Why Cost Matters for Breo Adherence

You know Breo Ellipta works. Once-daily dosing, the intuitive Ellipta device, strong clinical outcomes for both asthma and COPD — it's a medication that checks a lot of boxes. But when your patient gets to the pharmacy and sees a $350–$450 price tag for a single month's supply, adherence becomes a different conversation entirely.

Medication cost is one of the most significant drivers of non-adherence in respiratory care. Studies consistently show that patients who face high out-of-pocket costs are more likely to skip doses, split inhalers, or abandon treatment altogether. For a maintenance medication like Breo — where consistent daily use is critical to controlling inflammation — cost-driven non-adherence directly undermines clinical outcomes.

This guide provides a practical framework for helping your patients access Breo Ellipta at a price they can sustain, or identifying appropriate alternatives when brand-name cost is prohibitive.

What Your Patients Are Paying

Understanding the cost landscape helps you have more productive conversations:

• Cash price (no insurance): $350–$450 per 30-dose inhaler (one month supply)
• Commercial insurance: Typically Tier 3 (preferred brand) or Tier 4 (non-preferred brand). Copays range from $35–$100+ depending on plan design. Many plans require step therapy or prior authorization.
• Medicare Part D: Coverage varies significantly by plan. Patients in the coverage gap ("donut hole") may face particularly high costs.
• Medicaid: Generally covered with prior authorization, though formulary placement varies by state.
• Uninsured: Without assistance, the full cash price puts Breo out of reach for most patients.

The absence of a generic Breo Ellipta as of 2026 means there's no low-cost bioequivalent option — making savings programs and therapeutic alternatives even more important.

Manufacturer Savings Programs

GSK Savings Card (Commercially Insured Patients)

GSK offers a manufacturer copay card that can reduce the patient's out-of-pocket cost to as little as $10–$30 per month. Key details:

• Eligibility: Patients with commercial (private) insurance. Not valid for Medicare, Medicaid, Tricare, or other government-funded programs.
• Enrollment: Patients can enroll online at breoaprogram.com or by calling GSK's support line.
• How it works: The card covers the difference between the patient's copay and the program's maximum benefit, up to an annual limit.
• Your role: Consider having enrollment information available in your office or exam rooms. Staff can help patients activate the card during the visit so it's ready when they reach the pharmacy.

GSK Patient Assistance Program (Uninsured/Underinsured)

For patients who don't have insurance or can't afford their out-of-pocket costs, GSK offers free medication through the GSK Patient Assistance Program (GSK for You):

• Eligibility: Uninsured or underinsured patients at or below 300% of the federal poverty level.
• Application: Requires a prescription and documentation of income. Apply at gskforyou.com or call 1-888-825-5249.
• What's provided: Free Breo Ellipta shipped directly to the patient or your office.
• Your role: You'll need to complete and sign the prescriber portion of the application. Build this into your workflow for patients who report cost barriers — having the form available digitally speeds the process.

Coupon and Discount Cards

Third-party discount platforms can reduce costs for cash-paying patients or those whose insurance doesn't cover Breo well:

• GoodRx, SingleCare, RxSaver, and Optum Perks — These platforms negotiate discounted cash prices with pharmacies. Savings vary by pharmacy but can reduce the cash price significantly.
• BuzzRx, Inside Rx, America's Pharmacy — Additional discount card options worth checking.
• Important limitation: These discount cards are not insurance and cannot be combined with insurance copays. They're most useful for uninsured patients or when the cash price with a coupon is lower than the insurance copay.

Encourage patients to compare prices across multiple platforms, as pricing varies by pharmacy location. Tools like Medfinder can also help patients locate pharmacies with Breo in stock.

Generic Alternatives and Therapeutic Substitution

When Breo's cost is genuinely prohibitive, therapeutic alternatives offer a path to keeping your patient on effective ICS/LABA therapy:

Generic Advair (Wixela Inhub)

Fluticasone propionate/salmeterol — This authorized generic of Advair Diskus is often the most practical alternative. Key considerations:

• Significantly lower cost than brand-name Breo
• Same drug class (ICS/LABA) with strong evidence base
• Twice-daily dosing (vs. once daily for Breo) — may impact adherence
• Different dry powder inhaler device
• Available in multiple strengths for both asthma and COPD

Generic Symbicort (Budesonide/Formoterol)

Another ICS/LABA combination with a generic now available:

• MDI (metered-dose inhaler) formulation — requires different technique than Ellipta
• Twice-daily dosing
• Approved for both asthma and COPD
• Some patients may prefer the MDI format

Trelegy Ellipta (Step-Up for COPD)

For COPD patients who need more than dual therapy, Trelegy Ellipta (fluticasone furoate/umeclidinium/vilanterol) provides ICS/LAMA/LABA triple therapy in the same once-daily Ellipta device. While more expensive than Breo, it may be appropriate for patients with frequent exacerbations who are already using Breo plus a separate LAMA.

Clinical Decision Framework

When considering therapeutic substitution for cost reasons:

1. Is the patient well-controlled on Breo? If yes, switching introduces risk. Exhaust savings options first.
2. Is the patient new to ICS/LABA therapy? Starting with a generic may be the most cost-effective approach.
3. Does the patient value once-daily dosing? Some patients struggle with twice-daily regimens. For these patients, Breo's adherence advantage may justify working harder to reduce cost.
4. Does the patient have device preferences? The Ellipta is easier for many patients than MDIs or other DPIs. Device technique matters for drug delivery.

Building Cost Conversations into Your Workflow

Cost discussions shouldn't be an afterthought. Practical steps to integrate them:

At Prescribing

• Ask about insurance coverage before sending the prescription. A quick benefits check (or having your MA/nurse call the plan) can avoid pharmacy surprises.
• Check formulary status. If Breo requires step therapy or prior authorization, initiate that process immediately rather than letting it delay the patient's first fill.
• Provide savings card information at the point of prescribing. Don't assume the pharmacy will handle it.

At Follow-Up

• Ask directly: "Have you been able to fill your Breo prescription every month?" Patients often don't volunteer cost barriers.
• Check adherence data if your EHR integrates with pharmacy fill records.
• Reassess cost annually — insurance formularies change every year, and a medication that was affordable last year may not be this year.

Staff and Workflow

• Train staff to assist with savings card enrollment and PAP applications.
• Keep a reference sheet of current savings programs (savings card, PAP, discount cards) accessible to clinical staff.
• Consider adding a cost-barrier screening question to your intake forms.

For more on finding and stocking Breo for your patient panel, see our provider's guide to helping patients find Breo in stock. You can also direct patients to Medfinder for Providers for additional tools and resources.

Final Thoughts

Breo Ellipta's clinical profile — once-daily dosing, effective dual mechanism, easy-to-use device — makes it an excellent choice for many patients with asthma and COPD. But none of that matters if your patient can't afford to fill the prescription consistently.

The good news is that between GSK's savings card, their patient assistance program, third-party discount platforms, and appropriate therapeutic alternatives, most patients can find a path to affordable treatment. The key is building these conversations and processes into your clinical workflow so cost barriers are identified and addressed early — not after the patient has already stopped filling.

Your patients' lungs don't care about formulary tiers. Make sure cost isn't the reason they stop breathing easier.