How much should I expect to pay for Cyramza®?

Prescription drug prices can be confusing. Two people may pay different prices for the same drug, depending on their insurance situation.

For metastatic non-small cell lung cancer:
The list price1 of Cyramza is $10,780 per month, but the amount you pay will largely depend on your insurance plan.

For advanced or metastatic gastric or gastroesophageal junction cancer, metastatic colorectal cancer, and AFP-High liver cancer (HCC):
The list price1 of Cyramza is $13,860 per month, but the amount you pay will largely depend on your insurance plan.

The information below will give you a good idea of what to expect based on your insurance situation and support that may be available to you.

For the most accurate information, talk to your insurance provider who knows the details of your plan.

Which Option Below Best Describes Your Insurance Situation?

For metastatic non-small cell lung cancer:
About 98% of patients pay $0 per dose of Cyramza, with the remaining paying an average of $651 per dose.2

For advanced or metastatic gastric or gastroesophageal junction cancer, metastatic colorectal cancer, and AFP-High liver cancer (HCC):
About 95% of patients pay $0 per dose of Cyramza, with the remaining paying an average of $2,112 per dose.2

What you pay for Cyramza will depend on your insurance plan. Each plan has different preferred drug lists and out-of-pocket amounts, and most include an annual deductible. If you haven’t met your deductible, you’ll see higher prices and could pay list price until you meet your deductible.

Lilly PatientOne strives to offer reliable and individualized treatment support for eligible patients prescribed a Lilly Oncology medicine whether they are insured, underinsured, or simply uninsured. With the PatientOne Co-Pay Program, your co-pay may be as little as $25.

For more information about Lilly PatientOne, call 1-866-4PatOne (1-866-472-8663), Monday-Friday, 9AM-7PM ET, or visit LillyPatientOne.com

What you pay for Cyramza will depend on what type of Medicare coverage you have. Out-of-pocket costs can vary throughout the year depending on which phase of the Medicare benefit you are currently in.

For metastatic non-small cell lung cancer:
For most patients with Medicare Part B coverage, that do not have supplemental (Medigap) insurance, about 23% of patients pay $0 per dose of Cyramza, with the remaining paying an average of $1,484 per dose.2

For advanced or metastatic gastric or gastroesophageal junction cancer and metastatic colorectal cancer:
For most patients with Medicare Part B coverage, that do not have supplemental (Medigap) insurance, about 22% of patients pay $0 per dose of Cyramza, with the remaining paying an average of $1,284 per dose.2

For more information on Medicare Supplemental Insurance visit:
https://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap

Lilly PatientOne strives to offer reliable and individualized treatment support for eligible patients prescribed a Lilly Oncology medicine whether they are insured, underinsured, or simply uninsured.

For more information about Lilly PatientOne, call 1-866-4PatOne (1-866-472-8663), Monday-Friday, 9AM-7PM ET, or visit LillyPatientOne.com.

For most patients with Medicare Part B plus Supplemental Insurance (Medigap) coverage, out-of-pocket costs can vary throughout the year depending on which phase of the Part B benefit you are currently in.

For metastatic non-small cell lung cancer:
About 99% of patients pay $0 per dose of Cyramza, with the remaining paying an average of $8 per dose.2

For advanced or metastatic gastric or gastroesophageal junction cancer and metastatic colorectal cancer:
About 99% of patients pay $0 per dose of Cyramza, with the remaining paying an average of $1,278 per dose.2

For more information on Medicare Supplemental Insurance visit:
https://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap

Lilly PatientOne strives to offer reliable and individualized treatment support for eligible patients prescribed a Lilly Oncology medicine whether they are insured, underinsured, or simply uninsured.

For more information about Lilly PatientOne, call 1-866-4PatOne (1-866-472-8663), Monday-Friday, 9AM-7PM ET, or visit LillyPatientOne.com.

For most patients with Medicare Advantage coverage, out-of-pocket costs can vary throughout the year depending on which phase of the Medicare Advantage benefit you are currently in.

For metastatic non-small cell lung cancer:
About 80% of patients pay $0 per dose of Cyramza, with the remaining paying an average of $1,114 per dose.2

For advanced or metastatic gastric or gastroesophageal junction cancer and metastatic colorectal cancer:
About 70% of patients pay $0 per dose of Cyramza, with the remaining paying an average of $973 per dose.2

For more information on Medicare Advantage visit:
https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-advantage-plans

Lilly PatientOne strives to offer reliable and individualized treatment support for eligible patients prescribed a Lilly Oncology medicine whether they are insured, underinsured, or simply uninsured.

