Abiraterone acetate

Medicare

Part D (self-administered)

Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026). Generic abiraterone (since 2018) is inexpensive; the Yonsa formulation and brand Zytiga cost far more.

Commercial insurance

covered on label

Multi-source generic on low-cost tiers; usually no prior authorisation. Cash prices without insurance are modest. Many plans require generic abiraterone before enzalutamide or other novel hormonal agents.

Assistance programmes

• PAN Foundation — Disease-specific co-pay and premium funds; open and closed funds change monthly.
• HealthWell Foundation
• CancerCare Co-Payment Assistance Foundation
• Patient Advocate Foundation Co-Pay Relief

Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.

Appraised for

Metastatic castration-resistant prostate cancer after docetaxel

Notes

Before chemotherapy: TA387 (2016). Newly diagnosed high-risk hormone-sensitive disease (STAMPEDE/LATITUDE) was not recommended in TA721 (2021), but abiraterone went generic in 2022 and NHS England commissioned it for mHSPC via national policy.

NHS England

Routinely funded for the appraised indication (or via managed access)

Sources: NICE TA259 · SMC advice: abiraterone. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.