@boomermeg My insurance (BC BS of NC) only has a couple of specialty pharmacies in network, so my rheumatologist sent my prescription to one of them, Accredo, which is based in Tennessee. I don't know how the manufacturer discount works. I didn't have anything to do with it. I would think that the insurance company negotiated the discount, but that's just a guess. Actemra has competition now from some other biosimilars like Tyenne, so maybe that's why the manufacturer has the discount. I have a friend that has a Humana policy and takes Actemra injections, but I don't know any details about what Humana pays for it. I know from my friend that Humana has their own specialty pharmacy.