Last updated: March 2026
How Much Does Methotrexate Injection Cost?
Cost Breakdown by Type
| Type / Procedure | Without Insurance | With Insurance |
|---|---|---|
| 25mg/mL Vial Generic (single dose) | $20 – $60 | $5 – $15 |
| Otrexup Auto-Injector (4 prefilled) | $500 – $1,500 | $30 – $200 |
| Rasuvo Auto-Injector (4 prefilled) | $500 – $1,500 | $30 – $200 |
What Affects the Cost
- Brand-name vs. generic availability
- Insurance formulary tier placement
- Pharmacy choice (retail vs. mail-order vs. Costco)
- Manufacturer savings cards and coupons
- Dosage and quantity prescribed
- Geographic location
Insurance Coverage
Typical coverage: Tier 2 generic; auto-injector (Otrexup/Rasuvo) Tier 3-4
Most insurance plans use a tiered formulary: Tier 1 (generic) $0-$15 copay, Tier 2 (preferred brand) $25-$75, Tier 3 (non-preferred brand) $50-$150, Tier 4 (specialty) $100-$500+. Prior authorization may be required for certain medications. Step therapy may require trying cheaper alternatives first.
How to Save Money
- Always ask for generic when available — saves 50-90%
- Use GoodRx, RxSaver, or similar discount cards
- Costco pharmacy is open to non-members and often has lowest prices
- Mark Cuban's Cost Plus Drugs offers transparent low pricing
- Manufacturer patient assistance programs provide free medication to qualifying patients
- HSA/FSA funds can cover medication costs tax-free
Related Procedures & Costs
Frequently Asked Questions
Injectable methotrexate has better absorption (especially at higher doses), fewer GI side effects, and may be more effective than oral methotrexate.
Generic vials cost $20 to $60 per dose. Prefilled auto-injectors cost $500 to $1,500 for 4 syringes.
Yes, subcutaneous methotrexate can be self-administered at home after proper training from your healthcare provider.