Why Kalydeco Costs $15,750.00 Per Claim
Kalydeco (Ivacaftor) is used to treat cystic fibrosis. According to CMS Medicare Part D spending data, the program spent $567.0M on this drug, covering 4,200 beneficiaries across 36,000 claims.
A generic version of this drug is available, which means lower-cost alternatives exist. Patients should ask their pharmacist about generic Ivacaftor or talk to their doctor about therapeutic alternatives that may cost less.
Price Breakdown
Drug Details
Frequently Asked Questions
Kalydeco (Ivacaftor) costs an average of $15,750.00 per claim based on Medicare Part D data. The estimated annual cost per patient is $135,000.00. Actual out-of-pocket costs depend on your insurance plan and pharmacy.
Kalydeco averages $15,750.00 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 Kalydeco reflects in our Medicare Part D average of $15,750.00 per claim. Switching to generic Ivacaftor typically reduces cost by 80-95%. 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 Kalydeco, but coverage varies by formulary tier. Insurers typically prefer generic Ivacaftor (Tier 1, lowest copay) over brand-name Kalydeco (Tier 2-3, higher copay). 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. Switching to generic Ivacaftor is the single biggest cost reducer if your prescriber is open to it.
Brand-name Kalydeco costs more than generic Ivacaftor primarily for marketing reasons — patients can request the brand from their doctor even when a chemically identical generic exists. The active ingredient and clinical effect are the same.
Yes, a generic version of Kalydeco (Ivacaftor) is available. Generic medications typically cost 80-95% less than brand-name drugs. Ask your pharmacist about generic Ivacaftor.
Medicare Part D spent $567.0M on Kalydeco, covering 4,200 beneficiaries across 36,000 claims. This makes it one of the tracked drugs in the Medicare spending dashboard.
Ask your pharmacist about generic Ivacaftor, which is typically much cheaper. 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.
this entity is one of the data points covered by this site’s U.S. Medicare prescription-drug pricing dataset. The detail above comes directly from CMS Medicare Part D Drug Spending data; the context that follows situates the headline numbers against the broader distribution across U.S. prescription drugs.
Every number on this page links back to CMS Medicare Part D Drug Spending data; the methodology page describes the inputs, refresh cadence, and known limitations of the underlying data product.
For readers using this page as a decision input, the related-entity pages elsewhere on the site provide the comparison set. The most useful comparison for this entity is typically a peer within U.S. prescription drugs with similar size, similar exposure, or similar geography — not the national-level summary alone.
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.