Revlimid Prescription Drug Coverage

Revlimid is a chemotherapy medication that comes in capsule form. This drug is specifically designed for people with multiple myeloma, mantle cell lymphoma and myelodysplastic syndromes associated with severe anemia. 

Revlimid is the brand name for this drug, and the active ingredient is lenalidomide. It is produced by Bristol Myers Squibb, and a typical dosage is 10mg to 40mg per day, depending on whether the patient is newly diagnosed or on a maintenance regimen. Capsules are available in doses ranging from 2.5mg to 25mg, so the specific number of capsules taken as a daily dose is determined by a physician.

Revlimid acts by halting the growth of cancer cells. It is typically taken once per day for 21 days, and the results are evaluated during a 7-day break before the next 28-day cycle. Patients on a maintenance regimen of Revlimid may be prescribed a lower dosage to be taken every day for 28 days.

When used for the treatment of mantle cell lymphoma, Revlimid is prescribed after at least two prior therapy cycles, including at least one cycle of bortezomib, have been administered. For patients with multiple myeloma, Revlimid is administered in conjunction with another medication, dexamethasone. 

Revlimid Side Effects

Common side effects of Revlimid include nausea, constipation, diarrhea, feelings of tiredness, skin rashes, tiredness, itching, fever, persistent cough, headaches, sleep problems, muscle cramps and swelling in the limbs or skin.

Some more serious side effects may also occur, and Revlimid should only be taken under specific guidelines issued by a physician. Individuals with existing kidney problems may be more at risk for severe side effects.

Does Medicare Cover Revlimid?

Medicare Advantage Prescription Drug plans (MA-PD plans) and standalone Medicare Part D plans cover the prescription drug Revlimid.

While Medicare prescription drug plans each have a specific list of medications they cover, Revlimid is included in all MA-PD plans and Part D plans, so coverage is universal for anyone who has these plans. Most people with Medicare Advantage plans are enrolled in a plan offering prescription drug coverage.

Is There a Generic Version of Revlimid?

Prior to 2021, only the brand name version of lenalidomide was available in the U.S., but 2021 was the final year of exclusivity for the pharmaceutical company that produces the drug.  The first generic version of this drug debuted in spring 2022. 

What Is the Cost of Revlimid With a Medicare Prescription Drug Plan?

If you have a Medicare plan that covers prescription medication, you may still have to pay a deductible and copays for medication, including Revlimid. The deductible is the amount of money you have to pay before coverage kicks in. As of 2024, no Medicare prescription drug plan can have a deductible higher than $545. Some plans have a $0 deductible, in which case Revlimid is covered without requiring you to pay any deductible.

Once you have satisfied your deductible, you may be responsible for copayments or coinsurance on medication. Copayments are a flat fee that you must pay each time you fill any prescription, including prescriptions for Revlimid. Coinsurance is a percentage-based payment, which means that you pay a specific percentage of the cost every time you fill a prescription. 

Significant Concerns When Taking Revlimid

Because Revlimid affects cell growth, it should not be taken by anyone who is pregnant or breastfeeding. Revlimid can cause severe birth defects in a developing fetus and can cause embryo or fetal death.

Two negative pregnancy tests are required before administration of Revlimid, and individuals on Revlimid should use two forms of contraception for 4 weeks before starting this drug, throughout the course of treatment and for 4 weeks after stopping this drug.

Blood clots are another concern for those taking Revlimid. There is a risk of increased arterial and venous blood clots, stroke, myocardial infarction and pulmonary embolism in those taking Revlimid. Signs of blood clotting include shortness of breath, swelling of the arms or legs and chest pain. Someone on Revlimid who experiences these symptoms should seek out medical attention immediately.  

Talk to your doctor about whether you should take medication to reduce the risk of blood clots while on Revlimid.

Revlimid may also cause neutropenia, a severe and sudden decrease in white blood cells. Neutropenia may be treated through dosage reductions or additional medication.

People taking Revlimid may also have an increased risk of new cancers, severe skin reactions, severe liver problems, tumor lysis syndrome and thyroid problems. Individuals with chronic lymphocytic leukemia (CLL) may have an increased risk of death while taking this medication.

Revlimid may also make present tumors worse for some individuals, and this drug could increase the risk of early death for mantle cell lymphoma patients.