Tafasitamab

Medicare

Part B (clinician-administered)

Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies.

Commercial insurance

covered with prior authorisation

Covered under the medical benefit with prior authorisation confirming diagnosis, biomarker status and line of therapy; site-of-care policies may steer infusions away from hospital outpatient departments.

Assistance programmes

• IncyteCARES
• PAN Foundation: Disease-specific co-pay and premium funds; open and closed funds change monthly.
• HealthWell Foundation
• CancerCare Co-Payment Assistance Foundation
• Patient Advocate Foundation Co-Pay Relief
• Leukemia & Lymphoma Society financial support

20% Part B coinsurance on a high-cost infusion adds up quickly: Medigap Plan G or N, Medicare Advantage maximum out-of-pocket, Medicaid dual eligibility, or a charity fund are the usual buffers.

Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.

Appraised for

With lenalidomide for relapsed or refractory DLBCL in people who cannot have an autologous stem cell transplant

Notes

Published 3 May 2023: not recommended within its marketing authorisation; the evidence came from a small study with no direct comparison against polatuzumab vedotin with bendamustine-rituximab. MHRA-licensed (Minjuvi, PLGB 42338/0016). Appraisals in follicular lymphoma with lenalidomide-rituximab (ID6413) and untreated DLBCL with R-CHOP (ID6568) are in development.

Sources: NICE TA883. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.