The Cost Problem: Why Patients Struggle to Afford Trelegy

As a prescriber, you've likely seen the frustration firsthand. You prescribe Trelegy Ellipta — the right medication for your patient's COPD or asthma — only for them to call back saying they can't afford it. At $580–$700 per inhaler without insurance and no generic available, Trelegy Ellipta represents a significant financial burden for many patients.

Cost-related non-adherence is a real clinical problem. Patients who can't afford their maintenance inhaler skip doses, stretch supplies, or abandon treatment altogether — leading to exacerbations, emergency visits, and worse outcomes. As providers, we can make a meaningful difference by proactively connecting patients with savings resources.

This guide covers every major pathway to help your patients afford Trelegy Ellipta in 2026. For a complementary resource on locating Trelegy when stock is limited, see our provider's guide to finding Trelegy in stock.

1. GSK Trelegy Ellipta Savings Card

The manufacturer savings card is often the fastest and most impactful option for commercially insured patients.

Key Details

• Eligible patients may pay as little as $0 per month
• Available to patients with commercial (private) insurance
• Maximum savings limits apply per fill and per year
• Can be used at most retail pharmacies
• Patients can enroll at the GSK website or through their pharmacy

Who Does NOT Qualify

• Patients with government insurance: Medicare, Medicaid, Tricare, VA benefits
• Patients enrolled in state pharmaceutical assistance programs
• Cash-paying patients without insurance (a different program exists for them — see below)

Provider Action Steps

1. Mention the savings card at the time of prescribing — don't assume the pharmacy will do it
2. Have your staff help patients enroll during the visit or provide the enrollment URL
3. Consider keeping printed savings card information in exam rooms or at checkout
4. Note in the chart that the savings card was discussed to track adherence barriers

2. GSK Patient Assistance Program (GSK For You)

For uninsured or underinsured patients who meet income requirements, GSK offers Trelegy at no cost through their patient assistance program.

Eligibility Criteria

• US residents
• Uninsured or underinsured (insurance doesn't cover Trelegy or copay is unaffordable)
• Household income typically up to 300% of the federal poverty level
• Not eligible for or enrolled in government insurance programs that could cover the medication

How It Works

1. Patient or provider completes an application (available on the GSK For You website)
2. Requires proof of income and a valid prescription
3. If approved, medication is shipped directly to the patient or the provider's office
4. Approval typically covers a set period (often 12 months) with renewal required

Provider Action Steps

1. Screen patients for eligibility during the initial visit — especially those who express concern about cost
2. Assign a staff member to assist with applications (the paperwork can be a barrier for patients)
3. Set calendar reminders for renewal dates so patients don't experience gaps in coverage
4. Consider having the medication shipped to your office for patients with unstable housing

3. Discount Cards and Coupon Platforms

For patients paying cash or with high-deductible plans, third-party discount platforms can provide meaningful savings:

• GoodRx — Often shows significant discounts at local pharmacies
• SingleCare — Accepted at most major chains
• RxSaver — Compares prices across nearby pharmacies
• Optum Perks — Free discount card program

These platforms are free to use and can be combined with some insurance plans (though not with the GSK savings card or government insurance). Patients should compare prices across platforms, as discounts vary by pharmacy and location.

For a comprehensive list of discount options, see our patient-facing guide on saving money on Trelegy.

4. Formulary and Prior Authorization Strategies

One of the most impactful things you can do as a provider is ensure Trelegy gets covered by your patient's insurance in the first place.

Prior Authorization Best Practices

• Document step therapy thoroughly — Most plans require trial and failure of dual-combination inhalers (ICS/LABA or LAMA/LABA) before approving Trelegy. Ensure your chart documentation clearly shows what was tried, for how long, and why it was insufficient.
• Use clinical language the payer expects — Reference specific exacerbation frequency, FEV1 values, symptom scores (CAT or mMRC), and objective measures of inadequate control.
• Submit complete documentation upfront — Incomplete submissions are the #1 cause of delays and denials. Include diagnosis, medication history, test results, and clinical rationale in the initial request.
• Know the plan's preferred alternatives — If a plan prefers Breztri Aerosphere over Trelegy, understanding this lets you either prescribe accordingly or build a stronger case for why Trelegy is specifically needed.

