay Assistance Foundations

Several nonprofit organizations provide grants to help cover immunoglobulin therapy costs:

• Patient Access Network (PAN) Foundation
• HealthWell Foundation
• Immune Deficiency Foundation (IDF)
• 国家罕见病组织（NORD）

Fund availability varies throughout the year. AmeriPharma monitors these programs and alerts patients when new funding opens.

Hizentra vs. IVIG Cost Comparison

When evaluating immunoglobulin therapy options, total cost of care extends beyond the drug price alone. The following comparison illustrates the cost components for Hizentra (home-based SCIg) versus a typical 静脉免疫球蛋白输注 at an outpatient facility.

While the drug cost per gram is comparable, Hizentra’s home-based model eliminates facility and nursing fees, which can reduce total treatment costs by $700 to $2,500 per month depending on the infusion center.

How to Reduce Your Hizentra Costs

Here are practical steps to minimize your out-of-pocket expense for Hizentra therapy:

1. Verify your insurance benefits early. Understanding your plan’s specialty drug coverage, deductible, and out-of-pocket maximum helps you plan for the year ahead.
2. Enroll in the manufacturer copay program. Commercially insured patients should apply for CSL Behring’s copay assistance immediately after starting therapy.
3. Use a specialty pharmacy with copay navigation. AmeriPharma’s dedicated team monitors and applies every available program automatically, so you do not have to track funding windows yourself.
4. Ask about foundation grants. If you have Medicare or another government plan, independent foundations may cover your coinsurance.
5. Time your deductible strategically. If possible, coordinate the start of therapy with your plan year to maximize the months of coverage after your deductible is met.
6. Review Medigap or supplemental coverage. Medicare patients can reduce the 20% coinsurance burden with a Medicare Supplement plan.