Repatha is the brand name for evolocumab, a PCSK9 inhibitor made by Amgen and delivered by self-injection. The FDA approved Repatha in 2015 as an adjunct to diet and maximally tolerated statin therapy for adults with heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease who need additional LDL cholesterol lowering, and separately for homozygous familial hypercholesterolemia. Patients typically self-inject 140 mg every two weeks using the SureClick prefilled pen or 420 mg once monthly using the Pushtronex on-body infusor, according to the FDA-approved label. Cardiologists usually prescribe Repatha only after a patient has tried and failed, or cannot tolerate, generic statin therapy, since most insurers treat PCSK9 inhibitors as a second-line, higher-cost option behind cheaper first-line cholesterol drugs.
Amgen's 2026 cash retail price for Repatha runs $620 to $720 per month depending on the pharmacy and the device used. What a patient actually pays depends heavily on insurance status, formulary tier placement, and whether the patient qualifies for a manufacturer discount. Cash-pay shoppers who compare pharmacies can cut that price by more than half: Amgen's AmgenNow direct-pay program and GoodRx coupons bring the price to about $239 per month at Costco, CVS, Kroger, and several other national chains. This guide breaks down the real 2026 prices by point of pay, the Amgen Safety Net Foundation eligibility rules, and how Repatha compares to other cholesterol-lowering biologics like Praluent and Leqvio.
Cardiovascular drug pricing changed substantially for other brand-name medications after the Inflation Reduction Act's Medicare price negotiation program took effect, but Repatha was not selected for either the 2026 Round 1 group (which included Eliquis, Jardiance, and Xarelto) or the 2027 Round 2 group (which included Ozempic and Trelegy Ellipta). That means Medicare beneficiaries taking Repatha still pay standard Part D cost-sharing rather than a negotiated Maximum Fair Price. Patients managing high LDL cholesterol should also check whether their prescriber has explored generic statins first, since most payers require documented statin intolerance or an inadequate statin response before approving a PCSK9 inhibitor.
What Repatha Costs by Point of Pay (2026)
The price you pay depends almost entirely on WHERE you pay. The same repatha can cost many times more at a hospital than at your local pharmacy:
2026 Repatha Price by Point of Pay| Where you pay | Typical cost | Notes |
|---|
| Pharmacy counter (retail, cash) | $620 - $720/month | List price without insurance or manufacturer discount |
| AmgenNow / GoodRx cash-pay discount | About $239/month | Available to any cash-paying patient regardless of insurance status |
| Medicare Part D (2026) | $0 - $50/month for about 84% of prescriptions, capped at $2,100/year | Formulary tier and prior authorization dependent |
| Commercial insurance with Repatha Co-Pay Card | As low as $5/fill, capped near $25 (1-month) or $50 (3-month) | Commercial insurance only; not valid for government insurance |
| Medicaid | $1 - $8/prescription for about 99% of claims, with PA | Covered with prior authorization; nominal copay varies by state |
Retail prices reflect 2026 GoodRx and drug-pricing survey data. Part D and commercial figures depend on your plan's formulary tier and prior authorization outcome.
Source: CMS Part D 2026 benefit design, Amgen Repatha cost page, GoodRx, drugs.com price guide
Why Hospitals Charge So Much
Repatha is almost never administered in a hospital setting because it is a self-injected, outpatient prescription biologic given every two weeks or once monthly. When it does appear on a hospital or infusion-center bill, usually because a patient's supply was interrupted during an admission or the patient's own pen was administered by nursing staff, the charge can run several times the retail cash price. Facilities routinely add pharmacy handling fees, nursing administration charges, and general overhead on top of the drug's acquisition cost, and those add-on charges are rarely itemized clearly on a standard hospital bill.
Amgen's 2026 wholesale acquisition cost for a monthly Repatha supply is close to $580. If an inpatient itemized bill shows Repatha charged at $1,800 or more, ask the billing department for the National Drug Code and the line-item unit cost, since that number should match the SureClick or Pushtronex device actually dispensed. Most commercial insurance and Medicare only reimburse the outpatient pharmacy benefit rate for Repatha, so an inpatient markup above that figure is a common and reasonable dispute target under most state hospital price transparency rules, and CMS's hospital price transparency requirements mean the facility's negotiated rate for the drug should already be posted online for comparison.
