Ocrevus (ocrelizumab) has a list price of roughly $32,600 per year for multiple sclerosis treatment. That figure reflects the manufacturer’s price for the drug itself before insurance, and your actual out-of-pocket cost will depend heavily on your coverage type, deductible, and whether you qualify for financial assistance.
List Price and Annual Drug Cost
Each vial of Ocrevus carries a list price of about $8,150. Because the standard dosing schedule requires 600 mg every six months, most patients need four vials in their first year and four vials each year after that, bringing the annual drug cost to approximately $32,600. This is the wholesale acquisition cost, essentially what a pharmacy or hospital pays before any negotiated discounts or rebates.
On top of the drug price, you’ll pay for the infusion itself. Ocrevus is given intravenously at an infusion center or hospital outpatient facility, and the facility charges a separate administration fee that can range from a few hundred to over a thousand dollars per session. Pre-medications, which typically include an intravenous steroid, an antihistamine, and acetaminophen to reduce infusion reactions, add a small amount to each visit’s bill.
How the Dosing Schedule Affects Cost
The first year of Ocrevus treatment looks slightly different from subsequent years. Your initial dose is split into two 300 mg infusions given two weeks apart. After that, you receive a single 600 mg infusion every six months. So in your first year, you’ll have three infusion visits (two for the starter dose, one for the first maintenance dose), and two visits per year going forward. Each visit means a separate facility fee and monitoring time, which factors into your total annual spending.
Infusions take between 2.5 and 3.5 hours depending on the dose, plus observation time afterward. If you’re paying copays per visit, fewer visits in subsequent years can modestly reduce your costs.
What You’ll Pay With Insurance
Ocrevus is covered under the medical benefit rather than the pharmacy benefit for most insurance plans, because it’s administered by infusion. This distinction matters for how your costs are calculated.
With Medicare Part B, the standard coinsurance is 20% of the approved amount after you meet your deductible. Without supplemental coverage, that 20% on a $32,600 drug adds up to roughly $6,500 per year, though the actual approved amount Medicare pays may differ from list price. Many Medicare beneficiaries have Medigap or Medicare Advantage plans that reduce or eliminate that coinsurance.
Commercial insurance plans vary widely. Some require a flat copay per infusion, others charge a percentage coinsurance. Most major insurers, including UnitedHealthcare, cover Ocrevus as medically necessary for relapsing forms of MS and primary progressive MS, but they require prior authorization. To get approved, you typically need a confirmed MS diagnosis, documentation that you’re not combining Ocrevus with other disease-modifying therapies, and dosing that follows FDA-approved guidelines. Authorizations are usually granted for 12 months at a time, and continuing coverage requires documentation showing the treatment is working.
Financial Assistance Options
Genentech, the manufacturer of Ocrevus, runs a patient assistance program that can significantly reduce or eliminate out-of-pocket costs for eligible patients. For commercially insured patients, copay assistance programs can bring costs down to as little as $0 per infusion. Patients who are uninsured or underinsured may qualify for free drug through the manufacturer’s access program.
It’s worth noting that manufacturer copay assistance generally cannot be used with Medicare or Medicaid, due to federal rules. However, independent nonprofit foundations sometimes offer grants to help Medicare patients cover their coinsurance for MS treatments. These funds open and close throughout the year and tend to run out quickly, so applying early in the calendar year improves your chances.
How Ocrevus Compares in Cost
At around $32,600 per year, Ocrevus sits in the mid-range of MS disease-modifying therapies. Some newer oral medications and other infusion therapies cost $80,000 or more annually at list price. Rituximab, an older infusion drug sometimes used off-label for MS, costs substantially less, which has led some neurologists and health systems to favor it as a lower-cost alternative that works through a similar mechanism. The trade-off is that rituximab is not FDA-approved for MS, which can complicate insurance coverage.
Your real comparison point isn’t list prices but your personal out-of-pocket cost after insurance and any assistance programs. Before starting treatment, ask your neurologist’s office to run a benefits investigation, which will give you a concrete estimate of what you’ll owe per infusion with your specific plan.