Repatha Cost and Insurance Coverage by Plan Type

Repatha.com’s cost page provides manufacturer-sourced coverage statistics, co-pay assistance details, and out-of-pocket cost expectations stratified by insurance type. The data are drawn from MMIT coverage data (September 2025) and IQVIA claims data (January 2024–December 2024) — two standard industry data sources for pharmaceutical market access analysis.

Coverage statistics across the three major payer categories: 98% of commercial patients have coverage; approximately 89% of those pay $50 or less per fill. Medicaid coverage reaches 95% of patients, with 99% paying $10 or less. Medicare coverage stands at 84%, with 74% of covered patients paying $50 or less. The co-pay card program offers commercially insured patients costs as low as $25 per month (one-month supply) or $50 for a three-month supply — subject to enrollment in Amgen SupportPlus and ineligibility for government insurance programs.

Alternatives for government-insured patients: Medicare Part D Low Income Subsidy patients can pay $12.65 or less. Medicaid patients face nominal cost-sharing. Uninsured patients have access through the AmgenNow direct-to-patient program at $239 per month — substantially below the list price but still the highest accessible price point.

The access picture that emerges is better than the list price suggests and worse than the coverage statistics alone imply. Coverage is broad, but coverage alone does not guarantee filling — prior authorization requirements, step therapy mandates, and formulary restrictions create friction between coverage and dispensed prescription. Approximately 30% of commercial plans no longer require prior authorization for Repatha; among those that do, PCSK9 inhibitor utilization rates remain below what clinical trial risk profiles would predict.

We rate the evidence moderate. This Repatha manufacturer cost page provides reliable coverage and co-pay data for PCSK9 inhibitor access planning — though it is promotional material and represents the most favorable framing of an access landscape that remains problematic for a meaningful minority of patients.