Patient Assistance Programs
Amgen, the manufacturer of Repatha, runs three separate programs that can substantially lower cost depending on your insurance status, including a manufacturer coupon for commercially insured patients and a free-drug foundation program for the uninsured. Uninsured and underinsured patients qualify for a higher income ceiling than most manufacturer patient assistance programs, since Repatha's foundation program uses 500% of the federal poverty level rather than the more common 400% threshold.
Patient assistance programs for Repatha| Manufacturer program | Cost / Benefit | How to apply |
|---|
| Repatha Co-Pay Card | As little as $5 out of pocket per fill for commercially insured patients, target cost near $25 for a 1-month supply or $50 for a 3-month supply | repatha.com/enrollment |
| Amgen Safety Net Foundation | Free Repatha for uninsured or underinsured patients with household income at or below 500% of the federal poverty level | amgensafetynetfoundation.com |
| AmgenNow Direct-Pay Program | About $239/month cash price for any patient, insured or uninsured, who pays out of pocket | amgennow.com |
| NeedyMeds Drug Discount Card | Variable discount accepted at most US pharmacies as a backup option | needymeds.org |
The Repatha Co-Pay Card cannot be used by anyone whose prescription is paid for in whole or in part by Medicare, Medicaid, TRICARE, or VA, because federal anti-kickback law (42 U.S.C. Section 1320a-7b) bars manufacturer copay cards from government-insured beneficiaries. Medicare and Medicaid patients should apply for the Amgen Safety Net Foundation program instead, or ask their Part D plan about the Medicare Prescription Payment Plan to spread out-of-pocket costs across the year.
Source: repatha.com, amgensafetynetfoundation.com, amgennow.com, NeedyMeds.org
Medicare Part D
Medicare Part D plans generally place Repatha on a specialty formulary tier and require prior authorization confirming a diagnosis of atherosclerotic cardiovascular disease or familial hypercholesterolemia along with documented statin intolerance or an inadequate LDL response to maximally tolerated statin therapy. Amgen reports that about 84% of Medicare Part D prescriptions for Repatha cost patients $50 or less per month once approved, though your specific copay depends on your plan's formulary placement and where you are in the benefit year. Beneficiaries whose plan denies the first PA request should not assume the denial is final; most denials are reversible once a prescriber's office resubmits with lipid panel history attached.
For 2026, total annual out-of-pocket spending for all Part D drugs combined, including Repatha, is capped at $2,100 under the Inflation Reduction Act. Once a beneficiary reaches that cap in a calendar year, Part D covers the remaining cost for the rest of the year at $0 out of pocket. That cap replaced the old catastrophic-coverage coinsurance phase and applies regardless of how many Part D drugs a patient is taking, so a beneficiary on Repatha plus a statin plus a blood pressure medication only has to track one combined annual total, not a separate cap per drug.
The Medicare Prescription Payment Plan, available since 2025, lets beneficiaries spread their Part D out-of-pocket costs evenly across the calendar year instead of paying a large amount in the month Repatha therapy starts. Patients whose plan initially denies Repatha should ask their prescriber's office to submit supporting lab values (LDL-C level, lipid panel history) and a formal step-therapy override request rather than paying cash while the appeal is pending.
Common Repatha Billing Errors
If you got a bill for Repatha above $100 with commercial insurance, or above $50/month on Medicare Part D, check for these issues before paying:
- Prior authorization not submitted or denied without appeal: nearly all plans require documented statin intolerance or inadequate LDL response before approving Repatha. If your prescriber's office did not submit the PA paperwork, you may be paying cash unnecessarily.
- Repatha Co-Pay Card not applied at the pharmacy counter even though you have commercial insurance. Ask the pharmacist to rerun the claim with the savings card BIN and PCN before you pay full price.
- SureClick two-pen pack billed as two separate fills, doubling your copay for a single month's supply. One two-pen carton equals one month of therapy and should be billed as one fill.
- Charged standard cost-sharing after you already reached the $2,100 Part D annual out-of-pocket cap for the year.
