Understanding Erdafitinib (Balversa)
Erdafitinib, sold under the brand name Balversa, is a prescription medication used to treat adults with locally advanced or metastatic urothelial carcinoma (bladder cancer) [1.5.1]. It is specifically indicated for patients whose cancer has a certain type of abnormal fibroblast growth factor receptor (FGFR) gene and has progressed after at least one other systemic therapy [1.5.1, 1.4.1]. Erdafitinib belongs to a class of drugs known as kinase inhibitors [1.5.2]. It functions by blocking the action of abnormal FGFR proteins that signal cancer cells to multiply, thereby helping to slow or stop the spread of the cancer [1.5.2, 1.6.2]. The FDA granted full approval for Erdafitinib based on its proven efficacy in clinical trials, where it significantly improved overall survival compared to chemotherapy [1.10.2, 1.8.4].
The High Cost of Targeted Therapy: What is the price of Erdafitinib 4mg?
The price of specialized cancer medications like Erdafitinib can be substantial. The cash price for a supply of 56 tablets of Balversa 4mg can be approximately $28,222.92 [1.2.1, 1.3.5]. This price can fluctuate based on the pharmacy, location, and any available discount coupons [1.2.1]. For a 28-day supply, prices have been noted around $13,843.65 [1.3.2]. It is important to note that these figures represent the retail or cash price without insurance. The actual out-of-pocket cost for a patient is typically lower and depends heavily on their prescription drug coverage.
Factors Influencing the Cost of Erdafitinib
Several variables can affect how much a patient pays for Erdafitinib:
- Insurance Coverage: The most significant factor is the patient's health insurance plan. Coverage varies widely between private insurance, Medicare, and Medicaid. Medicare Part D plans may have different stages of coverage (deductible, initial coverage, coverage gap) that impact co-pays, which can range from over $500 to as low as $7 in the catastrophic coverage stage [1.3.3].
- Dosage and Administration: Erdafitinib treatment often starts with an 8 mg dose (two 4 mg tablets) once daily [1.8.2]. This dose may be increased to 9 mg daily after 14 to 21 days based on the patient's phosphate levels and tolerability [1.8.2]. Dosage adjustments due to side effects are common, which can alter the quantity of medication needed over time [1.7.3].
- Pharmacy and Discounts: Prices can differ between retail pharmacies, specialty pharmacies, and international sources [1.3.1, 1.2.4]. Programs like GoodRx can offer coupons that reduce the retail price [1.2.1].
Managing the Cost: Patient Assistance and Savings Programs
Given the high cost, several programs are available to help eligible patients afford Balversa.
J&J withMe (formerly Janssen CarePath): The manufacturer, Johnson & Johnson, offers a comprehensive support program. The J&J withMe Savings Program may allow commercially insured patients to pay as little as $5 per fill, subject to an annual maximum benefit [1.4.3].
Johnson & Johnson Patient Assistance Program: For patients who are uninsured or have inadequate coverage (including government-funded programs), this program may provide Balversa at no cost for up to one year, provided they meet specific income and eligibility requirements [1.4.1, 1.4.3].
Independent Foundations: Organizations like the PAN Foundation and CancerCare Co-Pay Foundation may offer grants to help with out-of-pocket costs for bladder cancer treatment [1.4.4, 1.4.5]. These foundations have their own eligibility criteria and funding availability [1.4.1].
Clinical Efficacy and Treatment Alternatives
Clinical trials have established Erdafitinib's effectiveness. The THOR trial, for instance, showed that the median overall survival for patients on Erdafitinib was 12.1 months, compared to 7.8 months for those on chemotherapy [1.5.3, 1.10.2]. The objective response rate was also significantly higher at 46% for Erdafitinib versus 12% for chemotherapy [1.10.2].
| Treatment Option | Mechanism of Action | Typical Use Setting | Key Efficacy Data (Objective Response Rate) |
|---|---|---|---|
| Erdafitinib (Balversa) | Pan-FGFR Kinase Inhibitor [1.6.2] | After platinum-based chemotherapy in FGFR-altered UC [1.5.1] | 40% - 46% [1.10.3, 1.10.2] |
| Pembrolizumab (Keytruda) | PD-1 Immune Checkpoint Inhibitor [1.9.1] | BCG-unresponsive or post-platinum therapy [1.9.1, 1.9.3] | ~41% (CIS patients) [1.9.1] |
| Enfortumab vedotin (Padcev) | Nectin-4 Directed Antibody-Drug Conjugate [1.9.5] | Post-platinum and post-PD-1/L1 inhibitor therapy [1.9.3] | Data varies based on trial and combination. |
| Chemotherapy (Docetaxel) | Mitotic Inhibitor | Second-line therapy after platinum failure [1.9.3] | ~12% [1.10.2] |
Other targeted FGFR inhibitors like Infigratinib and Pemigatinib have also been studied for urothelial cancer, showing varying response rates [1.9.2]. Immunotherapies such as Pembrolizumab and antibody-drug conjugates like Enfortumab vedotin are also key components of the treatment landscape for advanced bladder cancer [1.9.1, 1.9.5].
Common Side Effects
Patients taking Erdafitinib should be aware of potential side effects. The most common adverse reactions include high phosphate levels (hyperphosphatemia), mouth sores (stomatitis), fatigue, diarrhea, dry mouth, nail disorders, and changes in kidney function [1.7.3, 1.7.4]. Eye problems, such as dry eyes and central serous retinopathy, are also common and require monitoring by an eye specialist [1.7.4, 1.8.3].
Conclusion
The question 'What is the price of Erdafitinib 4mg?' reveals a complex landscape where the list price is high, but the final cost to the patient is highly variable. While the retail cost can exceed $28,000 for a 56-tablet supply, a combination of insurance coverage and robust patient assistance programs from the manufacturer and independent foundations can significantly reduce this financial burden [1.2.1, 1.4.1, 1.4.3]. Erdafitinib represents a vital, effective targeted therapy for a specific subset of bladder cancer patients, and exploring all available financial support avenues is a crucial part of the treatment journey.
For more information on patient support, you can visit the manufacturer's official website: https://www.balversa.com/support-resources/cost-support [1.4.1]