For more information about Lilly PatientOne, call 1-866-4PatOne (1-866-472-8663), Monday-Friday, 9AM-7PM ET, or visit LillyPatientOne.com.

For most people on Medicaid, medications like Cyramza range from $4 to $8 per month. Some states allow even lower copays, or eliminate the copay requirement altogether3.

To find out if you qualify for Medicaid, or for more information about copayments in your state, please visit: https://www.medicaid.gov/state-overviews/index.html.

Lilly PatientOne strives to offer reliable and individualized treatment support for eligible patients prescribed a Lilly Oncology medicine whether they are insured, underinsured, or simply uninsured.

For more information about Lilly PatientOne, call 1-866-4PatOne (1-866-472-8663), Monday-Friday, 9AM-7PM ET, or visit LillyPatientOne.com.

If you do not have prescription drug coverage4, or if your insurance does not cover Cyramza, you can expect to pay the list price shown above, plus any additional charges associated with the site of care.

See below for information regarding support services that may be available to you.

Lilly PatientOne strives to offer reliable and individualized treatment support for eligible patients prescribed a Lilly Oncology medicine whether they are insured, underinsured, or simply uninsured.

For more information about Lilly PatientOne, call 1-866-4PatOne (1-866-472-8663), Monday-Friday, 9AM-7PM ET, or visit LillyPatientOne.com.

Want More Information?

Lilly PatientOne strives to offer reliable and individualized treatment support for eligible patients prescribed a Lilly Oncology medicine whether they are insured, underinsured, or simply uninsured.

For more information about Lilly PatientOne, call 1-866-4PatOne (1-866-472-8663), Monday-Friday, 9AM-7PM ET, or visit LillyPatientOne.com.

Need Another Option?

Lilly donates medicines to the Lilly Cares Foundation, a separate nonprofit organization that helps qualified people in need receive Lilly medicines at no cost. Learn more at www.lillycares.com or by calling Lilly Cares at 1-800-545-6962.

1List price, also referred to as wholesale acquisition cost or WAC, is the price at which Lilly sells its products to wholesalers and may not represent actual transactional prices patients pay at the pharmacy. WAC from AnalySource accessed on August 27, 2019. Reprinted with permission by First Databank, Inc. All rights reserved. ©2019. https://www.fdbhealth.com/policies/drug-pricing-policy/. The dosing and pricing assumptions for a monthly supply of Cyramza are based on an average-sized patient: a 61 year old female that is 5’5” and 154 lb.

2Based on information licensed from IQVIA: IQVIATM, Real-World Evidence Claims Data for the period January - December 2018 reflecting estimates of real-world activity. All rights reserved. Accessed on May 3, 2019.

3 Centers for Medicare & Medicaid Services (CMS). Medicaid and CHIP Overview for Assisters. Maximum Allowable Copayments Determined by Eligible Population’s Household Income. Updated 2018. **All out-of-pocket charges are based on the specific state’s defined payment amount for that service. Certain groups, including children, terminally ill individuals, and individuals residing in an institution are exempt from cost sharing. Refer to your state agency for details about Medicaid out-of-pocket costs. https://marketplace.cms.gov/technical-assistance-resources/fast-facts-medicaid-chip.pdf. https://www.medicaid.gov/medicaid/cost-sharing/out-of-pocket-costs/index.html. Accessed on August 27, 2019.

4 Most people have some type of health insurance coverage that includes a prescription drug benefit. According to recent data, just under 10% of the total U.S. population is uninsured. https://www.kff.org/state-category/health-coverage-uninsured/health-insurance-status/. Updated August 27, 2019.

PURPOSE AND SAFETY SUMMARY
PURPOSE AND SAFETY SUMMARY

Important Facts About CYRAMZA® (sigh-RAM-zuh). It is also known as ramucirumab.

