@brettdf My understanding is that Brinsupri is distributed through a specialty pharmacy, who will contact you directly, so hang tight. Depending on income, you might have some cost sharing but it will not exceed your out-of-pocket maximum for this calendar year assuming medicare. Private insurance might be a whole different matter in which there might be a high Tier-whatever co-pay. Each case is individual and based in what insurance and income level.

@brettdf
I have Optum Rx and they have a separate specialty pharmacy. I can't speak to how it'll work with Brinsupri, but I started on Dupixent recently and get it thru the Specialty divisions. My doc sent order to usual CVS and I was in limbo for 4-5 weeks between doc's office, CVS and CVS Specialty. Once I found out it had to be thru Optum's Specialty, I spoke with them and they were enormously helpful! They called doc's staff while I was on phone to get info for approval. Couple hours later, the pharmacist called with question about the dose ordered and followed up with call to doc's office to get dose changed, then called me again with instructions. I was then sent tracking info for overnight delivery! I have no idea if they're always that great, but it's sure worth asking to speak with them. Good luck!

@brettdf
I do not have Part D yet but my understanding is if you have part D the most you can spend is $2000 a year. So if Brinsupri is covered by part D you will not pay more than that. Plus your premiums of course.