What Does Linzess Cost in 2026 and What Changes in 2027?

Linzess (linaclotide) is an oral prescription capsule used to treat irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) in adults. It works as a guanylate cyclase-C agonist, acting locally in the intestinal lining to increase fluid secretion and accelerate bowel transit. There is no generic available as of mid-2026.

At list price, a 30-day supply of Linzess costs $680 to $730 depending on dosage (72 mcg, 145 mcg, or 290 mcg). The drug is a Part D prescription drug, not a Part B infused or injected drug, so it has no Medicare ASP rate and no J-code. Patients fill it at a retail pharmacy. On January 1, 2027, the Medicare negotiated price drops to $136 per 30-day supply under the Inflation Reduction Act Round 2 program. If you check Medicare eligibility and qualify for Part D, that price change matters starting next year.

Most people with commercial insurance pay a $30 to $50 monthly copay with the AbbVie savings card. Uninsured patients or those on Medicare with limited income can apply for AbbVie's patient assistance program for free or low-cost medication. Patients with very low income should also check Medicaid income limits to see if they qualify for near-zero copays through their state Medicaid program.

What Linzess Costs by Point of Pay (2026)

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

Why Hospitals Charge So Much

Linzess is dispensed by retail and mail-order pharmacies, not typically administered in a hospital setting. However, patients who are hospitalized for bowel obstruction, severe IBS-C flares, or surgical preparation may receive linaclotide on their inpatient medication list. When that happens, the hospital bills the drug at its facility rate, which adds a markup for pharmacy overhead, nursing time, and administrative costs.

During a hospital stay, a 30-day-equivalent course of Linzess that retails at $680 to $730 may be billed at $900 to $1,400 or more on the itemized hospital bill. This reflects the standard facility markup pattern documented across US hospital price transparency data. Patients who receive Linzess as part of an inpatient stay should request an itemized bill and compare the drug line item to the retail list price. If you believe a charge is unreasonable, use the Medical Bill Analyzer to flag it.

Because Linzess is an oral drug dispensed in capsule form, it does not have a HCPCS J-code (those codes apply to injectable or infused drugs billed in a clinical setting). On a hospital or outpatient facility bill, Linzess may appear under a revenue code or pharmacy charge line rather than a J-code line. If you see a charge labeled 'linaclotide' or 'guanylate cyclase agonist' on your bill, that is this drug.

Patient Assistance Programs

AbbVie (which markets Linzess in the US alongside Ironwood Pharmaceuticals) offers two main programs to reduce or eliminate out-of-pocket costs for eligible patients:

Medicare Part D

Linzess is covered under Medicare Part D as a prescription drug filled at a retail pharmacy. Most Part D plans place it on Tier 3 (preferred brand), with varying plan copays and deductibles. In 2026, the annual out-of-pocket maximum for Medicare Part D is $2,100, which means no Part D enrollee pays more than $2,100 per year across all covered prescriptions. For a drug costing $680 to $730 per month at list price, most Medicare enrollees will hit that cap within a few months.

Starting January 1, 2027, Medicare Part D enrollees filling Linzess at participating pharmacies will pay no more than $136 per 30-day supply under the IRA Round 2 negotiated Maximum Fair Price. This is an 81% reduction from the 2026 list price. The negotiated price was announced by CMS and confirmed by Ironwood Pharmaceuticals. Medicare enrollees do not need to do anything to receive this lower price once it takes effect.

Common Linzess Billing Errors

Linzess is an oral capsule dispensed at retail pharmacies, but billing errors still occur, especially for patients who received it during a hospitalization or in a clinical trial setting:

• Billed at inpatient facility rate (10x to 20x retail price) when the patient was actually filling a prescription outpatient
• Charged for the wrong dosage strength (290 mcg billed when 145 mcg was prescribed, doubling the charge)
• Duplicate billing: the same 30-day supply appears twice on the same claim (common when a hospital discharge prescription overlaps with an inpatient medication record)
• Savings card benefit not applied: pharmacist failed to run the AbbVie savings card, leaving the patient billed at full list price instead of $30 per month
• Prior authorization denial billed to patient without appeal: Part D plan denied PA, but patient has right to appeal to the plan or request an exception

Frequently Asked Questions