Comprehensive medication guide to Kevzara including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$400 per fill with commercial insurance (Specialty Tier 4–5); commercially insured patients may pay $0/month with the KevzaraConnect Copay Card (up to $15,000/year maximum); Medicare Part D patients face copays of $100–$400+ depending on plan; prior authorization is required by virtually all payers.
Estimated Cash Pricing
$4,774–$5,555 retail for a 2-syringe (28-day) carton at specialty pharmacies; no generic or biosimilar is available in the US as of 2026, so there are no lower-cost alternatives to the brand-name product.
Medfinder Findability Score
55/100
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Kevzara (sarilumab) is a prescription biologic medication developed by Sanofi and Regeneron Pharmaceuticals. It is classified as an interleukin-6 (IL-6) receptor antagonist—a type of monoclonal antibody that blocks the IL-6 receptor to reduce inflammation in autoimmune conditions. Kevzara is a fully human IgG1 monoclonal antibody with an approximate molecular weight of 150 kDa, manufactured using recombinant DNA technology.
Kevzara is FDA-approved for three conditions: moderately to severely active rheumatoid arthritis (RA) in adults who have not responded adequately to at least one DMARD; polymyalgia rheumatica (PMR) in adults who did not respond to corticosteroids or cannot tolerate steroid taper (Kevzara is the first and only biologic FDA-approved specifically for PMR, approved February 28, 2023); and active polyarticular juvenile idiopathic arthritis (pJIA) in patients weighing 63 kg or more (approved 2024).
Kevzara is given as a subcutaneous injection once every 2 weeks. It comes in pre-filled syringes and pre-filled pens in 150 mg and 200 mg strengths. The standard starting dose is 200 mg every 2 weeks. As of 2026, there is no FDA-approved generic or biosimilar for sarilumab in the United States.
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Kevzara works by blocking the interleukin-6 (IL-6) receptor. IL-6 is an inflammatory protein (cytokine) that is overproduced in conditions like rheumatoid arthritis and polymyalgia rheumatica. When IL-6 binds to its receptor on immune cells, it triggers a cascade of inflammation that damages joints and tissues.
Sarilumab specifically binds to both the soluble and membrane-bound forms of the IL-6 receptor (IL-6Rα), preventing IL-6 from attaching to it. By occupying the receptor, Kevzara interrupts the entire IL-6-mediated inflammatory cascade—reducing joint inflammation, systemic symptoms, and elevated inflammatory markers like CRP and ESR.
Kevzara was developed using Regeneron's VelocImmune® technology, which uses genetically engineered mice with humanized immune systems to produce optimized fully human antibodies—minimizing the risk of the body mounting an immune reaction against the drug. Kevzara also affects CYP450 enzyme metabolism in the liver, which is why it can interact with medications like warfarin, statins, and oral contraceptives.
150 mg — subcutaneous injection (pre-filled syringe)
1.14 mL solution; used as dose reduction for neutropenia, thrombocytopenia, or elevated liver enzymes
200 mg — subcutaneous injection (pre-filled syringe)
1.14 mL solution; standard starting dose given once every 2 weeks
150 mg — subcutaneous injection (pre-filled pen)
1.14 mL solution; auto-injector pen format for patient convenience
200 mg — subcutaneous injection (pre-filled pen)
1.14 mL solution; auto-injector pen format; standard starting dose
Kevzara is not in an FDA drug shortage as of 2026, but it is consistently challenging for patients to access. The primary barriers are logistical and administrative rather than supply-related: Kevzara is a specialty biologic dispensed only through specialty pharmacies—not available at retail chains like CVS or Walgreens. Most insurance plans require prior authorization (which can take 1–14+ business days), and many require step therapy through a less expensive biologic first.
Because there is no FDA-approved biosimilar for sarilumab in the US, Kevzara remains brand-only at a list price of $4,774–$5,555 per 28-day supply. This cost creates additional barriers for uninsured and underinsured patients, even when the drug is physically available. The KevzaraConnect program from Sanofi provides meaningful support, but requires enrollment and varies by insurance status.
If you're struggling to confirm which specialty pharmacy near you can fill your Kevzara prescription, medfinder calls pharmacies on your behalf and texts you the results—saving you hours on hold.
Kevzara is not a controlled substance and does not have DEA-specific prescribing requirements. Any licensed physician, nurse practitioner, or physician assistant can technically prescribe it. However, in practice, Kevzara is almost exclusively managed by specialists because most insurance prior authorizations require documentation from a rheumatologist, and the diagnosis and monitoring of RA and PMR requires specialty expertise.
Types of prescribers who commonly initiate or manage Kevzara:
Rheumatologists — Primary prescribers; board-certified in autoimmune and inflammatory conditions including RA, PMR, and JIA
Internists and general practitioners — May co-manage established patients, particularly in areas with limited rheumatology access
Pediatric rheumatologists — For pJIA patients weighing ≥63 kg
Nurse practitioners and physician assistants — Advanced practice providers working under or alongside rheumatologists can prescribe Kevzara in most states
Telehealth rheumatology is available for follow-up visits and prescription renewals in established patients. Initial diagnosis of RA or PMR typically requires an in-person physical examination. Telehealth platforms including Rheumatology Care Network and various academic health system virtual care programs offer rheumatology consultations. Confirm state licensure and insurance acceptance before booking.
