Procrit® Medicare Coverage

Procrit is a prescription medication that contains the active ingredient epoetin alfa. It is typically administered either intravenously or subcutaneously once to three times per week.

Procrit helps the body make red blood cells to treat anemia and reduces the need for red blood cell transfusions during surgery.

The major side effects of Procrit include irritation where the shot is given, fever, headache, upset stomach, coughing and bone and joint pain.

How much does Procrit cost with Medicare?

Procrit coverage and costs may vary based on the specific plan you have, as well as what coverage stage you're in.

Contact your plan carrier or consult your plan formulary for more cost information.

Does Medicare cover Procrit?

According to GoodRx, 64% of Medicare Advantage plans and Medicare Part D plans covered Procrit in 2023.¹

• Medicare Advantage plans or Part D plans that cover Procrit include copay amounts that can range widely from one plan to another. Plan members may also be responsible for meeting a deductible before the plan’s drug coverage kicks in.
  
  
• Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). 89% of 2023 Medicare Advantage plans included prescription drug coverage.²
  
  
• Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Procrit. We represent carriers such as Humana, UnitedHealthcare^®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

You can also compare Part D prescription drug plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Additional information

Procrit is administered either subcutaneously (into the fatty part of the skin) or intravenously (into a vein). Procrit should only be administered if the patient’s hemoglobin is less than 10g/dL.

Procrit can increase the risk of serious cardiovascular events, MI, stroke, blood clots and death when inappropriately administered to patients with hemoglobin levels above 11g/dL. These risks are also high in patients with cancer and/or chronic kidney disease.

Patients with high blood pressure should use caution when using Procrit, as it can make blood pressure rise. The lowest dose of Procrit possible should be used to avoid the above risks.

Procrit is available as a single and multi-dose vial.

Patients who are pregnant or breastfeeding may safely use single-dose vials of Procrit that are free of benzoyl alcohol. Benzoyl alcohol is present in multi-dose vials and may cause negative – and sometimes deadly – side effects in newborns and infants.

Procrit is indicated for patients with HIV who experience anemia due to the medication Zidovudine.

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

Written by Hayden Gharibyar, Pharm.D.