Why Krystexxa Costs $5,302.00 Per Claim
Krystexxa (Pegloticase) is used to treat gout. According to CMS Medicare Part D spending data, the program spent $456.0M on this drug, covering 9,600 beneficiaries across 86,000 claims.
A generic version of this drug is available, which means lower-cost alternatives exist. Patients should ask their pharmacist about generic Pegloticase or talk to their doctor about therapeutic alternatives that may cost less.
Spending on Krystexxa increased by +32.4% year-over-year, driven by increased utilization among Medicare beneficiaries.
Price Breakdown
Drug Details
Frequently Asked Questions
Krystexxa (Pegloticase) costs an average of $5,302.00 per claim based on Medicare Part D data. The estimated annual cost per patient is $47,500.00. Actual out-of-pocket costs depend on your insurance plan and pharmacy.
Krystexxa averages $5,302.00 per Medicare Part D claim — roughly equivalent to a 30-day supply for most patients on standard dosing. Without insurance, expect higher cash-pay prices unless you use a discount program (GoodRx, SingleCare, manufacturer copay assistance). With Medicare or commercial insurance, your out-of-pocket cost depends on your plan's formulary tier and deductible status.
A typical 30-day supply of Krystexxa reflects in our Medicare Part D average of $5,302.00 per claim. Switching to generic Pegloticase typically reduces cost by 80-95%. Cash-pay prices vary by pharmacy — comparison shopping (or using GoodRx coupons) often saves 20-50% off the listed price.
Most commercial insurance plans and Medicare Part D plans cover Krystexxa, but coverage varies by formulary tier. Insurers typically prefer generic Pegloticase (Tier 1, lowest copay) over brand-name Krystexxa (Tier 2-3, higher copay). Some plans require prior authorization or step therapy. Check your plan's formulary or call the number on your insurance card to confirm.
Several options for cash-pay patients: (1) Manufacturer patient assistance programs — the manufacturer may offer copay cards or free-drug programs for income-qualified patients; (2) Discount programs like GoodRx, SingleCare, or RxSaver typically save 20-80% off the cash price; (3) Mark Cuban's Cost Plus Drugs offers transparent generic pricing if a generic is available; (4) 340B-eligible community health centers offer drugs at federally negotiated discounts. Switching to generic Pegloticase is the single biggest cost reducer if your prescriber is open to it.
Brand-name Krystexxa costs more than generic Pegloticase primarily for marketing reasons — patients can request the brand from their doctor even when a chemically identical generic exists. The active ingredient and clinical effect are the same.
Yes, a generic version of Krystexxa (Pegloticase) is available. Generic medications typically cost 80-95% less than brand-name drugs. Ask your pharmacist about generic Pegloticase.
Medicare Part D spent $456.0M on Krystexxa, covering 9,600 beneficiaries across 86,000 claims. This makes it one of the tracked drugs in the Medicare spending dashboard.
Ask your pharmacist about generic Pegloticase, which is typically much cheaper. You can also compare prices at different pharmacies, use prescription discount programs (GoodRx, SingleCare, Cost Plus Drugs), or ask your doctor about therapeutic alternatives in the same drug class.
this entity is one of the data points covered by this site’s U.S. Medicare prescription-drug pricing dataset. The detail above comes directly from CMS Medicare Part D Drug Spending data; the context that follows situates the headline numbers against the broader distribution across U.S. prescription drugs.
Every number on this page links back to CMS Medicare Part D Drug Spending data; the methodology page describes the inputs, refresh cadence, and known limitations of the underlying data product.
Practical use of this page is in combination with the comparison and ranking pages elsewhere on the site, which surface the same data for this entity’s peers within U.S. prescription drugs. A single-entity reading without peer context can be misleading when an entity is an outlier on one axis but typical on another.
Related
Cost data reflects Medicare Part D spending and may not represent retail pharmacy prices. Average cost per claim represents the total drug cost (not patient out-of-pocket) divided by total claims.