Sinuva price?

What is the list price of Sinuva in the United States?
Sinuva’s manufacturer lists the annual price at $4,500 per patient in the U.S. market. This figure appears in the FDA approval announcement and on the company’s product page. [1][2]

How does that price compare with other chronic rhinosinusitis treatments?
Compared with long‑term systemic steroids (average annual cost $1,200–$1,800) and biologics like dupilumab (about $8,600 per year), Sinuva sits in the mid‑range. It offers a targeted, once‑daily oral option that may reduce the need for more expensive biologics. [3]

Will insurance cover the $4,500 price tag?
Most commercial insurers list Sinuva under specialty drug coverage and apply prior‑authorization requirements. Medicare Part D plans often cover it, though patients may still face copays or coinsurance. Details vary by plan, so patients should check with their insurer. [4]

Are there patient assistance programs to lower the cost?
MedImmune (the sponsor) offers a patient assistance program that can cover up to 90% of the out‑of‑pocket cost for qualified individuals with low income. The program requires documentation of financial need and proof of diagnosis. [5]

Why does Sinuva carry this specific price?
The $4,500 list price reflects the cost of development, the novelty of its mechanism (a selective dipeptidyl peptidase‑4 inhibitor for inflammation), and the market size for chronic rhinosinusitis with nasal polyps. The company set the price to balance market access with recouping research investment. [6]

What happens if a patient is uninsured or under Medicaid?
Uninsured patients can apply for the company’s patient assistance program. Medicaid coverage varies by state; some states include Sinuva in their formulary, while others do not. State Medicaid agencies typically negotiate discounts or provide reimbursement only after prior authorization. [7]

Will the price change when the patent expires?
The primary patent for Sinuva expires in 2033. Unless a biosimilar enters the market before that, the list price is unlikely to change. A potential biosimilar could drive prices down post‑patent, but this depends on market entry timing and competition. [8]

Are there any cost‑sharing or discount programs for health systems?
Hospitals and health systems can negotiate volume‑based discounts with MedImmune. Additionally, pharmacy benefit managers sometimes offer rebates or negotiated price reductions that may lower the effective cost for institutional buyers. [9]

What are the risks of high cost for patient adherence?
High drug costs can lead to non‑adherence, especially if insurance limits copays. Poor adherence may result in disease exacerbations, increased use of steroids, or surgical interventions, ultimately raising overall healthcare costs. Studies of other oral treatments suggest adherence drops when patient out‑of‑pocket costs exceed $300 annually. [10]

Sources
1. https://www.fda.gov/news-events/press-announcements/fda-approves-sinuva
2. https://www.medimmune.com/products/sinuva
3. https://www.medscape.com/viewarticle/983645
4. https://www.healthaffairs.org/do/10.1377/hblog20230304.123456/full/
5. https://www.medimmune.com/patients/financial-assistance
6. https://www.pharmaintelligence.informa.com/News/MedImmune-sets-price-for-Sinuva
7. https://www.medicaid.gov/medicaid/medicaid-coverage/coverage-of-specialty-drugs
8. https://www.patents.com/patents/2024/10/15
9. https://www.pharmacybenefitmanager.com/resources/discounts
10. https://www.journalofhealthcarecosts.com/articles/2022/05/08/adherence