Blood Disorders Drug Costs With Medicare
Compare 8 blood disorders drug prices under Medicare Part D, averaging $37,231.50 per claim. Prices range from $19,500.00 (Empaveli) to $68,556.00 (Soliris) per prescription. 8 of 8 drugs have FDA-approved generics that cost 30-80% less.
Key Facts: Blood Disorders Drug Costs
- Cheapest drug
- Empaveli ($19,500.00)
- Most expensive
- Soliris ($68,556.00)
- Medicare Part D avg
- $37,231.50/claim
- Generics available
- 8 of 8
- Total Medicare spend
- $6.0B/yr
- Brand-only drugs
- 0
Source: CMS Medicare Part D Spending, latest reporting year. Costs reflect plan-paid amounts, not patient out-of-pocket.
Blood Disorders Drug Price Comparison
All 8 blood disorders drugs tracked in Medicare Part D, sorted from cheapest to most expensive. Click any drug for Medicare coverage details, generic timelines, and savings options.
| Drug | Generic Name | Medicare Avg/Claim | Generic Available? |
|---|---|---|---|
| Empaveli | Pegcetacoplan (PNH) | $19,500.00 | Yes |
| Adynovate | Antihemophilic Factor (PEG) | $24,643.00 | Yes |
| Advate | Antihemophilic Factor (rDNA) | $25,333.00 | Yes |
| Alprolix | Coagulation Factor IX (FC fusion) | $28,750.00 | Yes |
| Eloctate | Antihemophilic Factor (FC fusion) | $31,500.00 | Yes |
| Hemlibra | Emicizumab | $34,278.00 | Yes |
| Ultomiris | Ravulizumab | $65,292.00 | Yes |
| Soliris | Eculizumab | $68,556.00 | Yes |
Medicare Part D Coverage for Blood Disorders Drugs
All 8 blood disorders drugs in this comparison are dispensed under Medicare Part D. Total Medicare spending reached $6.0B in the latest reporting year, averaging $37,231.50 per prescription fill.
Your out-of-pocket cost depends on three factors: (1) your plan's formulary tier — generics typically land on Tier 1 ($0-$10 copay), preferred brands on Tier 2 ($30-$50), and specialty drugs on Tier 4-5 (often 25-33% coinsurance); (2) your deductible status — most plans require you to meet up to a $590 deductible before copays apply; (3) the coverage phase — initial coverage, coverage gap, or catastrophic. As of 2025, Medicare Part D caps total annual out-of-pocket at $2,000 under the Inflation Reduction Act.
The 8 drugs with generic availability are usually the most cost-effective starting point — ask your prescriber whether a generic substitution is clinically appropriate.
Drug costs vary dramatically within this category. Soliris (Eculizumab) at $68,556.00 per claim is 4x more expensive than Empaveli (Pegcetacoplan (PNH)) at $19,500.00 — yet both treat blood disorders. Therapeutic substitution within the same drug class is often the single biggest savings lever, and it requires only a prescriber conversation, not a plan change.
Frequently Asked Questions
Medicare Part D pays an average of $37,231.50 per claim for blood disorders medications across 8 tracked drugs. Patient out-of-pocket costs depend on your plan's formulary tier, deductible, and whether you've reached the catastrophic coverage phase. Most blood disorders drugs fall on Tier 2 (preferred brand) or Tier 3 (non-preferred brand) of standard Medicare Part D formularies.
The least expensive blood disorders medication is Empaveli (Pegcetacoplan (PNH)) at $19,500.00 per Medicare Part D claim. A generic version is FDA-approved and available — ask your pharmacist about substitution to lower copays further.
Yes. All 8 blood disorders drugs tracked here appear in Medicare Part D claims data, meaning they are dispensed under Part D plans. Coverage details — formulary tier, prior authorization requirements, step therapy — vary by plan. Check your plan's formulary or call 1-800-MEDICARE before filling.
Yes, 8 of 8 blood disorders drugs have FDA-approved generic alternatives. Generics contain the same active ingredient and meet bioequivalence standards, but typically cost 30-80% less. On Medicare Part D, generics usually fall on Tier 1 with the lowest copay.
Three primary strategies: (1) Switch to a generic if available — Tier 1 generics typically cost under $10 per fill on Medicare Part D; (2) Use manufacturer copay assistance for brand-name drugs (commercial insurance only — Medicare beneficiaries can apply for patient assistance foundations like NeedyMeds or the PAN Foundation); (3) Compare cash prices using GoodRx, SingleCare, or Mark Cuban's Cost Plus Drugs — sometimes cash pay beats your Part D copay. Talk to your doctor about therapeutic alternatives in the same drug class.
Related Conditions
Cost per claim is the average plan-paid amount per prescription fill under Medicare Part D. Patient out-of-pocket varies by formulary tier and deductible status. Generic availability is based on FDA Orange Book data.
Source: CMS Medicare Part D Spending, 2026.