A full course of Tepezza typically costs between $300,000 and $450,000 before insurance. A single vial carries a wholesale acquisition cost of nearly $15,000, and the standard treatment requires eight infusions spread over about five months. The total varies based on your body weight, where you receive the infusions, and what your insurance plan covers.
What a Full Course of Tepezza Costs
Tepezza is the only FDA-approved medication for thyroid eye disease, a condition where inflammation causes the tissues and muscles behind your eyes to swell, pushing your eyes forward and sometimes affecting your vision. The treatment is given as an IV infusion every three weeks for a total of eight sessions. Your first infusion uses a lower dose (based on body weight), and the remaining seven use a higher dose, roughly double the initial amount.
Because dosing is weight-based, a heavier patient needs more vials per infusion, which drives the total cost up. A study published through ARVO Journals found the mean treatment-related cost for a full Tepezza course was $386,424. That figure includes the drug itself plus associated medical costs, and individual totals ranged widely, with a standard deviation of about $65,000 in either direction. So some patients’ courses land closer to $320,000 while others exceed $450,000.
Costs Beyond the Drug Itself
The price tag for Tepezza doesn’t include everything you’ll be billed for. Each infusion session comes with facility fees and administration charges that are billed separately. These cover the infusion center’s overhead, nursing time, IV supplies, and monitoring during and after your treatment. Facility fees for biologic infusions commonly range from a few hundred dollars to $1,000 per session, depending on whether you’re treated at a hospital outpatient center (more expensive) or a freestanding infusion clinic. Over eight sessions, these charges add several thousand dollars to your total.
You may also have costs related to lab work, imaging, or ophthalmology visits before and during treatment. If your infusion center is far from home, travel and time off work are real expenses that don’t show up on any bill.
How Insurance Typically Handles Tepezza
Most commercial insurance plans and Medicare Part B cover Tepezza, but coverage almost always requires prior authorization. Your doctor’s office will need to submit documentation confirming your diagnosis of thyroid eye disease. The FDA approved Tepezza for thyroid eye disease regardless of disease activity or duration, which means insurers can no longer require a specific clinical activity score before authorizing treatment, though some plans have been slow to update their criteria.
Even with approval, your out-of-pocket share depends on your plan’s structure. If Tepezza is processed under your medical benefit (as most infused drugs are), you’ll typically owe a percentage as coinsurance rather than a flat copay. At 20% coinsurance on a $386,000 treatment, that’s still roughly $77,000 out of pocket before any cap kicks in. Most plans have an annual out-of-pocket maximum that limits your exposure, but because treatment spans multiple calendar months, you could hit that maximum in two separate plan years.
Amgen, the company that now sells Tepezza after acquiring Horizon Therapeutics, offers a copay assistance program for commercially insured patients. Eligibility requirements and annual caps on assistance vary, so it’s worth contacting the manufacturer directly to see what help is available for your situation. Patients on government insurance (Medicare, Medicaid, Tricare) are not eligible for manufacturer copay cards but may qualify for independent charitable foundations that help cover specialty drug costs.
Why the Price Keeps Climbing
Tepezza launched in 2020 as the first and still only drug approved for thyroid eye disease, which gives it no direct competition to pressure pricing downward. Amgen’s 2025 financial results show that full-year Tepezza revenue increased 3%, driven primarily by higher net selling prices rather than more patients receiving the drug. In the fourth quarter of 2025, volume growth of 11% was partially offset by pricing dynamics, but the overall trend has been upward on price. With no biosimilar on the horizon and no competing medication in late-stage development for this indication, there’s little market pressure to reduce costs.
How Tepezza Compares to Surgical Options
Before Tepezza existed, the standard approach for moderate-to-severe thyroid eye disease was to wait for the active inflammation phase to burn out (often 1 to 3 years), then address the damage surgically. Orbital decompression surgery removes bone and fat from behind the eye to reduce bulging, and strabismus surgery corrects misaligned eyes. Some patients need multiple procedures staged over months or years.
Surgery costs significantly less upfront than Tepezza. A single orbital decompression typically runs in the tens of thousands of dollars rather than hundreds of thousands. But the comparison isn’t straightforward. Surgery corrects structural damage after it’s happened, while Tepezza works during the active disease phase to reduce inflammation and prevent some of that damage from occurring in the first place. Some patients who complete Tepezza still need surgery afterward, which means they end up paying for both. Long-term data on whether Tepezza reliably reduces the need for later surgery is still limited, making it hard to calculate a true cost comparison over the full course of the disease.
Practical Steps to Manage the Cost
If you’re facing a Tepezza prescription, start by confirming your insurance plan’s specific requirements for prior authorization. Ask your doctor’s office to handle this process, as they’re typically experienced with it. Request a predetermination of benefits from your insurer so you know your expected coinsurance and whether your out-of-pocket maximum will apply.
Choose your infusion site carefully. Hospital outpatient infusion centers often charge two to three times more in facility fees than independent infusion clinics for the same drug and the same nursing care. Ask your doctor if a freestanding clinic is an option, and verify it’s in-network before scheduling.
If your out-of-pocket costs are still unmanageable after insurance, contact Amgen’s patient support line for copay assistance (for commercial insurance) or ask a social worker at your treatment center about independent foundations that provide grants for specialty medication costs. Some patients also time their treatment start to maximize a single plan year’s out-of-pocket maximum, avoiding the reset that comes with crossing into a new calendar year.