- In-office administration billed under a nonspecific, not-otherwise-classified code (J3490 or J3590) instead of matching the correct National Drug Code for Repatha, which can trigger a claim denial or a manual pricing review.
- Inpatient hospital charge for a Repatha dose marked up to several thousand dollars when the outpatient cash price is around $620 to $720 per month.
Frequently Asked Questions
Is there a generic or biosimilar for Repatha?
No. No generic or biosimilar evolocumab is approved in the United States as of 2026. Amgen's core composition-of-matter patent on Repatha is expected to expire around 2029, with additional formulation and method-of-use patents extending toward 2033, and biosimilar applications are not expected to reach the FDA before roughly 2029 to 2031. Praluent (alirocumab) and Leqvio (inclisiran) are competing brand-name cholesterol-lowering biologics with different mechanisms and different dosing schedules, but neither is a generic or biosimilar version of Repatha.
How do I apply for the Amgen Safety Net Foundation patient assistance program?
Call 1-800-932-3060 or visit asnfapply.com to start the pre-screen. Download the patient application from amgensafetynetfoundation.com, have your prescriber complete the prescription section, and gather proof of income and US residency. Submit the completed packet by fax to 1-833-959-1409 or online. Processing takes about 5 to 7 business days, and eligible patients receive Repatha free with household income at or below 500% of the federal poverty level.
Can I use the Repatha Co-Pay Card with Medicare?
No. Federal anti-kickback law bars manufacturer copay cards from being used by anyone with Medicare, Medicaid, TRICARE, or VA coverage. The Repatha Co-Pay Card is for commercially insured patients only and can bring the copay down to about $5 per fill. Medicare beneficiaries should apply for the Amgen Safety Net Foundation instead, which has no insurance-type restriction beyond the 500% federal poverty level income limit for uninsured or underinsured patients.
What if my insurance denies coverage for Repatha?
Request the written denial reason, then file a formal appeal with your prescriber's lab documentation (LDL-C levels, statin trial history) attached. If denied again, ask for a peer-to-peer review with the plan's medical director, and escalate to your state Department of Insurance or a Medicare independent review entity if needed. While the appeal is pending, the Amgen Safety Net Foundation can supply Repatha free if you meet the 500% federal poverty level income limit.
Does the IRA negotiated Maximum Fair Price apply to Repatha?
No. Repatha was not selected for Round 1 of Medicare drug price negotiation (effective January 1, 2026, covering Eliquis, Jardiance, Xarelto, and seven other drugs) or Round 2 (effective January 1, 2027, covering Ozempic, Trelegy Ellipta, and 13 other drugs). There is no Inflation Reduction Act Maximum Fair Price for Repatha in 2026. Medicare Part D beneficiaries pay standard cost-sharing under the $2,100 annual out-of-pocket cap instead.
What does Repatha cost without insurance at the pharmacy counter?
In 2026, Repatha's cash retail price without any discount runs $620 to $720 per month, with Walmart around $687 and Walgreens around $702 for the standard cash price. Amgen's AmgenNow direct-pay program and GoodRx coupons drop that to about $239 per month at most major chains, including Costco, CVS, and Kroger pharmacies. That $239 cash price is available to any patient who pays out of pocket, whether or not they have insurance, and does not require an income application or approval wait time.
Do I qualify for the Amgen Safety Net Foundation?
You likely qualify if you are uninsured or your insurance does not cover Repatha (or the copay is unaffordable), you are a US resident, and your household income is at or below 500% of the federal poverty level, which is $79,800 for a household of one or $165,000 for a household of four in 2026. You will also need a valid Repatha prescription with a documented diagnosis from your prescriber.
Is Repatha the same as Praluent or Leqvio?
No. Repatha (evolocumab, Amgen), Praluent (alirocumab, Regeneron and Sanofi), and Leqvio (inclisiran, Novartis) all lower LDL cholesterol but are different molecules with different dosing schedules and different manufacturer assistance programs. Repatha and Praluent are both monoclonal antibody PCSK9 inhibitors injected every two weeks or monthly; Leqvio is a small interfering RNA (siRNA) drug injected only twice a year. Your prescriber and insurer will typically require documentation of prior statin therapy before covering any of the three.
