Vascepa is a prescription medication used to treat high levels of triglycerides in the blood. It is a type of omega-3 fatty acid that is derived from fish oil. According to the sources provided, there are some restrictions on Vascepa coverage.
Firstly, the patent for Vascepa expired in December 2019 [1]. This means that generic versions of the medication may become available, which could affect coverage and pricing.
Secondly, Medicare coverage for Vascepa is limited. While it is covered under Medicare Part D, some plans may require prior authorization or have restrictions on the quantity that can be prescribed [2]. Patients are advised to check with their specific plan for details on coverage.
Finally, access and coverage for Vascepa may vary depending on the patient's insurance plan. The manufacturer of Vascepa offers a co-pay assistance program for eligible patients, which can help with out-of-pocket costs [3]. Patients are advised to check with their insurance provider and the manufacturer for details on coverage and assistance programs.
In conclusion, while Vascepa is covered under Medicare Part D, there may be restrictions and limitations on coverage depending on the patient's specific plan. Additionally, the expiration of the medication's patent and potential availability of generic versions could affect coverage and pricing. Patients are advised to check with their insurance provider and the manufacturer for details on coverage and assistance programs.
Sources:
[1] https://www.drugpatentwatch.com/p/tradename/VASCEPA
[2] https://www.goodrx.com/vascepa/medicare-coverage
[3] https://www.vascepahcp.com/access-and-coverage/