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Why Entresto Costs $379.00 Per Claim
Entresto (Sacubitril/Valsartan) is used to treat heart failure. According to CMS Medicare Part D spending data, the program spent $4.8B on this drug, covering 1,085,000 beneficiaries across 12,560,000 claims.
This drug is currently protected by patents expiring Nov 11, 2026. Until patent protection ends, no generic version can enter the market, which limits price competition. Once generics become available, the price typically drops 80-95%.
Spending on Entresto increased by +18.3% year-over-year, driven by increased utilization among Medicare beneficiaries.
Price Breakdown
Drug Details
Frequently Asked Questions
Entresto (Sacubitril/Valsartan) costs an average of $379.00 per claim based on Medicare Part D data. The estimated annual cost per patient is $4,392.00. Actual out-of-pocket costs depend on your insurance plan and pharmacy.
Entresto averages $379.00 per Medicare Part D claim — roughly equivalent to a 30-day supply for most patients on standard dosing. Without insurance, expect higher cash-pay prices unless you use a discount program (GoodRx, SingleCare, manufacturer copay assistance). With Medicare or commercial insurance, your out-of-pocket cost depends on your plan's formulary tier and deductible status.
A typical 30-day supply of Entresto reflects in our Medicare Part D average of $379.00 per claim. No generic is available yet, so cost remains at brand-name pricing. Cash-pay prices vary by pharmacy — comparison shopping (or using GoodRx coupons) often saves 20-50% off the listed price.
Most commercial insurance plans and Medicare Part D plans cover Entresto, but coverage varies by formulary tier. Entresto is often Tier 2 or Tier 3 on most formularies, meaning a higher copay than generic alternatives. Some plans require prior authorization or step therapy. Check your plan's formulary or call the number on your insurance card to confirm.
Several options for cash-pay patients: (1) Manufacturer patient assistance programs — the manufacturer may offer copay cards or free-drug programs for income-qualified patients; (2) Discount programs like GoodRx, SingleCare, or RxSaver typically save 20-80% off the cash price; (3) Mark Cuban's Cost Plus Drugs offers transparent generic pricing if a generic is available; (4) 340B-eligible community health centers offer drugs at federally negotiated discounts. Patient assistance programs are the primary affordability path while no generic is available.
Entresto is still under patent protection until Nov 11, 2026, giving the manufacturer market exclusivity. Once the patent expires, generics enter the market and prices typically fall 80-95% within 1-2 years.
No, Entresto is currently brand-only. Patent protection expires Nov 11, 2026, after which generic versions may enter the market.
Medicare Part D spent $4.8B on Entresto, covering 1,085,000 beneficiaries across 12,560,000 claims. This makes it one of the tracked drugs in the Medicare spending dashboard.
Check manufacturer patient assistance programs for potential savings. You can also compare prices at different pharmacies, use prescription discount programs (GoodRx, SingleCare, Cost Plus Drugs), or ask your doctor about therapeutic alternatives in the same drug class.
Reading Entresto's Medicare Pricing
At $379.00 per claim, Entresto is a mid-priced medication — more than a bargain generic but well short of a specialty product. Drugs in this range are often brands with partial competition, recently-genericized molecules still carrying brand pricing, or moderately complex formulations. The cost is real but rarely catastrophic for heart failure, and a same-class or generic substitute frequently closes most of the gap.
As a Medicare line item, Entresto is enormous: $4.8B in total Part D spending across 12,560,000 claims for 1,085,000 beneficiaries. At that scale the total is a product of both reach and price — a drug this widely prescribed at this cost is exactly the kind of molecule that draws CMS price-negotiation attention and PBM formulary leverage. The per-beneficiary figure, roughly $4K a year, is what translates the aggregate into an individual cost picture.
No generic competes with Entresto yet — patent protection runs to Nov 11, 2026, the date that matters most for its future price. Until then the savings levers are narrower: manufacturer copay assistance for those who qualify, discount-card pricing on cash-pay fills, and therapeutic substitution to a cheaper in-class option for heart failure where one exists. The structural price drop arrives with generic entry, which historically pulls prices down 80–95% within a year or two of the patent cliff.
Every figure here comes from the CMS Medicare Part D Drug Spending dashboard, which reports what the program paid — not the cash price at a retail pharmacy and not a patient's out-of-pocket cost. List prices also overstate the real economics: manufacturers pay confidential rebates to pharmacy benefit managers, so the net price plans actually pay is often well below the sticker. Treat $379.00 as a consistent Medicare-program benchmark for Entresto, useful for comparing drugs on the same basis, rather than the price any one patient will see at the counter.
Related
Cost data reflects Medicare Part D spending and may not represent retail pharmacy prices. Average cost per claim represents the total drug cost (not patient out-of-pocket) divided by total claims.