How to Help Your Patients Save Money on Entresto (Sacubitril/Valsartan): A Provider's Guide to Savings Programs

Cost-related non-adherence is a real and underreported problem in heart failure care. Entresto's brand-name list price of $600–$700 per month without insurance is a significant barrier for many patients — and even with coverage, copays can run $100–$400 per month without supplemental support. As a prescriber, knowing the available cost-reduction tools is as important as knowing the drug's pharmacology. This guide provides a complete 2026 reference.

The Cost Landscape for Sacubitril/Valsartan in 2026

Before recommending savings strategies, know the baseline costs your patients face:

Brand-name Entresto (no insurance): ~$600–$700 per 30-day supply

Generic sacubitril/valsartan (no insurance): ~$45–$255 per 30-day supply depending on pharmacy and discount card

Generic with GoodRx/SingleCare: As low as ~$45–$52 at CVS

Medicare Part D (IRA negotiated): ~$295 per 30-day supply effective 2026

Commercial insurance with copay card: As low as $10 per 30-, 60-, or 90-day supply

Strategy 1: Switch to Generic Sacubitril/Valsartan (Highest Impact)

For most patients — particularly those who are uninsured, underinsured, or on high-deductible plans — switching to generic sacubitril/valsartan is the highest-impact cost-reduction measure available. The FDA-approved generic is bioequivalent to brand-name Entresto in all three strengths. Prescribe with DAW-0 (dispense as written = off) to allow any generic manufacturer's product.

With a GoodRx or SingleCare discount card, a 30-day supply of generic sacubitril/valsartan can cost as little as $45–$50 at large chain pharmacies. This is more than 90% cheaper than the brand-name list price. Counsel patients that the generic contains the same active ingredients and will work identically.

Strategy 2: Novartis Entresto Copay Savings Card (Commercially Insured)

For patients with commercial (private) insurance who are on brand-name Entresto, the Novartis copay savings program is the most powerful tool available. Key facts:

Reduces out-of-pocket cost to as little as $10 per 30-, 60-, or 90-day supply

Combined annual program limit of $4,100 (Co-pay Offer + Payment Card + Rebate)

NOT valid for Medicare, Medicaid, TRICARE, VA, DoD, or other government programs

Patients enroll at entresto.com/financial-support

Once the $4,100 cap is reached, patients are responsible for remaining costs — advise patients to track their spending

Strategy 3: Medicare Part D Patients — Know the 2026 Changes

Two major legislative changes make 2026 significantly more favorable for Medicare patients on Entresto:

IRA Price Negotiation: Entresto was selected in the first cycle of Medicare Drug Price Negotiation. The negotiated maximum fair price is approximately $295 per 30-day supply for Part D beneficiaries starting in 2026. This represents a significant reduction from the list price.

$2,000 Annual OOP Cap: Starting in 2025, Medicare Part D caps annual out-of-pocket drug spending at $2,000. For patients on multiple medications including Entresto, this cap provides meaningful financial protection.

Note: Novartis's manufacturer copay card is not valid for Medicare patients. Point Medicare patients to the Extra Help (Low Income Subsidy) program if they are low-income.

Strategy 4: Patient Access Network (PAN) Foundation

The PAN Foundation's Heart Failure disease fund offers grants of up to $1,200 initially and up to $2,400 total per year to help cover out-of-pocket costs. Eligibility requirements include income thresholds and insurance status. Funding availability fluctuates throughout the year — advise patients to check the PAN Foundation website (panfoundation.org) regularly and apply when the fund is open.

Strategy 5: Novartis Patient Assistance Program (Uninsured/Underinsured)

For patients who are completely uninsured or significantly underinsured and meet income-based eligibility criteria, Novartis's Patient Assistance Program (accessed through RxAssist.org or directly through Novartis) may provide Entresto at no cost. This is an underutilized resource for your most financially vulnerable heart failure patients.

Strategy 6: Formulary Exception Requests

If a patient's insurance plan places Entresto on a non-preferred tier with high cost-sharing, a formulary exception request may move it to a preferred tier. To support this request, submit: LVEF documentation, NYHA class, prior therapy history, and a letter of medical necessity. Some plans will grant exceptions when equivalent alternatives are not clinically appropriate.

Strategy 7: 90-Day Fills and Mail Order

For stable patients at target dose, prescribing a 90-day supply through mail-order pharmacy often reduces per-tablet cost and eliminates co-pay per fill. Many insurance plans offer additional savings for mail order versus retail. This also reduces refill burden and risk of medication gaps.

Additional Provider Resources

For help getting patients access to Entresto when their pharmacy is out of stock, visit medfinder for providers and our complete provider guide to helping patients find Entresto in stock.