What Does Breo Ellipta Cost in 2026, and What Changes in 2027?

Breo Ellipta is a once-daily dual-combination inhaler made by GlaxoSmithKline (GSK), containing fluticasone furoate (an inhaled corticosteroid) and vilanterol (a long-acting beta-2 agonist). The FDA approved Breo Ellipta in 2013 for the maintenance treatment of chronic obstructive pulmonary disease (COPD) in adults, and later for maintenance treatment of asthma in patients aged 5 years and older. Roughly 626,000 Medicare beneficiaries use Breo Ellipta, making it one of the highest-volume respiratory inhalers in the Medicare Part D program.

Breo Ellipta is dispensed through retail and mail-order pharmacies and self-administered at home, making it a Medicare Part D drug. Because it is not administered in a clinical setting, Breo has no HCPCS J-code and is not billed under Part B. The 2026 retail cash price ranges from approximately $380 to $550 per inhaler depending on the pharmacy and the dose (100/25 mcg or 200/25 mcg). An authorized generic (fluticasone furoate/vilanterol by Prasco) has been available since May 2022, though list prices for the authorized generic are sometimes comparable to the brand. Patients who compare Breo Ellipta to Trelegy Ellipta should note that Trelegy is a triple-combination inhaler (ICS/LABA/LAMA) while Breo is a dual combination (ICS/LABA only), making the two appropriate for different stages of COPD severity.

CMS selected Breo Ellipta for Round 2 of Medicare drug price negotiation under the Inflation Reduction Act of 2022. The negotiated Maximum Fair Price of $67 per month takes effect January 1, 2027, representing an 83 percent reduction from the 2024 list price of $397. In 2026, before the negotiated price takes effect, Medicare Part D enrollees taking Breo Ellipta are protected by the 2026 annual out-of-pocket cap of $2,100. Patients who also qualify for the Medicare Low Income Subsidy (Extra Help) may pay as little as $0 to $11 per fill in 2026. Patients using Trelegy Ellipta, the triple-combination version, can review the separately negotiated price at the Trelegy Ellipta cost page.

What Breo Ellipta Costs by Point of Pay (2026)

The price you pay depends almost entirely on WHERE you pay. The same breo ellipta can cost many times more at a hospital than at your local pharmacy:

Why Hospitals Charge So Much

Breo Ellipta is almost always dispensed at retail or mail-order pharmacies and administered by the patient at home. During an inpatient hospital stay, respiratory maintenance medications like Breo Ellipta are typically bundled into the facility's DRG-based (Diagnosis Related Group) payment rate rather than billed as separate retail-priced line items. Patients who see an itemized charge for Breo Ellipta on a hospital bill should treat this as a potential billing error and request an itemized review, since the drug is a Part D benefit dispensed through pharmacy, not a Part B hospital drug.

The retail list price for Breo Ellipta ($380 to $550 per inhaler in 2026) reflects a brand-only market with limited generic competition. The authorized generic from Prasco has been available since 2022, but generic pricing has not consistently tracked below the brand in the way typical small-molecule generics do. This is partly because the device component (the Ellipta dry-powder inhaler mechanism) is complex to replicate. The $67 Maximum Fair Price negotiated by CMS for 2027 effectively caps Medicare patients' costs at a level much closer to the drug's underlying manufacturing cost, bypassing the brand premium.

For Medicare Part D enrollees using Breo Ellipta in 2026, the $2,100 annual out-of-pocket cap from the Inflation Reduction Act provides meaningful protection. A patient paying full retail-range costs could hit this threshold within 4 to 6 months of fills and pay $0 for the remainder of the year. The 2027 negotiated price of $67 per month removes the need to rely on the catastrophic cap for Breo users, as the negotiated cost falls well below the monthly amount that would trigger rapid cap accumulation. Patients on Medicaid typically pay $1 to $4 per fill if Breo Ellipta appears on their state plan's formulary.

Patient Assistance Programs

GSK runs two programs that can significantly reduce or eliminate the cost of Breo Ellipta depending on your insurance status. For patients with commercial insurance, the GSK $35/month savings program caps out-of-pocket costs at $35 per month for all GSK inhalers including Breo. For uninsured or underinsured patients who meet income requirements, the GSK For You patient assistance program can provide Breo Ellipta at no cost. Without either program, Breo Ellipta retails at $380 to $550 per inhaler in 2026 at the pharmacy counter.

Medicare Part D

Breo Ellipta is covered by Medicare Part D. Most Part D and Medicare Advantage prescription drug plans include it on their formulary, typically on Tier 4 (non-preferred brand) or Tier 5 (specialty), which carries the highest cost-sharing before the out-of-pocket cap applies. The 2026 annual out-of-pocket cap for Medicare Part D is $2,100, per the Inflation Reduction Act. Once a Part D enrollee has paid $2,100 in out-of-pocket drug costs during the calendar year, cost-sharing drops to $0 for the remainder of the year on all covered drugs, including Breo Ellipta.

Prior authorization is common for Breo Ellipta under Medicare Part D. Many plans require step therapy, meaning patients may need to document that they tried a lower-cost inhaled corticosteroid or short-acting bronchodilator first before a plan will cover Breo. If your plan requires step therapy or prior authorization, ask your prescriber to submit documentation of your COPD or asthma severity and your response to prior treatments. The formulary tier placement also affects whether Breo Ellipta requires prior authorization in your specific plan.

Starting January 1, 2027, Breo Ellipta will have a Medicare Maximum Fair Price of $67 per 30-day supply, negotiated under IRA Round 2. Medicare enrollees will pay no more than this amount regardless of formulary tier. Patients who also qualify for Extra Help (Low Income Subsidy) typically pay significantly less, often between $0 and $11 per fill in 2026. Check eligibility for Extra Help at ssa.gov/medicare/part-d-extra-help. Patients who cannot afford Breo Ellipta in 2026 and do not qualify for Medicare's Low Income Subsidy may apply for the GSK For You patient assistance program if they have no prescription drug coverage and meet income requirements.

Common Breo Ellipta Billing Errors

Breo Ellipta is a pharmacy-dispensed, patient-administered inhaler. These billing errors appear most often on Breo Ellipta claims:

• Separate retail-price line item for Breo Ellipta on an inpatient hospital bill: inhaled maintenance medications administered at home are bundled into the DRG facility payment during a hospital stay and should not appear as a separate charge at retail pharmacy rates
• Medicare billing for Breo Ellipta under Part B instead of Part D: Breo is self-administered at home and is a Part D benefit only; Part B covers only a narrow set of inhalation drugs administered in a clinical setting (such as nebulized solutions administered by a provider)
• Applying the GSK commercial savings card or manufacturer coupon to a Medicare or Medicaid claim: the commercial savings card cannot legally reduce cost-sharing for government-insured patients under the anti-kickback statute; applying it to a government claim can constitute a False Claims Act violation
• Failure to apply the 2026 Part D annual out-of-pocket cap: once a Part D enrollee has paid $2,100 in covered drug costs in a calendar year, cost-sharing drops to $0; a pharmacy continuing to collect copays after the cap is reached is billing incorrectly
• Quantity mismatch: being billed for a 60-day supply when only a 30-day inhaler was dispensed, or for two inhalers when one was filled

Frequently Asked Questions