CYRAMZA is a prescription medicine used to treat certain types of cancer. It is given by intravenous (IV) infusion. An IV infusion is when a needle is placed into your vein and a medicine is given slowly. CYRAMZA is prescribed in these ways:

  • By itself or with a chemotherapy medicine called paclitaxel to treat certain kinds of stomach cancer or cancer of the area where the stomach and esophagus (food pipe) meet that is advanced or has spread to other parts of the body. The area where the stomach and esophagus meet is often called the gastroesophageal (GE) junction. CYRAMZA is for people whose stomach cancer got worse during or after certain other types of chemotherapy.
  • With a chemotherapy medicine called docetaxel to treat non-small cell lung cancer (NSCLC) that has spread to other parts of the body and has gotten worse during or after another type of chemotherapy. People who have tumors with certain abnormal genes should not receive CYRAMZA unless they have already been treated with medicine that targets those changes and their cancer became worse during treatment.
  • With a combination of chemotherapy medicines called FOLFIRI (irinotecan, folinic acid, and fluorouracil). This is given to treat colorectal cancer (CRC) that has spread to other parts of the body and has gotten worse during or after certain other types of chemotherapy.
  • By itself to treat a type of liver cancer called hepatocellular carcinoma (HCC). CYRAMZA is for people who have levels of alpha-fetoprotein of at least 400 nanograms per milliliter (ng/mL) in their blood and have been treated with another type of chemotherapy medicine called sorafenib.

It is not known if CYRAMZA is safe and effective in children.

Warnings

CYRAMZA may cause serious side effects, including:

  • Severe bleeding, including bleeding in the stomach or bowel, has happened with CYRAMZA. This can be life threatening. If severe bleeding happens, you will have to stop receiving CYRAMZA.
  • Tears in the stomach or bowel wall may happen with CYRAMZA. This can be life threatening. If you have tears in the stomach or bowel wall, you will have to stop receiving CYRAMZA.
  • Wounds may not heal quickly or completely. If you get a wound that won’t heal during treatment, you will have to stop receiving CYRAMZA. If you are having surgery, CYRAMZA treatment should be stopped beforehand. Your doctor may put you back on CYRAMZA after your surgical wound has healed.
  • Strokes, mini-strokes, blood clots, and heart attacks have happened to people on CYRAMZA. These can be fatal. If you have one of these events, you will have to stop receiving CYRAMZA.
  • Severe high blood pressure has happened with CYRAMZA. Your doctor will take your blood pressure at least every two weeks while you are receiving CYRAMZA. Depending on your blood pressure, your doctor may adjust your treatment, or pause or permanently stop it.
  • Reactions related to infusing CYRAMZA have happened. These can be severe and life threatening. Most of these reactions happened during or after the first or second CYRAMZA infusion. In severe reactions, rapid heartbeat, low blood pressure, and severe trouble breathing may happen. Your healthcare team will give you medicine before each CYRAMZA infusion and will watch you for these side effects. If a reaction happens, CYRAMZA treatment may be infused at a slower rate or may be permanently stopped, depending on how severe the reaction is.
  • CYRAMZA may worsen certain types of liver disease.
  • A very rare but serious brain disorder has been found in research trials with CYRAMZA. The disorder is called RPLS (reversible posterior leukoencephalopathy syndrome). Signs of RPLS may include headache, seizures, and changes in your vision or thinking. These symptoms usually stop or improve within days. However, the changes in thinking can be ongoing, and RPLS can be fatal.
  • Too much protein in the urine (called proteinuria) has been found in research trials with CYRAMZA. This may be a sign of kidney damage. Your doctor will watch your urine protein levels during treatment. If you develop protein in your urine, your doctor may pause your treatment and lower your dose of CYRAMZA. If you have severe proteinuria, you will have to stop receiving CYRAMZA permanently.
  • Thyroid gland problems have been found in research trials with CYRAMZA. Your doctor will do blood tests to track how well your thyroid gland works during treatment.
  • CYRAMZA can harm your unborn baby. You should avoid getting pregnant, and use effective birth control while receiving CYRAMZA and for 3 months after your last dose.
  • CYRAMZA may harm a breastfeeding child. Do not breastfeed your child during treatment with CYRAMZA and for 2 months after your last dose.

