Be confident in coverage for BENLYSTA

See how the formulary coverage for BENLYSTA compares to another FDA-approved biologic for lupus.

BENLYSTA coverage in local plans

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See how BENLYSTA coverage compares with other therapies in the area

Plans BENLYSTA IV Saphnelo

* “Unknown” means the product is not listed on the plan’s formulary and coverage cannot be determined. An exception process may be available for coverage determination.

 

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Source: Managed Markets Insight & Technology, LLC (MMIT) database as of .

What you need to know about this formulary information:
Formulary status may vary and is subject to change. Formulary comparisons do not imply comparable indications, safety, or efficacy. This is not a guarantee of partial or full coverage or payment. Consumers may be responsible for varying out-of-pocket costs based on an individual’s plan and its benefit design. Each plan administrator determines actual benefits and out-of-pocket costs per its plan’s policies. Verify coverage with plan sponsor or Centers for Medicare & Medicaid Services. Medicare Part D patients may obtain coverage for products not otherwise covered via the medical necessity process. GSK does not endorse individual plans.

UnitedHealthcare-specific statements
Nothing herein may be construed as an endorsement, approval, recommendation, representation, or warranty of any kind by any plan or insurer referenced herein. This communication is solely the responsibility of GSK. Communication only to Providers — not approved for Prescription Drug Plan member distribution.

PA = prior authorization.

More than 94% of patients with lupus and lupus nephritis nationwide have coverage for BENLYSTA Autoinjector and IV*

Source: Managed Markets Insights & Technology (MMIT) database as of January 2024.

 

* Covered under a patient's medical benefit or pharmacy benefit. Covered means any potential for reimbursement from a health plan and may include step edits, prior authorizations, and other restrictions based on an analysis of formal coverage policies. Patients reflects the number of lives within a plan, as determined by MMIT. Formulary status may vary and is subject to change. Formulary coverage does not imply clinical efficacy or safety. Verify coverage with the plan sponsor.

Pay As Little As $0

† The maximum amount available per year from the copay program for most patients is $9,450. Patients in health plans that do not allow the amounts available from the copay program to count towards their copay, coinsurance, deductible, or other out-of-pocket cost sharing obligations, sometimes referred to as “maximizer plans,” are subject to a yearly program maximum of $5,000. Visit  www.gskcopayprograms.com for complete information about Program Eligibility, Terms and Conditions.

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BENLYSTA Cares

Support for your patients at every step of their treatment journey.

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How to start a patient on BENLYSTA

BENLYSTA Gateway can help you and your patients access BENLYSTA.

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BENLYSTA could help with financial support*

BENLYSTA could help with financial support*

* The BENLYSTA Copay Program helps eligible commercially insured patients with their eligible out-of-pocket costs for BENLYSTA. Eligibility for the BENLYSTA Copay Program must be determined by the GSK Copay Program. Eligibility restrictions and program maximums apply. Visit www.gskcopayprograms.com for complete Program Terms and Conditions.