• Intravenous (IV) disease-modifying therapies (DMTs) for multiple sclerosis (MS) often come with a high price tag.
• Infusion costs may include additional expenses like administration fees, time off work, and travel, adding to the overall financial burden.
• Drug manufacturers and copay assistance programs may help reduce the cost of these infused treatments.

DMTs for MS can be expensive. Some DMTs are given by IV infusion at a clinic, which may add costs beyond copays. When you factor in administration costs at the clinic, time off work, and sometimes even travel costs to visit the infusion center, the price of MS treatment can become even steeper.

Read on to learn more about infusion costs, including related expenses, and how to find financial assistance to help you save on your MS treatments.

How Do Infusion Costs Affect People With MS?

One small study of people on infused DMTs for MS found that mean annual costs ranged from $72,000 to $121,000 for these medications and their administration fees. Insurance may not cover the full cost, leaving people with MS facing significant medical bills.

One small study found that mean annual costs ranged from $72,000 to $121,000 for infused DMTs and their administration fees.

Infusion costs are a common concern on MyMSTeam. “Knowing how much MS medication costs, how are people without insurance able to pay for their medication?” one member wrote.

“I know how high the financial burden is when I have to go to get my infusions or just see the doctor,” another member said. “I need to travel to Cleveland Clinic, and usually that entails staying overnight at a motel, plus the fuel costs are ridiculous. Then, this cost rolls downhill to our personal finances.”

The good news is that financial help may be available to help cover some of your out-of-pocket expenses associated with MS infusion treatment, such as through a copay assistance program.

What Is a Copay Assistance Program?

Copay assistance programs are for people with insurance who still have out-of-pocket expenses for medical treatments due to copays and high deductibles. These programs can help cover the costs of:

• Prescription drugs
• Copays
• Deductibles
• Medical insurance premiums
• Coinsurance

Some programs have household income requirements, and you will qualify only if your income is below a certain limit.

Some copay programs are operated by organizations that distribute financial support for copays and other expenses related to a medical condition. These programs may provide direct payments to drug or health care providers. They also may provide reimbursement for payments already made.

Some companies that make infused DMTs sponsor programs that pay a part or all of a person’s out-of-pocket expenses after their insurance company has paid its portion.

Other financial assistance programs, such as prescription drug savings cards, copay cards, and copay coupons, can provide immediate rebates for prescription drugs when you purchase them at a pharmacy. Prescription savings cards helped save Americans almost $200 million from 2009 through 2016 — an average of $18 per prescription. These programs are generally designed for people with commercial (private) insurance and don’t apply to people on Medicare or Medicaid.

Many drug companies also provide direct assistance to help reduce the cost of medication for those who qualify. These programs pay some or all of a person’s out-of-pocket expenses after their insurance company has paid its portion. With some insurance plans, these payments may count toward your annual deductible or maximum out-of-pocket payment limit.

How Copay Assistance Programs Can Help Pay for MS Infusion Drugs

Five infused DMTs have been approved by the U.S. Food and Drug Administration (FDA) for treating MS. Each has a different schedule of infusions:

• Alemtuzumab (Lemtrada) — Given over five days, followed by another three-day round a year later
• Natalizumab (Tysabri) — Administered every four weeks for relapsing forms of MS
• Ocrelizumab (Ocrevus) — Infused every six months
• Ublituximab-xiiy (Briumvi) — Administered once every 24 weeks
• Mitoxantrone — Given once every three months

Many programs can help lower the cost of these medications and their administration fees. Eligibility and rules for copay assistance vary based on where you live. You may want to ask a nurse or social worker at your neurologist’s office to help determine which program may be best for you.

“Got my meds, and a discount program is helping to cover the $2,500 copay,” one MyMSTeam member reported.

Ask your doctor or pharmacist about copay assistance programs for MS drugs with copays and other forms of financial support for your MS treatment plan. They may be aware of programs to help with MS drug costs, such as Lemtrada copay assistance or help with Tysabri infusion costs.

Organizations That Provide Financial Help

Several nonprofit organizations have copay assistance foundations that provide support to people with MS. You can refer to the following organizations, among others, for more information on the status of their programs, eligibility criteria, and application process:

• The Assistance Fund
• HealthWell Foundation
• Patient Advocate Foundation
• Good Days
• National Organization for Rare Disorders

NeedyMeds, a nonprofit that connects people with resources to pay for medications, offers a free Patient Assistance Program Update Service with daily and weekly email reports on changes to programs, applications, and eligibility requirements.

Pharmaceutical Research and Manufacturers of America also provides detailed information and tools for accessing copay savings programs.

Financial Help From Drug Manufacturers

Drug manufacturers with copay assistance programs will have information about financial help on their websites. Copay assistance grants from drug manufacturers are typically limited to people with commercial insurance. Visit the manufacturer's website for a drug your doctor has prescribed, and look for menu options such as:

• Copay assistance
• Financial support
• Insurance coverage
• Manufacturer coupon
• Savings card

You can also look at the Multiple Sclerosis Association of America’s database of prescription programs operated by various DMT manufacturers. Don’t hesitate to call these companies to ask about financial help for your treatments, including MS infusions. One of their representatives can talk with you about the programs they offer, eligibility requirements, and how to apply. The health care professional who prescribed your medications may need to provide them with information about your prescription.

“If any of you are having trouble with copays, please contact the manufacturer of your particular medication,” wrote a MyMSTeam member. “I did, and I’m getting $9,000 a year toward my copay.”

“After copay assistance went through, my Ocrevus bill was only $5,” another member wrote. “I’m floored and feel like crying with relief and happiness.”

“After copay assistance went through, my bill was only $5. I’m floored and feel like crying with relief and happiness.”

— A MyMSTeam member

Can You Get Financial Help if You Have Medicare or Medicaid?

People with Medicare Part D, which offers prescription medicine coverage, may qualify for copay assistance if they meet certain requirements.

If you would like more information about Medicare Part D drugs and prescription coverage, call 800-633-4227 or search for your state insurance department. If you’re eligible for both Medicare and Medicaid, you may have more options.

Copay Accumulator Programs

Some private health insurance plans may have a copay accumulator program. With these programs, the amount paid by a drug manufacturer won’t count toward your deductible and out-of-pocket maximum under your health plan.

If your health plan has a copay accumulator program, you may still owe a significant amount of money toward your deductible after reaching the maximum annual amount offered by your copay assistance program.

Ask your insurance provider or your employer’s human resources administrator if your health plan includes a copay accumulator program. If it does, be sure to talk to your employer if you need help paying for drugs due to high costs.

Copay accumulator programs are controversial. Several states have passed or introduced legislation to ban or restrict them.

Help With Nonprescription Costs

Because DMT infusions may involve expenses beyond copays, you may also want to explore other programs that can help with financial assistance for those out-of-pocket costs.

The Multiple Sclerosis Foundation offers grants for transportation assistance, which helps people with MS get to medical appointments, and emergency assistance to help pay for rent or other utilities. You may want to look into these programs to help cover the costs of your infusion treatments.

Talk With Others Who Understand

MyMSTeam is the social network for people with MS and their loved ones. On MyMSTeam, more than 215,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Do you use a copay assistance program or other financial support for your infused DMT? Do you have advice for others looking to reduce drug-related expenses? Share your thoughts and experience in the comments below, or start a conversation by posting on your Activities page.