Appeal Denials

If a prior authorization is denied:

1. Review the denial reason carefully
2. Provide additional documentation addressing the specific reason for denial
3. Consider a peer-to-peer review with the insurance company's medical director
4. File a formal appeal with supporting clinical evidence
5. Many denials are overturned on appeal — don't give up after the first denial

5. Patient Assistance Databases

Beyond GSK's own program, several independent organizations help patients find financial assistance:

• NeedyMeds (needymeds.org) — Comprehensive database of patient assistance programs, discount cards, and financial aid
• RxAssist (rxassist.org) — Searchable database of pharmaceutical assistance programs
• RxHope (rxhope.com) — Connects patients with manufacturer programs
• Partnership for Prescription Assistance — Helps uninsured and underinsured patients find programs

Consider bookmarking these resources and sharing them with your case managers or social workers.

6. Medicare-Specific Strategies

Medicare patients present unique challenges because they're excluded from manufacturer savings cards. Options include:

• Extra Help / Low-Income Subsidy (LIS) — Medicare patients with limited income and resources may qualify for Extra Help, which significantly reduces Part D costs including copays.
• Medicare Part D plan optimization — During open enrollment, help patients (or refer them to SHIP counselors) to compare Part D plans and choose one with favorable Trelegy coverage and lower copays.
• State Pharmaceutical Assistance Programs (SPAPs) — Many states offer additional prescription drug assistance for Medicare beneficiaries.
• Foundation grants — Organizations like the Patient Access Network Foundation and HealthWell Foundation sometimes offer copay assistance for COPD medications. Availability varies and funds can run out.

7. Therapeutic Alternatives When Cost Is Prohibitive

When all savings options are exhausted and cost remains a barrier, consider therapeutic alternatives that may be more affordable:

• Breztri Aerosphere — Another triple-combination inhaler that may be preferred on some formularies
• Separate dual-therapy approach — Breo Ellipta (ICS/LABA) + Incruse Ellipta (LAMA) may sometimes be cheaper depending on formulary placement
• Symbicort + Spiriva — A dual-inhaler approach using medications that may have generics or better formulary positioning

For a full comparison, see our article on alternatives to Trelegy. Note that switching to a multi-inhaler regimen may reduce adherence, so weigh this carefully.

Building a System: Making Cost Conversations Routine

The most effective practices build cost screening into their workflow:

• Ask about cost concerns at every visit — Patients often don't volunteer this information
• Train front desk and MA staff to identify patients who may need assistance and initiate the conversation
• Create a "savings resources" handout for Trelegy that includes the GSK savings card, PAP application, and discount card websites
• Track prior authorization outcomes to identify patterns with specific payers and improve future submissions
• Partner with pharmacy staff — Pharmacists can often suggest alternatives, apply discount cards, or facilitate manufacturer programs

Additional Provider Resources

Visit MedFinder for Providers for tools designed to help you manage medication access challenges for your patients. Whether it's locating stock, navigating prior authorizations, or connecting patients with savings programs, MedFinder can streamline the process.

Also see our companion guides for providers:

• How to Help Your Patients Find Trelegy in Stock
• Trelegy Shortage: What Providers Need to Know in 2026

The Bottom Line

Trelegy Ellipta is an effective but expensive medication, and cost is one of the biggest barriers to adherence. By proactively connecting patients with manufacturer savings cards, patient assistance programs, discount platforms, and optimizing insurance coverage, you can help ensure your patients actually fill and continue their prescribed treatment.

The few minutes spent discussing cost and connecting patients with resources can prevent exacerbations, reduce emergency visits, and improve the long-term outcomes of your COPD and asthma patients.