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← Return to Anyone tried Kevzara for PMR?
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Polymyalgia Rheumatica (PMR) | Last Active: 15 hours ago | Replies (72)
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It's my understanding the maximum out-of-pocket cost for prescription drugs under Medicare Part D is capped at $2,000 in 2025, meaning you won't pay any more for covered drugs once you reach that limit. I also believe Kevzara is now covered under Medicare (Tier 5) and on the formulary for PMR. Because the cap for 2025 was recently reduced to $2,000, that might be very helpful for many. This is just my loose understanding, so would need to confirmed with a Medicare consultant. Best of luck!
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Unfortunately the $2000 cap is meaningless if no Medicare Part D plan in your area will cover Kevzara, which is what I faced for 2025. I was on patient assistance in 2024 but was cut off at the end of the year. It seems illegal to me to have a drug Medicare-approved for a disease and then to allow drug plans not to cover it. My drug plan did offer me a "deal": $16,000 a year as opposed to the original estimate of $33,000. I went off Kevzara and had a flare-up of PMR with some possible GCA symptoms. My rheumatologist has put in a prescription for an Actemra biosimilar infusion. We'll see what happens. In the meantime he raised my prednisone dose.