What Is Skyrizi and How It Works

Skyrizi is a prescription medication manufactured by AbbVie that contains the active ingredient risankizumab-rzaa. It belongs to a class of medications called interleukin-23 (IL-23) inhibitors. This biologic treatment works by targeting a specific protein in your immune system that causes inflammation associated with psoriasis and psoriatic arthritis.

The medication is administered as an injection, typically given as two 75 mg injections (150 mg total) initially, followed by the same dosage 4 weeks later, and then every 12 weeks thereafter. This relatively infrequent dosing schedule (maintenance injections only 4 times per year) is one factor patients consider when evaluating treatment options, but the cost often becomes a primary consideration.

List Price vs. Actual Patient Cost

The list price (wholesale acquisition cost) of Skyrizi is approximately $18,000-$20,000 per dose, which translates to about $65,000-$80,000 annually during maintenance therapy. However, it's important to understand that very few patients pay this full amount out-of-pocket.

What patients actually pay depends on several factors:

  • Insurance coverage - Commercial insurance, Medicare, or Medicaid coverage can significantly reduce out-of-pocket expenses
  • Copay structure - Some insurance plans require a fixed copay while others charge a percentage of the medication cost
  • Deductibles - High-deductible health plans may require patients to pay more initially until deductibles are met
  • Prior authorization - Most insurance providers require documentation that other treatments have been tried first

Without insurance, the full list price would apply, making the medication prohibitively expensive for most patients. However, there are several programs available to help reduce this financial burden.

Patient Assistance Programs and Savings Options

AbbVie, the manufacturer of Skyrizi, offers a comprehensive patient support program called Skyrizi Complete. This program includes a savings card that can reduce out-of-pocket costs to as little as $5 per dose for eligible commercially insured patients.

For patients who qualify based on financial need and lack of adequate insurance coverage, AbbVie also offers a patient assistance program that may provide Skyrizi at no cost. Additionally, there are independent foundations and nonprofit organizations that provide assistance for biologic medications like Skyrizi:

Specialty pharmacies that dispense Skyrizi may also have financial counselors who can help navigate these assistance options and identify the most cost-effective approach for individual patients.

Insurance Coverage Comparison for Skyrizi

Insurance coverage for Skyrizi varies widely across different providers and plan types. Here's how coverage typically breaks down across major insurance types:

  • Commercial Insurance - Often covers 70-80% of costs after prior authorization, with manufacturer copay assistance available
  • Medicare Part D - Coverage varies by plan, with patients potentially facing higher costs during the coverage gap ("donut hole")
  • Medicare Advantage - May offer more comprehensive coverage than standard Medicare Part D plans
  • Medicaid - Coverage policies vary by state, but typically covers approved biologics with prior authorization

When comparing insurance options for Skyrizi coverage, patients should consider not just the premium costs but also the specific tier placement of Skyrizi within the plan's formulary, prior authorization requirements, step therapy protocols, and out-of-pocket maximums.

Many insurance providers require patients to try and fail on less expensive treatments before approving coverage for biologics like Skyrizi. This process, called step therapy, can delay access to the medication but is often necessary to secure coverage.

Comparing Skyrizi Costs to Alternative Treatments

When evaluating the cost of Skyrizi, it's helpful to compare it with other biologic treatments for psoriasis and psoriatic arthritis:

  • Janssen's Tremfya - Similarly priced to Skyrizi, with comparable dosing frequency
  • Novartis's Cosentyx - Typically costs $70,000-$85,000 annually, with more frequent initial dosing
  • Amgen's Otezla - Oral medication with lower annual cost ($30,000-$45,000) but different mechanism of action
  • Eli Lilly's Taltz - Annual cost similar to Skyrizi, with monthly injections initially

While the list prices of these biologics are similar, the actual patient cost can vary significantly based on individual insurance coverage and available manufacturer assistance programs. Some patients may find that an alternative treatment has better coverage under their specific insurance plan.

It's also worth noting that the effectiveness and side effect profiles differ among these medications. The most expensive option isn't necessarily the most effective for every patient. Working with healthcare providers to find the right balance between cost, convenience, and efficacy is essential.

Conclusion

The cost of Skyrizi presents a significant consideration for patients with psoriasis or psoriatic arthritis. While the list price exceeds $65,000 annually, most patients pay substantially less through insurance coverage and assistance programs. For commercially insured patients, out-of-pocket costs can be as low as $5 per dose through the AbbVie savings program.

When evaluating Skyrizi as a treatment option, patients should work closely with their healthcare providers, insurance companies, and the Skyrizi Complete program to understand their specific costs. The investment in effective treatment must be balanced against financial considerations, but with proper planning and utilization of available resources, this effective biologic treatment can be financially accessible for many patients who need it.

Citations

This content was written by AI and reviewed by a human for quality and compliance.