Vyvgart is argenx’s brand name for efgartigimod alfa, an antibody fragment used for generalized myasthenia gravis. It comes in two forms. The original Vyvgart is an IV infusion given over an hour. Vyvgart Hytrulo pairs the same molecule with hyaluronidase so it can be injected under the skin in under two minutes, and it is the only one of the two also approved for chronic inflammatory demyelinating polyneuropathy.
Both are billed under your medical benefit rather than your drug benefit, which means two charges per visit and a gross charge on the bill that has little relationship to what any insurer pays. Everything below was researched on September 4, 2026 from the CMS payment files current that day.
What Does Vyvgart Cost Without Insurance?
Two independent sources price each form. For the IV product, Drugs.com lists a cash price of $6,175.60 for the 400 mg vial, while Medicare’s Part B payment limit for HCPCS J9332, effective July 1 through September 30, 2026, is $32.553 per 2 mg, which works out to $6,510.60 for the same vial. For the subcutaneous product, Drugs.com lists $16,037.42 for the 5.6 mL vial containing 1,008 mg, while Medicare’s limit for J9334 is $34.258 per 2 mg, which is $17,266.03 for that vial.
The IV dose is 10 mg/kg, so a 165-pound patient needs about 750 mg and is dispensed two 400 mg vials. Vyvgart Hytrulo is a fixed dose regardless of weight, either the 1,008 mg vial administered by a health professional or a 1,000 mg prefilled syringe that patients and caregivers can use themselves.
| Vyvgart cost item | Low | Average | High |
|---|---|---|---|
| Vyvgart IV, one 400 mg vial, drug only | $6,176 | $6,511 | $16,328 |
| Vyvgart IV, one infusion for a 165-pound patient (two vials) | $12,351 | $13,021 | $32,656 |
| IV infusion administration, CPT 96365 | $60 | $217 | $223 |
| One four-week IV cycle, drug only | $49,405 | $52,085 | $130,624 |
| Vyvgart Hytrulo, one subcutaneous injection (1,008 mg vial) | $16,037 | $17,266 | $40,494 |
| Subcutaneous injection administration, CPT 96372 | $13 | $55 | $74 |
| One four-week Hytrulo cycle, drug only | $64,150 | $69,064 | $161,977 |
| Vyvgart Co-pay Program (commercial insurance required) | $0 | $0 | $0 |
The High column for the drug rows is the average charge providers actually submit, from CMS’s national 2024 claims data. For J9332 that is $81.64 submitted per 2 mg against $31.44 allowed, a 160% markup. For J9334 it is $80.35 submitted against $32.33 allowed, a 149% markup. Those national rows rest on 938 and 584 beneficiaries respectively, small denominators, so read them as a directional national average rather than a precise local forecast.
Administration figures follow the same logic. The Low column is the 2024 physician-office allowed amount, the Average is the July 2026 hospital outpatient rate for CPT 96365, and the High is the 2024 average submitted charge. For CPT 96372, the subcutaneous injection code, the ordering flips: the average submitted charge of $55.33 sits below the $73.56 hospital outpatient rate, because the code is so cheap that hospital packaging rules dominate.
What Drives the Price
The IV dose is weight-based and the subcutaneous dose is not
At 10 mg/kg, a 130-pound patient and a 250-pound patient do not pay the same for an IV infusion, and the label caps the dose at 1,200 mg for anyone weighing 120 kg or more. Vyvgart Hytrulo has one dose for everyone. That means the subcutaneous form is relatively more expensive for a small patient and relatively less expensive for a large one, which is worth pricing out before you pick a route.
Cycles, not a monthly prescription
For myasthenia gravis, both forms are dosed as cycles of four weekly treatments, and the label says subsequent cycles are given based on clinical evaluation. There is no fixed annual quantity, which is exactly why nobody publishes an annual price. Budget by the cycle, then ask your neurologist how many cycles a year is typical for someone with your pattern.
CIDP is different. Vyvgart Hytrulo for CIDP is dosed as once-weekly injections on an ongoing basis, so a year of treatment is 52 doses. At the prices above that is roughly $834,000 to $898,000 of drug a year, one of the highest annual drug costs on this site.
Where you sit, and for how long
The IV form runs an hour and bills as CPT 96365. Medicare pays a hospital outpatient department $217.31 for that code under the July 2026 payment file, against a physician-office allowed amount of $60.45 in 2024 claims data. The subcutaneous form is a 30 to 90 second push and bills as a therapeutic injection instead, where the office allowed amount was $13.42. Across a four-treatment cycle, the setting and route together move the administration cost from roughly $50 to roughly $870.