No. Kevzara (sarilumab) is not a controlled substance and has not been scheduled by the DEA. There are no restrictions on how many refills can be written or filled, and it does not require a special DEA prescription form. However, Kevzara does require a valid prescription from a licensed healthcare provider, and virtually all insurance plans require prior authorization before dispensing.
While it is not a controlled substance, Kevzara does carry an FDA Boxed Warning for serious infections. Before prescribing, providers must screen patients for latent tuberculosis and ensure there are no active infections. Regular lab monitoring (CBC, liver function tests, lipid panel) is required throughout treatment as a safety measure.
The most frequent side effects reported in clinical trials (occurring in ≥3% of patients) include:
Neutropenia (low white blood cell count) — the most common significant lab abnormality
Elevated ALT/liver enzymes
Injection site erythema, pain, or pruritus
Upper respiratory infections
Urinary tract infections
Elevated cholesterol and triglycerides (hyperlipidemia)
Leukopenia and thrombocytopenia (less common)
Serious infections (Boxed Warning): Tuberculosis, bacterial, fungal (including candidiasis, pneumocystis), viral, and opportunistic infections
Gastrointestinal perforation: Especially in patients with diverticulitis history or concomitant NSAID/corticosteroid use
Serious allergic reactions: Anaphylaxis, urticaria, angioedema
Hepatotoxicity: Liver damage symptoms including jaundice, dark urine, severe fatigue, upper right abdominal pain
Increased cancer risk: Potential increased risk of certain cancers through immune system modification
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Tocilizumab (Actemra)
IL-6 receptor antagonist with same mechanism as Kevzara; available in SC and IV forms; multiple biosimilars available in 2026 (Tofidence, Tyenne, Vegzelma) at lower cost; comparable efficacy to sarilumab in head-to-head trials
Adalimumab (Humira/biosimilars)
TNF inhibitor; most widely prescribed biologic for RA; many biosimilars available at significantly lower cost; SC injection every 1–2 weeks; often first-line biologic before IL-6 inhibitors
Baricitinib (Olumiant)
JAK inhibitor; oral tablet once daily; FDA-approved for RA; alternative for patients who prefer an oral medication; carries boxed warning for serious infections, cardiovascular events, and malignancy
Abatacept (Orencia)
T-cell costimulation blocker; different mechanism from Kevzara; available as monthly IV or weekly SC; favorable infection profile in some patients; approved for RA and polyarticular JIA
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Live vaccines (MMR, live flu spray, Zostavax, yellow fever, varicella)
majorContraindicated — do not administer live vaccines during Kevzara treatment due to risk of active infection from live virus in an immunosuppressed patient
Upadacitinib (Rinvoq)
majorContraindicated — combined immunosuppression creates unacceptable risk of serious infections
Biological DMARDs (TNF inhibitors, IL-1R antagonists, anti-CD20, JAK inhibitors, abatacept)
majorAvoid — combination results in excessive immunosuppression with dramatically increased serious infection risk; not studied in combination
Warfarin (Coumadin)
moderateMonitor INR closely when starting or stopping Kevzara — CYP450 enzyme changes can alter warfarin metabolism and INR; dose adjustment likely required
Statins (simvastatin, atorvastatin, lovastatin)
moderateMonitor lipid levels and statin efficacy — Kevzara increases CYP3A4 activity, reducing statin blood levels (simvastatin acid decreased ~36–45% in studies); statin dose adjustment may be needed
Oral contraceptives (pills, patch, ring)
moderateMay reduce contraceptive effectiveness — increased CYP3A4 activity may lower hormone levels; consider backup contraception method during Kevzara therapy
Theophylline
moderateMonitor drug levels — narrow therapeutic index drug metabolized by CYP1A2; starting or stopping Kevzara may change theophylline blood levels requiring dose adjustment
NSAIDs and corticosteroids
moderateIncreased GI perforation risk when used concurrently with Kevzara, especially in patients with history of diverticulitis or GI ulcers
Kevzara (sarilumab) is an important biologic option for patients with rheumatoid arthritis, polymyalgia rheumatica, and polyarticular juvenile idiopathic arthritis. As the only FDA-approved biologic specifically indicated for PMR, it fills a unique therapeutic gap. Its efficacy is well-established in multiple Phase 3 clinical trials, and it has a comparable safety profile to its closest competitor, tocilizumab.
The primary challenges with Kevzara are access-related rather than clinical: specialty-only distribution, prior authorization requirements, step therapy hurdles, and a high list price with no biosimilar competition as of 2026. The KevzaraConnect program (1-844-538-9272) from Sanofi significantly mitigates cost barriers for most commercially insured patients, offering $0/month copay assistance up to $15,000/year.
If you're having difficulty finding a specialty pharmacy that can fill your Kevzara prescription, medfinder can help. medfinder calls specialty pharmacies on your behalf to identify which ones can fill your prescription, and texts the results back to you. Working with your rheumatologist and KevzaraConnect together gives you the best chance of starting and staying on Kevzara therapy without interruption.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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