How to Help Your Patients Save Money on Qbrelis

Qbrelis (Lisinopril oral solution, 1 mg/mL) fills a critical therapeutic niche — it is the only FDA-approved, ready-to-use oral Lisinopril solution on the market. For patients who cannot swallow tablets, including pediatric populations and those with dysphagia, Qbrelis is often the most appropriate formulation.

However, with a cash price of approximately $690–$800 per 150 mL bottle, cost is a significant barrier for many patients. As a prescribing provider, you play an essential role in helping patients navigate savings options and maintain adherence to therapy.

This guide outlines actionable strategies to reduce your patients' out-of-pocket costs for Qbrelis.

Understanding the Cost Landscape

The cost disparity between Qbrelis and generic Lisinopril tablets is substantial:

There is currently no generic Lisinopril oral solution available. This means Qbrelis remains the sole commercially available option for patients requiring a liquid ACE inhibitor formulation — contributing to both its elevated price point and formulary challenges.

For a clinical overview, see What Is Qbrelis? Uses, Dosage, and What You Need to Know.

Strategy 1: Manufacturer Copay Assistance

Azurity Pharmaceuticals, the manufacturer of Qbrelis, offers a copay assistance program for eligible commercially insured patients. Key details:

• Eligible patients may pay as little as $0 copay
• Available through qbrelis.com
• Typically limited to patients with commercial (private) insurance
• Patients with government insurance (Medicare, Medicaid, Tricare) are generally not eligible

Provider action: Proactively inform patients about this program at the point of prescribing. Your staff can help patients enroll or direct them to qbrelis.com for the copay card.

Strategy 2: Prior Authorization Support

Many commercial and managed care plans require prior authorization or step therapy before covering Qbrelis. Common requirements include:

• Documentation that the patient cannot swallow tablets
• Evidence that generic Lisinopril tablets have been tried or are not appropriate
• Clinical rationale for the liquid formulation (e.g., pediatric dosing, dysphagia, tube feeding)

Provider action: Anticipate the prior authorization requirement and prepare documentation proactively. Include specific clinical details in your request:

• Patient's inability to swallow solid oral dosage forms
• Need for precise weight-based dosing (pediatric patients)
• Medical conditions contributing to swallowing difficulty
• Why compounding is not a suitable alternative (e.g., stability concerns, dosing accuracy)

A well-documented first submission reduces delays and denials. For insights into what patients experience, see Why Is Qbrelis So Hard to Find?

Strategy 3: Patient Assistance Programs (PAPs)

For uninsured or underinsured patients who do not qualify for manufacturer copay cards, patient assistance programs may provide Qbrelis at reduced or no cost:

• NeedyMeds (needymeds.org) — Comprehensive database of assistance programs searchable by drug name
• RxAssist (rxassist.org) — Directory of pharmaceutical company PAPs and state programs
• State pharmaceutical assistance programs — Many states offer supplemental drug coverage for residents who meet income criteria

Provider action: Assign a staff member or social worker to screen patients for PAP eligibility and assist with applications. Many programs require a prescriber signature on the application.

Strategy 4: Explore Formulary Alternatives When Appropriate

In cases where Qbrelis cost is prohibitive and assistance programs are insufficient, consider clinically appropriate alternatives:

• Compounded Lisinopril oral suspension: Some compounding pharmacies can prepare a Lisinopril suspension. However, note that compounded products lack the standardized stability and bioequivalence data of Qbrelis.
• Epaned (Enalapril oral solution): Another FDA-approved ACE inhibitor oral solution that may be covered by the patient's plan.
• Crushed Lisinopril tablets: For some patients, crushing generic Lisinopril tablets and mixing with a small amount of water may be acceptable — consult with your pharmacist regarding stability.
• Captopril oral solution: Captopril can be compounded into a liquid formulation and may be less expensive.

For a detailed comparison of options, see Alternatives to Qbrelis.

Provider action: Document the clinical rationale for your chosen formulation. If switching from Qbrelis to an alternative, ensure appropriate dose conversion and follow-up.

Strategy 5: Leverage Pharmacy Tools

Help your patients locate pharmacies that stock Qbrelis and offer competitive pricing:

• MedFinder: medfinder.com/providers enables providers and patients to identify pharmacies with Qbrelis in stock. This eliminates the time-consuming process of calling multiple pharmacies.
• Specialty pharmacies: Specialty and mail-order pharmacies often have better access to Qbrelis than retail chains and may offer competitive pricing or work directly with insurance for coverage.

For guidance you can share with patients, see How to Check If a Pharmacy Has Qbrelis in Stock and How to Find Qbrelis in Stock Near You.

Strategy 6: Coupon and Discount Card Programs

Third-party prescription discount programs can sometimes reduce the cash price of Qbrelis for uninsured patients or those with high-deductible plans. Options include:

• GoodRx
• SingleCare
• RxSaver
• Optum Perks

While the discounts on specialty medications like Qbrelis may be modest compared to generics, they are worth checking — particularly for patients paying entirely out of pocket.

For patient-facing savings guidance, refer patients to How to Save Money on Qbrelis.

Strategy 7: Ongoing Monitoring and Adherence

Cost-related non-adherence is a significant concern with high-cost medications. Proactive steps include:

• Ask about cost at every visit: Patients may not volunteer that they're struggling to afford Qbrelis.
• Monitor refill patterns: Gaps in refills may indicate cost barriers.
• Re-evaluate necessity: Periodically assess whether the patient still requires a liquid formulation or could transition to tablets.
• Check for supply issues: Qbrelis has experienced intermittent supply disruptions. Stay informed via our Qbrelis shortage update and the provider-focused shortage guide for prescribers.

Clinical Reminders

While addressing cost, do not overlook clinical considerations:

• Drug interactions: Review current medications for interactions with Qbrelis, particularly NSAIDs, potassium-sparing diuretics, Aliskiren, and Entresto. See Qbrelis Drug Interactions.
• Side effect management: Educate patients about common side effects (dry cough, dizziness) and serious adverse events (angioedema, hyperkalemia). See Qbrelis Side Effects.
• Pregnancy contraindication: Qbrelis carries a boxed warning for fetal toxicity. Verify pregnancy status in women of childbearing age.
• Mechanism of action: For patient education resources, direct patients to How Does Qbrelis Work?

Provider Resources at a Glance

For guidance on helping patients locate Qbrelis, see our companion provider guide: How to Help Your Patients Find Qbrelis in Stock.

Summary

Qbrelis is an essential medication for patients who require a liquid ACE inhibitor, but its cost can be a major barrier. By proactively leveraging manufacturer copay cards, patient assistance programs, prior authorization support, and pharmacy tools like MedFinder, you can help your patients access and afford their medication.

The most effective approach combines multiple strategies: enroll eligible patients in copay programs, prepare strong prior authorization documentation, and use MedFinder to identify stocking pharmacies. When Qbrelis is not accessible, have a clear plan for clinically appropriate alternatives.

Your advocacy at the point of prescribing makes a meaningful difference in patient access and adherence.