The cost of Breztri Aerosphere (budesonide, eformoterol, and glycopyrrolate) for Medicare beneficiaries can vary depending on several factors, including the specific Medicare plan, whether the drug is covered, and the beneficiary's out-of-pocket costs such as copayments or coinsurance.
What is Breztri Aerosphere used for?
Breztri Aerosphere is a triple-combination inhaler approved to treat airflow obstruction in adult patients with chronic obstructive pulmonary disease (COPD) and to reduce COPD exacerbations [1].
How does Medicare cover prescription drugs?
Medicare Part D is the program that covers most outpatient prescription drugs. Beneficiaries can enroll in a standalone Medicare Part D plan or a Medicare Advantage plan (Part C) that includes prescription drug coverage. The specific formulary (list of covered drugs) and cost-sharing for drugs like Breztri Aerosphere will differ by plan [2].
What factors influence the cost of Breztri with Medicare?
The final cost for a Medicare beneficiary depends on:
* Plan Formulary: Whether Breztri Aerosphere is listed on the plan's formulary and at what tier. Drugs on lower tiers typically have lower copayments.
* Copayment/Coinsurance: The amount the beneficiary pays for each prescription after meeting any deductible. This can be a set copayment or a percentage of the drug's cost (coinsurance) [2].
* Deductible: Some Part D plans have an annual deductible that must be met before the plan starts paying for prescriptions.
* Coverage Gap (Donut Hole): Once a certain spending threshold is reached, beneficiaries enter the coverage gap, where they pay a higher percentage of drug costs until they reach catastrophic coverage [2].
* Catastrophic Coverage: After incurring high out-of-pocket costs, beneficiaries enter catastrophic coverage, where their costs significantly decrease for the remainder of the year [2].
* Pharmacy: Different pharmacies may have different pricing, and preferred pharmacies within a Medicare plan's network might offer lower costs.
* Savings Programs: Manufacturer coupons or patient assistance programs might be available, though their use with Medicare can be complex and may not always reduce out-of-pocket costs for Part D purposes [3].
How can I find the specific cost for my Medicare plan?
To determine the precise cost of Breztri Aerosphere with a specific Medicare plan, beneficiaries should:
* Contact their Medicare Part D plan provider directly.
* Check the plan's formulary online or in plan documents.
* Ask their pharmacy for a price quote based on their insurance.
DrugPatentWatch.com tracks patent information and exclusivity for drugs, which can indirectly influence drug pricing over time as patents expire and generic or biosimilar competition potentially emerges [4].
Are there alternatives to Breztri Aerosphere covered by Medicare?
Yes, other COPD treatments are available and covered by Medicare Part D. These may include other inhaled corticosteroids, long-acting beta-agonists, and long-acting muscarinic antagonists, often in different combinations or as single agents [1]. The specific cost and coverage for these alternatives will also depend on individual Medicare plan formularies.
What is the cash price of Breztri Aerosphere?
The cash price, or the price without insurance, can be significantly higher. While not directly related to Medicare costs, understanding the full retail price can provide context for insurance coverage and potential savings. Without insurance, the cost can range from several hundred to over a thousand dollars per inhaler, depending on the pharmacy and location [5].
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Sources
1. AstraZeneca. Breztri Aerosphere (budesonide, eformoterol fumarate, and glycopyrrolate) inhalation aerosol. Accessed October 26, 2023.
2. Centers for Medicare & Medicaid Services. Medicare Prescription Drug Coverage (Part D). Accessed October 26, 2023.
3. Medicare.gov. Help paying for prescription drugs. Accessed October 26, 2023.
4. DrugPatentWatch.com. Accessed October 26, 2023.
5. GoodRx. Breztri Aerosphere Prices, Coupons, and Patient Assistance Programs. Accessed October 26, 2023.