There is no retail channel
CMS’s National Average Drug Acquisition Cost survey returns zero rows for “Vyvgart” and “efgartigimod” under two different search operators, while a control drug returns thousands. That is a real finding, not a failed search. Neither form moves through retail pharmacy, so no discount card, coupon site or pharmacy price comparison applies. Even the self-administered prefilled syringe is dispensed through specialty distribution and billed under the medical benefit.
Vial size sets a floor
The IV vial is 400 mg and there is no smaller size, so any dose between 401 mg and 800 mg costs the same two vials. The Hytrulo vial is a single fixed 1,008 mg presentation. When a drug is only sold in large fixed units, there is no partial-fill discount available at any price.
Cash Price vs. Insurance
On most services covered here, paying cash sometimes beats using a benefit. This is not one of those. At $12,000 or more per treatment and four treatments per cycle, no self-pay discount closes the gap between cash and coverage, and there is no direct-to-patient purchase channel at all.
The useful distinction here is billed versus allowed, not cash versus insured. The 2024 claims data shows providers submitting roughly 2.5 times the allowed amount on both codes. If you have already received a bill quoting the charge column, that number is a starting position rather than a fixed price. Get an itemized bill with the J code and unit count on it, check the units against the vial sizes above, and work through how to negotiate a medical bill before you agree to anything.
It is also worth noting what argenx does and does not publish. Its patient site describes a Quick Start Program that supplies Vyvgart Hytrulo at no cost for a limited time, but that program is aimed at patients experiencing access delays through commercial insurance, not at uninsured patients. The company publishes no income-based free-drug program on its patient or prescriber sites as of September 4, 2026, which is a meaningful difference from how several other infused biologics are supported.
How to Pay Less
Read the copay terms before you count on them. The My VYVGART Path Commercial Co-payment Program terms state plainly that uninsured and cash-paying patients are not eligible, nor are patients with government coverage of any kind, nor patients whose commercial plan does not cover Vyvgart. Eligible commercially insured patients may pay as little as $0 per injection up to $25,000 a calendar year for drug and administration combined, and residents of Massachusetts and Rhode Island are excluded from the administration portion. Eligibility must be reapplied for every calendar year.
Chase coverage first, because nothing else scales to this number. If you are uninsured, a Medicaid eligibility screening or a marketplace special enrollment period is worth more than any discount you can negotiate. A single four-week cycle exceeds most annual out-of-pocket maximums, which means one covered cycle usually pays for a year of premiums several times over.
Ask for the office or infusion-center site of care. A freestanding infusion center or a neurology office is paid a fraction of a hospital outpatient department for the same hour. Health systems often have both, and the drug price is identical either way.
Apply for charity care rather than signing a payment plan. Nonprofit hospitals must publish written financial assistance policies, and a six-figure treatment course clears most thresholds. Read how hospital charity care works first, since agreeing to a payment plan can complicate an application later.
Check the posted cash price for the administration codes. The drug price barely moves between facilities, but the facility fee does. Use the fair price checker to benchmark the infusion charge, and ask the billing office for the discounted cash rate in writing before your first visit.
Price both routes with your actual weight. If your clinician is open to either form, run the numbers. At 165 pounds the IV route is roughly $3,700 to $4,200 cheaper per dose at published prices, but the gap narrows as weight rises and reverses near the 120 kg dose cap, where the IV dose takes three vials.
The Bottom Line
Vyvgart is a $12,351 to $13,021 drug per IV infusion and a $16,037 to $17,266 drug per subcutaneous injection, before any clinic bills for giving it to you. A single four-week cycle runs $49,000 to $69,000 of drug depending on the form, and CIDP treatment with the subcutaneous version is an ongoing weekly cost rather than a course.
The structure is the same one that shows up on other clinic-administered biologics such as Keytruda and iron infusions: the drug goes through the medical benefit, the gross charge runs well above the allowed amount, and the manufacturer’s copay card is written for insured patients only. Self-injected specialty drugs like Kesimpta and infused antibodies like Leqembi show the same split between drug price and administration fee.
All figures were researched September 4, 2026. The CMS payment limits cited are effective July 1 through September 30, 2026, are built on first-quarter 2026 average sales price data, and reset on October 1, 2026, along with the hospital outpatient rates.