For patients requiring the breast and prostate cancer medication Talzenna (talazoparib), understanding the cost in the US is a crucial first step toward treatment. As a brand-name, specialty oncology drug, its list price is exceedingly high, but the final out-of-pocket cost is heavily influenced by a patient's insurance status and access to financial assistance programs.
Uninsured Cash Price: A Significant Financial Burden
Without insurance, the cash price for a 30-day supply of Talzenna 1mg is one of the highest expenses a patient might face. PharmacyChecker data from late 2024 listed a monthly discount price starting around $18,132.24 for 30 capsules of 1mg. However, prices vary significantly by pharmacy and location. Other drug pricing websites have shown different ranges, sometimes suggesting prices around $6,175 for 30 capsules, reflecting the high variability of specialty drug pricing.
This high retail price is why most patients do not pay the full amount out-of-pocket. Instead, they rely on various programs and insurance coverage to reduce or eliminate the cost. For an uninsured individual, a direct conversation with the prescribing oncologist and pharmacy benefits manager is essential to explore every available avenue for financial assistance.
The Role of Insurance: Tiers and Out-of-Pocket Costs
For many patients, health insurance is the primary method of managing the cost of Talzenna. However, coverage varies significantly by plan.
Commercial Insurance
For those with private, employer-sponsored, or state marketplace insurance, the cost of Talzenna depends on the plan's formulary and tier placement. Because it is a specialty drug, it is almost always on the highest tier, which requires the highest co-payment or co-insurance. As of late 2024, the manufacturer, Pfizer, noted that Talzenna was covered for approximately 79% of commercially insured patients.
Medicare and Government Programs
For patients on Medicare, Talzenna is typically placed on Tier 5, the most expensive tier. Out-of-pocket costs will depend on which coverage stage the patient is in. For example, a patient in the Catastrophic Coverage stage might only pay a small amount, while someone in the Deductible or Coverage Gap (Donut Hole) stage could pay hundreds or thousands of dollars monthly. The good news is that as of late 2024, approximately 98% of Medicare patients were covered for Talzenna.
Financial Assistance and Savings Programs
Recognizing the financial strain, manufacturers and independent foundations offer robust programs to help patients afford their medication.
Manufacturer Patient Programs: Pfizer Oncology Together
As the drug's manufacturer, Pfizer offers comprehensive support through its Pfizer Oncology Together program. This program includes:
- Co-Pay Savings Card: Eligible commercially insured patients can receive a co-pay card that may reduce their monthly cost to as little as $0, with an annual cap of up to $10,000 in savings per product. Patients on government insurance like Medicare or Medicaid are not eligible for this co-pay card.
- Patient Assistance Program (PAP): Uninsured patients and those on government insurance who meet specific income requirements can receive Talzenna for free through the Pfizer Patient Assistance Program.
Non-Profit Foundation Support
Several independent charitable foundations specialize in helping patients with high-cost medications. These include:
- Patient Access Network (PAN) Foundation: Offers co-pay assistance for eligible Medicare patients and others who have unaffordable deductibles or co-pays.
- HealthWell Foundation: Provides financial assistance for patients who are underinsured and have high out-of-pocket costs.
- Patient Advocate Foundation: The Co-Pay Relief Program helps insured patients with co-pays, co-insurance, and deductibles.
Pharmacy Discount Cards and Comparison Tools
Websites like GoodRx and PharmacyChecker allow patients to compare coupon prices across different pharmacies. While these tools can offer significant savings on many medications, the discount for a specialty drug like Talzenna still leaves a substantial cash price. These services can, however, be useful for uninsured patients seeking the lowest possible retail cost.
Comparison of Potential Costs
To illustrate the wide range of potential out-of-pocket expenses, here is a comparison table for a 30-day supply of Talzenna 1mg in the US, based on different scenarios.
| Scenario | Estimated Out-of-Pocket Cost (Per Month) | Considerations |
|---|---|---|
| Uninsured (Cash Price) | \$18,000+ | Highly variable by pharmacy; requires use of PAP for affordability. |
| Commercially Insured (without assistance) | Varies greatly | Dependent on plan's deductible, co-insurance, and out-of-pocket maximum. |
| Commercially Insured (with Pfizer co-pay card) | \$0 (or minimal co-pay) | Requires enrollment; up to \$10,000 annual limit. |
| Medicare Insured (Deductible/Donut Hole) | \$239–\$635+ | Dependent on coverage stage; may require additional foundation support. |
| Medicare Insured (with Low-Income Subsidy) | \$11.20 | As of Nov 2024, for full LIS. |
| Uninsured (with Pfizer PAP) | \$0 | Requires meeting income eligibility criteria. |
Conclusion
In summary, the cost of Talzenna 1mg in the US varies dramatically. The cash price for uninsured patients is prohibitively high, but robust financial assistance options are available. The final out-of-pocket cost for an individual depends on their insurance status and proactive enrollment in manufacturer or foundation programs. The key takeaway is to never accept the full cash price as the only option. Patients should work closely with their healthcare provider and pharmacy to navigate the complex landscape of specialty drug costs and access available financial support through programs like Pfizer Oncology Together.
For more information on the manufacturer's support programs, visit the official Talzenna support website.
