Key takeaways

  • The cost of Xphozah can vary depending on factors like insurance coverage and pharmacy prices; checking with your doctor, pharmacist, or insurance provider can help you determine your specific cost.
  • While Xphozah is currently only available as a brand-name drug, there are ways to reduce long-term costs, such as exploring drug coupons and looking into financial assistance programs.
  • Although Xphozah is unlikely to be covered under Medicare Part D at this time, the manufacturer is working to get the drug covered in the future. Speaking with a doctor can provide options if you have concerns about affording the medication.

Several factors can affect the price you’ll pay for Xphozah. These include:

  • your treatment plan
  • your insurance coverage
  • the pharmacy you use
  • available financial assistance for Xphozah (see the “Financial and insurance assistance” section)

To find out your cost for Xphozah, talk with your doctor, pharmacist, or insurance provider. This section also has information about how much you can save by using an Optum Perks coupon.

Xphozah may need to be purchased through a specialty pharmacy authorized to carry specialty drugs. This type of drug may be costly or require help from healthcare professionals to be taken safely and effectively. For more details about how to obtain Xphozah, talk with your doctor.

Coupons and savings

To save money on your Xphozah prescription, explore these Optum Perks coupons.

Xphozah only comes as a brand-name drug. It’s not currently available in a generic version. A generic contains an exact copy of the active drug in a brand-name medication but tends to cost less.

Why is there such a cost difference between brand-name drugs and generics?

Years of research and testing are needed to ensure that brand-name drugs are safe and effective. This testing can make the drugs expensive. The manufacturer of a brand-name drug can sell the drug exclusively for up to 20 years. After that, other drugmakers can create generic versions. This competition in the market can lead to lower costs for generics. And because generics have the same active ingredients as brand-name drugs, they don’t need to be studied again. This can also lead to lower generic costs.

If you take Xphozah long term, you may be able to lower your costs in the following ways:

  • Look into getting a 90-day supply: You may be able to get a 90-day supply of Xphozah if approved by your insurance company. This could reduce your number of trips to the pharmacy and help lower the cost of the drug. If you’re interested in a 90-day supply of Xphozah, talk with your doctor, pharmacist, or insurance provider.
  • Use a mail-order pharmacy: Using a mail-order pharmacy might help lower your cost for X drug. Plus, you could get your medication without leaving home. Some Medicare plans may help cover the cost of mail-order drugs. You may also be able to get a 90-day supply of the drug through mail order. If you don’t have health insurance, talk with your doctor or pharmacist. They may be able to suggest online pharmacy options that could work for you.

If you need financial support to pay for Xphozah or help understanding your insurance coverage, assistance is available. For example:

  • A program called ArdelyxAssist is available for Xphozah. For more information and to find out whether you’re eligible for support, call 877-527-3927 or visit the program website.
  • Some websites provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services. Two such websites are:

Here are answers to some commonly asked questions about Xphozah’s cost.

Is Xphozah covered by Medicare?

Xphozah is unlikely to be covered under Medicare Part D. However, the manufacturer is currently trying to get the drug covered by Medicare in the future.

Xphozah is only available through a specialty pharmacy that ships directly to your home. If you have any concerns about affording Xphozah, speak with a doctor. You can also look into Xphozah’s patient assistance program.

How much does Xphozah cost without insurance?

The price you’ll pay for Xphozah without insurance can vary based on several factors. But typically, the cost is higher for those not using insurance.

Other factors may also affect what you pay for this drug. These include:

  • the quantity you’re prescribed (such as a 90-day or 30-day supply)
  • whether you apply and qualify for any available savings programs

To learn the exact cost you’d pay for this medication without insurance, consider speaking with a doctor or pharmacist.

You may want to consider the following information if you have insurance and take Xphozah.

If you have insurance, your insurance company may require prior authorization before it covers Xphozah. This means the company and your doctor will discuss the drug in regard to your treatment. The insurance company will then determine whether Xphozah is covered.

If a drug requires prior authorization but you start treatment without the prior approval, you could pay the full cost of the medication. You can ask your insurance company whether Xphozah requires prior authorization.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.