Tell your doctor right away if you have:

  • Bleeding or symptoms of bleeding, including lightheadedness.
  • Severe diarrhea, vomiting, or severe abdominal pain.
  • A wound that doesn’t heal properly or have a surgery planned.
  • High blood pressure or symptoms of high blood pressure, including severe headache or lightheadedness or confusion, changes in your vision, or seizure.
  • Symptoms of infusion reactions, including:
    • Shaking or stiffness of the body
    • Back pain or spasms
    • Chest pain or tightness
    • Chills
    • Flushing (sudden warmth and/or reddened skin on the face, neck, or upper chest)
    • Difficulty breathing
    • Wheezing (a whistling sound in the breath caused by narrowed breathing tubes)
    • Becoming blue due to lack of oxygen
    • Tingling or numbness of the skin
  • Had liver disease or other liver problems.
Common side effects

The most common side effects of CYRAMZA when given by itself include:

  • Low blood platelet count
  • Feeling tired
  • Low albumin (protein in the blood)
  • Low sodium in the blood
  • Swelling in the arms, legs, hands, or feet
  • High blood pressure
  • Stomach pain
  • Low white blood cell count
  • Not feeling hungry
  • Too much protein in the urine
  • Feeling like you want to throw up (vomit)
  • Unusual buildup of fluid in the belly
  • Low calcium in the blood
  • Headache
  • Diarrhea
  • Nose bleeds
  • Trouble falling or staying asleep
  • Fever
  • Vomiting
  • Back Pain

The most common serious side effects of CYRAMZA when given by itself include:

  • Anemia (a decrease in red blood cells)
  • Blocked digestive tract
  • Unusual buildup of fluid in the belly
  • Pneumonia

Some people needed to have extra red blood cells put into their blood.

The most common side effects of CYRAMZA when given with certain chemotherapy medicines include:

  • Low white blood cell count
  • Diarrhea
  • Tiredness
  • Mouth sores with or without swelling in the lining of the mouth
  • Decreased appetite
  • Nose bleeds
  • Low blood platelet count
  • High blood pressure
  • Swelling in the arms, legs, hands, or feet
  • Too much protein in the urine
  • Low white blood cell count with fever
  • Swelling, redness, or pain in the palms or soles (hand-foot syndrome)
  • Increased production of tears
  • Bleeding in the digestive tract
  • Low albumin (a protein in the blood)

The most common serious side effects of CYRAMZA when given with certain chemotherapy medicines include:

  • Low white blood cell count with fever
  • Pneumonia
  • Low white blood cell count
  • Diarrhea
  • Blocked digestive tract

Some people needed treatment to increase their white blood cell counts.

These are not all the possible side effects of CYRAMZA. Tell your doctor if you have any side effects. You can report side effects at 1-800-FDA-1088 or www.fda.gov/medwatch.

Before using

Before you receive CYRAMZA, tell your doctor if you:

  • Have had or are at high risk for strokes or heart attack.
  • Have high blood pressure or have blood pressure problems.
  • Are planning to have surgery of any kind.
  • Have ever had liver problems, including cirrhosis or other diseases of the liver.
  • Are pregnant or may be pregnant: CYRAMZA can harm your unborn baby. You should avoid getting pregnant and use effective birth control during treatment with CYRAMZA and for 3 months after the last dose.
  • Are breastfeeding: Your doctor will tell you to stop breastfeeding during treatment with CYRAMZA and for 2 months after the last dose.

Also tell your doctor about all the medicines and supplements you take, whether they have been prescribed for you or you buy them without a prescription.

How to take
  • CYRAMZA is given by intravenous (IV) infusion. The infusion will last 60 minutes. If you handle the first infusion of CYRAMZA well, then your next infusions may only take 30 minutes. The schedule for receiving CYRAMZA depends on what type of cancer you are being treated for. These are typical schedules:
    • Once every 2 weeks for stomach cancer or GE junction cancer that is advanced or has spread to other parts of the body, colorectal cancer that has spread to other parts of the body, or hepatocellular carcinoma that has AFP levels of at least 400 ng/mL or higher.
    • Once every 3 weeks for non-small cell lung cancer that has spread to other parts of the body.
  • Your doctor will give you other medicines before your CYRAMZA infusion to help lower the chance of an infusion reaction.
Learn more

For more information, call 1-800-545-5979 or go to CYRAMZA.com.

This summary provides basic information about CYRAMZA. It does not include everything known about this medicine. This information does not take the place of talking with your doctor. Be sure to talk to your doctor or other healthcare provider about CYRAMZA and how it is given. Your doctor is the best person to help you decide if CYRAMZA is right for you.

CYRAMZA® is a registered trademark owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates.

RB CON BS 08AUG2019