What sacubitril and valsartan costs if you have no insurance

What this medicine is for

MedlinePlus, a health site from the National Library of Medicine, says sacubitril and valsartan is usually taken with other medicines. It lowers the risk of death and hospital stays in adults with certain kinds of heart failure. Heart failure means the heart cannot pump blood as well as the body needs. The same page says the medicine is also used for some children who are 1 year old or older.

Because heart failure is a long-term condition, the medicine is usually taken for a long time. That makes the monthly price a big deal for people who pay for it themselves.

What the brand and the generic cost

The Centers for Medicare and Medicaid Services, or CMS, is the federal agency that runs Medicare and Medicaid. In a 2026 fact sheet, CMS listed the brand-name version at $628 for a 30-day supply, based on 2023 list prices. A list price is the price a drug maker sets before any discounts.

Medicare is the government health plan for adults 65 and older and for some younger people with disabilities. CMS says its negotiated price for 2026 is $295 for a 30-day supply. That lower price is only for people with Medicare drug coverage, so it does not help if you are uninsured.

For a second look at the real cost, we used NADAC, a CMS survey that tracks the average amount pharmacies pay to buy each drug. It is not a counter price, because it shows only the store's cost before the store adds its own charges. All of these figures come from the week of October 21, 2026.

• Generic tablets cost pharmacies about $0.50 for the lowest strength and $0.54 for the middle strength. The highest strength cost pharmacies about $0.58 each.
• The brand-name tablets cost pharmacies about $11.56 to $11.59 for each strength.

To see how this adds up, multiply by the number of tablets on a prescription. As an example, 60 tablets of the middle strength come to about $33 for the generic at the survey price. The same 60 tablets of the brand come to about $695. Your doctor chooses the strength and the number of tablets, so we show this only to give you a sense of the gap.

The counter price is higher than the survey price. How much higher depends on the pharmacy, so a few phone calls can show you a wide range.

A generic is on the market now

The Food and Drug Administration, or FDA, approved the first generic versions of this medicine on May 28, 2024. The same cost survey now lists dozens of generic products from many makers. That tells us generic tablets are being sold in the United States in 2026.

The FDA says a generic medicine has the same active ingredients as the brand-name one and tends to cost less. Whether a generic is right for you is a question for your doctor or pharmacist. Please do not switch medicines on your own, even to save money.

When you call a pharmacy, ask for the price of the generic by its plain name, sacubitril and valsartan. Then ask for the brand price too, so you can see the difference. Our guide on comparing prescription prices explains how to do this step by step, and our guide on asking for the cash price has words to use on the phone.

Ways to get help paying

Some drug makers run patient assistance programs, which are free or low-cost drug plans for people who qualify. The maker of this medicine runs a nonprofit program that gives medicines at no charge to eligible people. Those people have no insurance or only government coverage. Its page says you must live in the United States and meet income guidelines. It also says that if your medicine is not on its list, the program does not support it. Check the list or call the program before you apply.

According to MedlinePlus, patient assistance programs may give discount cards or free or low-cost medicines, depending on your income and health needs. It also warns that not everything sold online is safe, so use a licensed U.S. pharmacy.

A community health center may also help. HRSA, the federal Health Resources and Services Administration, says these centers can buy outpatient drugs at lower prices through a program named 340B. Its page is silent on how much of that discount passes to patients, so ask the center for its price on this medicine before you go. Our guides on community health centers and prescriptions without insurance cover more options.

Heart failure care also needs regular visits and lab work. Many of those visits can be handled by a cash-pay doctor with a monthly membership. Direct primary care plans usually run $50 to $200 a month, and our directory lets you find a cash-pay doctor in your area. You can also find low-cost care near you with our tool.

Talking with your doctor about cost

Tell your doctor or pharmacist that cost is a problem. Say it at a visit, or call the office before your supply runs low. Ask what the choices are and what each one costs. Which medicine is safe for you depends on your health and your other medicines, so that choice belongs to you and your doctor.

A doctor may also know about a program that you have not heard of. Asking early gives them time to look for help.

Safety facts to know

MedlinePlus says to keep taking this medicine even if you feel well, and not to stop without talking to your doctor. So if money is the problem, please do not skip doses to make a supply last. Call your doctor or pharmacist before you run out.

MedlinePlus also gives a warning about pregnancy and this medicine. It says not to take this medicine if you are pregnant, because it can cause death or serious injury to an unborn baby. It lists swelling of the lips, tongue, face or throat, and trouble breathing, as reasons to call your doctor right away. In an emergency, such as trouble breathing, call 911 or go to the nearest emergency room. Use this page for general information only, because your own doctor knows your health best.

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