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FDA approved Tyenne significantly cheaper biosimilar to Actemra
Polymyalgia Rheumatica (PMR) | Last Active: Feb 27 5:20am | Replies (11)Comment receiving replies
I have GCA, and started Actemra infusions Feb. 2025. About 3 months ago, Medicare switched the infusion coverage to Tyenne. I don’t notice any difference, and I like the monthly infusions. They are covered %100 by Medicare part B, although I have original (classic) Medicare and also a Supplemental policy Plan F that covers all deductibles, copayments, etc. My understanding is that the weekly injections are covered under Part D (the drug plan, so coverage depends on your Medicare Advantage drug coverage.
Replies to "I have GCA, and started Actemra infusions Feb. 2025. About 3 months ago, Medicare switched the..."
@sjc123 I started Tyenne injection in Jan. I too have classic Medicare with a Plan D and Plan F. I had to get a Prior Authorization for the Tyenne injectables before I could start them. That process was not without drama, in the end it was approved. Within 6 weeks I managed to spend $2,100 on drugs and now for the remainder of the year my drugs will be of no cost to me. They got rid of the drug donut and replaced with an annual cap on the cost to a patient. This year the cap is $2,100, last year it was $2,000. The injectables provide a great deal of freedom for me to travel, which is something that brings me joy. It is worth the additional costs and other logistical concerns.
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@sjc123
I think everything you posted is true.