See the DrugPatentWatch profile for viltepso
Viltepso (C1‑esterase inhibitor [C1‑INH] – brand name) is an orphan drug used to treat and prevent episodes of hereditary angioedema (HAE).
Because it is an injectable biologic, its price is high relative to many oral medications. Below is a general outline of what patients and payers usually encounter:
| Item | Typical Cost | Notes |
|------|--------------|-------|
| List price (manufacturer) | ≈ $95 000–$105 000 per year | This is the wholesale acquisition cost (WAC). It represents the price the drug would carry if it were sold at full retail without insurance discounts or rebates. |
| Per‑infusion cost | ≈ $8 000–$9 000 (12–15 vials per year, each vial ≈ $8 000) | Each vial contains 60 mg of C1‑INH. The dosing schedule (usually 60 mg every 2–4 weeks) drives the annual cost. |
| Patient out‑of‑pocket | $5 000–$25 000 (depending on plan, copay, deductible, and negotiated rebates) | Most commercial plans have high copays or coinsurance. Some plans may have an “exclusive” formulary that covers the drug fully after a deductible. |
| Medicaid / Medicare | Covered in most states | Medicare Part B usually covers the drug for eligible patients, but prior authorization is required. Medicaid coverage varies by state; many states have a dedicated HAE formulary. |
| Patient Assistance Program (PAP) | Free or discounted (subject to eligibility) | Bristol Myers Squibb (BMS) offers a PAP for Viltepso. Eligibility criteria include income thresholds, insurance status, and proof of HAE diagnosis. Applicants can find more info and apply at https://www.bms.com/medical-education/patient-assistance-programs. |
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How to Determine Your Own Cost
1. Check your insurance formulary – Look for Viltepso (brand name) or the generic C1‑INH name. Some plans list it as an “exclusive” drug, meaning you may get it with minimal out‑of‑pocket cost after meeting a deductible.
2. Contact your pharmacy benefit manager (PBM) – They can tell you the negotiated price for Viltepso and whether they have any rebates that lower your coinsurance.
3. Ask your provider to apply for the PAP – If you’re uninsured, underinsured, or facing a high out‑of‑pocket cost, your prescriber can help submit an application. The PAP can cover the full cost of the drug for eligible patients.
4. Consider a “patient cost‑sharing” program – Many insurers offer cost‑sharing assistance for high‑cost biologics. This may involve a copay cap or a monthly fee that covers the drug at a discounted rate.
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Practical Tips
| Scenario | Action |
|----------|--------|
| You have commercial insurance but high coinsurance | Ask your PBM if Viltepso is on an “exclusive” formulary; if so, your out‑of‑pocket cost could drop dramatically. |
| You’re on Medicaid | Contact your state Medicaid office; most states have an HAE coverage program, often with no copay. |
| You’re uninsured or your coverage is insufficient | Apply for the BMS PAP. The application can be submitted online; you’ll need proof of HAE diagnosis, income documentation, and insurance status. |
| You’re under a high‑deductible plan | Consider a “Health Savings Account” (HSA) or “Flexible Spending Account” (FSA) to pre‑pay for the drug and reduce taxable income. |
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Bottom Line
- List price ≈ $95 000–$105 000/year.
- Insurance coverage can lower your out‑of‑pocket cost to a few thousand dollars or even zero if you qualify for the PAP or an exclusive formulary.
- Always check with your insurer and ask your provider for help with prior authorization or assistance program applications.
Disclaimer: Prices and coverage rules can change. Always verify with your insurance provider, pharmacy, or the manufacturer’s patient assistance portal before making decisions.