The Cost Barrier to Corlanor Adherence

Corlanor (ivabradine) is an important component of guideline-directed medical therapy for heart failure with reduced ejection fraction (HFrEF). However, cost remains a significant barrier to adherence. When patients can't afford their medications, they skip doses, split pills inappropriately, or abandon therapy altogether — outcomes that directly increase hospitalization risk.

As a prescriber, you're uniquely positioned to help. This guide covers the current cost landscape for Corlanor and actionable strategies you can implement in your practice to help patients access and afford their medication.

What Patients Actually Pay for Corlanor

Understanding the price landscape helps frame cost conversations with patients:

• Brand-name Corlanor: $450–$600 per month (cash price for 60 tablets)
• Generic ivabradine: $80–$250 per month, varying significantly by pharmacy and discount card
• With commercial insurance: Copays typically range from $25–$75 per month for generic, $50–$150+ for brand (plan-dependent)
• Medicare Part D: Placement varies — Tier 3–4 for generic, Tier 5 for brand. Coverage gap (donut hole) can significantly increase out-of-pocket costs mid-year.

The generic-to-brand price differential is substantial, making generic ivabradine the preferred first-line approach for most patients from a cost perspective.

Manufacturer Savings Programs

Corlanor Savings Card (Amgen)

Amgen offers a copay savings card for commercially insured patients that can reduce the monthly copay to as low as $10–$25. Key details:

• Eligibility: Commercially insured patients only
• Exclusions: Not valid for Medicare, Medicaid, Tricare, VA, or other government-funded insurance
• Enrollment: Available through the Amgen website or through your office
• Duration: Typically valid for 12 months with renewal options

This is the single most impactful intervention for commercially insured patients on brand-name Corlanor. Consider keeping enrollment forms or links readily accessible in your practice.

Amgen Safety Net Foundation

For uninsured or underinsured patients who meet financial criteria:

• Eligibility: Typically household income ≤300% of the federal poverty level
• Benefit: Free Corlanor
• Application: Through amgensafetynetfoundation.com or by calling 1-888-762-6436
• Provider role: You may need to complete a prescriber section of the application

This program can be transformative for uninsured patients who would otherwise have no access to ivabradine.

Discount Cards and Coupon Programs

For patients paying cash or with high deductibles, pharmacy discount cards can significantly reduce the cost of generic ivabradine:

• GoodRx, SingleCare, RxSaver: Can reduce generic ivabradine to $40–$100 at some pharmacies
• Pharmacy-specific programs: Costco, Walmart, and other retailers may offer competitive pricing on generics
• Important note: Discount cards cannot be combined with insurance. They're most useful for uninsured patients or when the cash price with a discount beats the insurance copay.

Encourage your patients to compare prices across pharmacies — the variance for generic ivabradine can be substantial. MedFinder for Providers can help your team identify pharmacies with competitive pricing and current stock.

Generic Ivabradine: The Default Cost Strategy

Generic ivabradine has been available since 2019 and is therapeutically equivalent to brand-name Corlanor. For the vast majority of patients, generic substitution is the most straightforward cost-reduction strategy:

• Prescribe generic by default. Write prescriptions for "ivabradine" rather than "Corlanor" to allow automatic generic substitution.
• Verify formulary placement. Some insurance formularies have different tier placements for brand vs. generic. Confirm that generic ivabradine is preferred on the patient's plan.
• Monitor for switchback. Occasionally, pharmacies may dispense brand when generic is out of stock. Alert patients to check their receipts and contact the pharmacy if they're unexpectedly dispensed brand.

For information on availability challenges, see our provider-focused article on Corlanor supply issues.

Navigating Prior Authorization

Most insurance plans require prior authorization for Corlanor or ivabradine. Streamlining this process reduces delays and patient frustration:

• Common PA criteria: Documentation of LVEF ≤35%, sinus rhythm, resting HR ≥70 bpm, and trial of maximally tolerated beta-blocker (or documented contraindication)
• Have documentation ready: Recent echocardiogram, current medication list with beta-blocker dose and rationale, and heart rate documentation
• Appeal denials promptly: If the initial PA is denied, peer-to-peer review is often the most efficient path to approval
• Consider your EHR: Many EHR systems now support electronic prior authorization (ePA), which can accelerate the process

Having Cost Conversations With Patients

Cost is a clinical issue, not just an administrative one. Proactive cost conversations improve adherence:

Ask Early and Often

Many patients won't volunteer that they can't afford a medication. Consider incorporating cost screening into your workflow:

• "Before I send this prescription, let's talk about what it might cost you."
• "Are you having any trouble affording your heart failure medications?"
• "Would it help if we looked into savings programs for this medication?"

Empower Your Staff

Train medical assistants, nurses, or pharmacy liaisons to:

• Provide savings card enrollment information at the point of prescribing
• Follow up on prior authorization status
• Direct patients to patient assistance programs when appropriate

Document Cost Barriers

When patients report cost barriers, document them in the chart. This information is valuable for PA appeals, assistance program applications, and care coordination.

When Cost Is Prohibitive: Clinical Alternatives

If a patient truly cannot access or afford ivabradine despite all available programs, consider the clinical picture:

• Optimize beta-blocker therapy: Ensure the patient is on the maximum tolerated dose of a guideline-recommended beta-blocker (metoprolol succinate, carvedilol, or bisoprolol)
• Review the full HFrEF regimen: ARNI, SGLT2 inhibitor, MRA, and beta-blocker should all be optimized before adding ivabradine
• Digoxin: May provide some heart rate control, though it lacks the mortality and hospitalization benefit data of ivabradine

For a detailed discussion of alternatives, see our article on alternatives to Corlanor.

Final Thoughts

Cost should never be the reason a heart failure patient goes without guideline-directed therapy. By proactively leveraging manufacturer programs, generic substitution, discount tools, and patient assistance, you can help most patients access ivabradine at an affordable price.

For help locating pharmacies with current Corlanor or generic ivabradine stock — and connecting patients with the lowest available pricing — visit MedFinder for Providers.