How Much Does Entresto Cost With Medicare?
Entresto (Sacubitril/Valsartan) costs an average of $379 per Medicare Part D claim, with total Medicare spending of $4765.0M in the latest year. No generic alternative is currently available.
Key Facts: Entresto Cost
- Medicare Part D avg
- $379/claim
- Likely Part D tier
- Tier 3 (non-preferred brand)
- Annual cost/patient
- $4,392
- Generic available
- No
- Manufacturer
- Novartis
- Treats
- Heart Failure
- Patent expires
- 2026-11-11
- YoY price change
- +18.3%
Source: CMS Medicare Part D Spending Dashboard. Tier placement inferred from typical formulary norms — confirm with your specific Part D plan.
Entresto Medicare Coverage & Out-of-Pocket Cost
Entresto is covered under Medicare Part D, with the program paying an average of $379 per prescription fill. Entresto typically falls on Tier 3 (non-preferred brand) of standard Part D formularies. Typical copay: $40-$100 per fill, depending on plan formulary.
Your actual out-of-pocket cost depends on three factors: (1) formulary tier — your plan's specific placement; (2) deductible status — most plans require you to meet up to a $590 deductible (2025) before copays kick in; (3) coverage phase — initial coverage, then the donut hole was eliminated in 2025, replaced by a hard $2,000 annual out-of-pocket cap under the Inflation Reduction Act. Once you hit $2,000 in true out-of-pocket spending, the rest of your Part D drugs are free for the year.
No generic is currently available for Entresto. Medicare beneficiaries cannot use manufacturer copay cards (anti-kickback statute prohibits them for federal program enrollees), but charity foundations such as the PAN Foundation, NeedyMeds, and the HealthWell Foundation offer copay grants for many heart failure drugs. The Medicare Extra Help (LIS) program also reduces Part D costs to near-zero for income-qualified beneficiaries (under 150% of the federal poverty level).
For cash-pay or commercial insurance scenarios, compare prices using GoodRx, SingleCare, or Cost Plus Drugs before filling — discount-program prices sometimes beat Part D copays for lower-cost generics.
Entresto is manufactured by Novartis and prescribed primarily for Heart Failure. In the most recent Medicare Part D data, 12,560,000 claims were filed for 1,085,000 unique beneficiaries, at an average cost of $379 per claim. Average annual cost per beneficiary is $4,392.
Year over year, Medicare spending on Entresto has increased by +18.3%. No generic substitute is available, so the brand-name price reflects the full market cost. Its patent expires 2026-11-11.
Key Data
| Metric | Value |
|---|---|
| Avg Cost Per Claim | $379 |
| Total Medicare Spending | $4765.0M |
| Total Claims | 12,560,000 |
| Beneficiaries | 1,085,000 |
| Generic Available | No |
| Year-Over-Year Change | +18.3% |
Other Drugs for Heart Failure
Frequently Asked Questions
Medicare Part D pays an average of $379 per claim for Entresto. Entresto is typically placed on Tier 3 (non-preferred brand) of standard Part D formularies. Typical copay: $40-$100 per fill, depending on plan formulary. As of 2025, total annual out-of-pocket on Part D is capped at $2,000 under the Inflation Reduction Act.
Yes. Entresto appears in Medicare Part D claims data, with 1,085,000 beneficiaries filling 12,560,000 prescriptions in the latest year. Specific coverage depends on your plan's formulary — call the number on your insurance card or check the plan's Summary of Benefits to confirm prior authorization, step therapy, or quantity limit requirements.
Entresto (Sacubitril/Valsartan) costs an average of $379 per Medicare Part D claim, with total Medicare spending of $4765.0M in the latest year. No generic alternative is currently available.
No. As of the latest FDA Orange Book data, there is no generic version of Entresto (Sacubitril/Valsartan). Patent protection extends until 2026-11-11, after which generics may enter the market.
Medicare beneficiaries cannot use manufacturer copay cards (anti-kickback statute), but several options exist: (1) Apply to charity copay foundations like the PAN Foundation, NeedyMeds, HealthWell Foundation, or Patient Advocate Foundation — many cover heart failure drugs; (2) Ask your prescriber about therapeutic alternatives in the same drug class that may be on a lower tier; (3) For some drugs, paying cash via GoodRx or Cost Plus Drugs can beat your Medicare copay — always compare before filling; (4) If your income is below 150% of the federal poverty level, you may qualify for the Medicare Extra Help (Low-Income Subsidy) program, which reduces Part D costs to near-zero.
Entresto is manufactured by Novartis. The FDA application number is NDA207620.
Entresto (Sacubitril/Valsartan) is primarily prescribed for Heart Failure.
Medicare Part D spending on Entresto has increased +18.3% year over year. Total program spending reached $4765.0M in the latest reporting year.
Entresto (Sacubitril/Valsartan) costs an average of $379 per Medicare Part D claim, with total Medicare spending of $4765.0M in the latest year. No generic alternative is currently available.
This answer pulls from CMS Medicare Part D Drug Spending data, the authoritative federal source for U.S. Medicare prescription-drug pricing. The headline number above is the direct answer; what follows is the additional context most readers need to use the answer for a real decision rather than just a fact lookup.
For readers turning this answer into action: cross-reference against the underlying CMS Medicare Part D Drug Spending data record before acting on time-sensitive decisions. The site renders the data as it was published; subsequent revisions can shift the picture, and the live federal data is always the authoritative current reference.
Source: CMS Medicare Part D Spending, 2026.