How Yervoy Pricing Works
Yervoy (ipilimumab), made by Bristol Myers Squibb, prices per vial or dose unit, not per patient weight or body surface area. The standard vial is 10 mg/mL at 40 mg/4 mL or 200 mg/20 mL, listed at a wholesale acquisition cost (WAC) of about $4,800 for the 40 mg vial and $24,000 for the 200 mg vial as of recent data.[1][2] Higher dosages mean buying more vials, so total cost scales linearly with the amount administered.
Dosage Levels and Matching Costs
- Standard dose: 3 mg/kg every 3 weeks for melanoma (up to 4 doses), or 1 mg/kg with nivolumab (Opdivo). A 70 kg patient at 3 mg/kg needs 210 mg per infusion—roughly one 200 mg vial plus a partial 40 mg vial, costing around $26,000 per dose.
- Higher doses: 10 mg/kg induction (e.g., earlier trials) requires 700 mg for a 70 kg patient (three 200 mg + one 40 mg vials), pushing costs to $75,000+ per dose. Clinical use rarely exceeds 3 mg/kg now due to toxicity data, but off-label or trial higher dosing directly multiplies vial purchases.[3]
No discounts for bulk; payers negotiate rebates separately.
What Happens with Patient Weight Variations
Heavier patients need more drug volume, buying extra vials or wasting partial ones (vials aren't splittable across sessions). A 100 kg patient at 3 mg/kg uses 300 mg (two 200 mg vials, ~$48,000), versus $24,000 for a 50 kg patient (one 200 mg vial). Real-world costs rise 20-50% for obese patients based on weight bands.[4]
Factors Beyond Dosage Affecting Price
- Combination therapy: Yervoy + Opdivo doubles costs; full melanoma regimen exceeds $500,000.[1]
- Rebates and access: Net price drops 30-50% via PBM deals, but list price stays fixed per vial. Patient assistance caps copays at $10,000/year for eligible U.S. patients.[2]
- International pricing: Lower in Europe (e.g., €3,000-15,000 per vial) due to negotiations, but still scales with dose.[5]
Patent Status and Generic Outlook
Yervoy's key composition patent (US 7,078,496) expires in 2027, with others to 2030-2033; no generics yet, keeping prices elevated.[6] Biosimilar challenges are pending, unlikely before 2028.
[1]: Drugs.com - Yervoy Pricing
[2]: BMS Access & Reimbursement
[3]: FDA Label - Yervoy
[4]: JAMA Oncology - Immunotherapy Costs by Weight
[5]: EMA Pricing Data
[6]: DrugPatentWatch.com - Yervoy Patents