How to Save Money on Copper Sulfate/Manganese Sulfate/Selenious Acid/Zinc Sulfate in 2026: Coupons, Discounts, and Patient Assistance

Trace Elements Injection: What It Costs and How to Spend Less

If you or a loved one depends on parenteral nutrition, you know that the costs add up fast. Copper Sulfate/Manganese Sulfate/Selenious Acid/Zinc Sulfate — sold as Tralement — is just one component of your daily TPN, but it's an essential one. And when supply is tight, prices can climb even higher.

In this guide, we'll break down what this medication costs in 2026, how insurance typically covers it, and every strategy we know for reducing your out-of-pocket expenses.

What Does Copper Sulfate/Manganese Sulfate/Selenious Acid/Zinc Sulfate Cost Without Insurance?

Tralement is a sterile injectable product supplied in single-dose 1 mL vials. Pricing depends on where you get it and current market conditions:

• Institutional/wholesale pricing: $5–$25 per vial through hospital pharmacies and home infusion providers with Group Purchasing Organization (GPO) contracts
• Cash pricing without insurance: $10–$50 per vial, though prices can spike during shortages
• Monthly cost estimate: Since most patients need 1 vial per day, the trace element component alone can cost $150–$1,500 per month depending on pricing — and that's just one piece of the total PN cost

The total cost of home parenteral nutrition, including amino acids, dextrose, lipids, vitamins, trace elements, IV supplies, and nursing support, can range from $10,000 to $30,000+ per month. Trace elements are a small fraction of the overall cost, but every dollar matters when you're managing a chronic condition.

How Insurance Covers Trace Elements

Copper Sulfate/Manganese Sulfate/Selenious Acid/Zinc Sulfate is typically covered under the medical benefit, not the pharmacy benefit. This is an important distinction:

Medicare Part B

Medicare Part B covers parenteral nutrition — including all additives like trace elements — for patients with permanent intestinal failure. To qualify, your condition must result in severe impairment of gut function expected to last at least 3 months. Coverage includes:

• PN solutions (amino acids, dextrose, lipids)
• Vitamins and trace element additives (including Tralement)
• IV supplies and equipment
• Home infusion pharmacy services

Patients are typically responsible for 20% coinsurance after meeting the Part B deductible ($257 in 2026). A Medicare Supplement (Medigap) plan can cover some or all of this coinsurance.

Private Insurance

Most private health plans cover home PN, including trace elements, but with key requirements:

• Prior authorization is almost always required
• Your doctor must document medical necessity for parenteral nutrition
• Some plans classify home PN under durable medical equipment (DME) benefits, which may have different copay structures
• Out-of-network home infusion pharmacies may result in higher costs — confirm your provider is in-network

Medicaid

Medicaid coverage for home PN varies by state. Most state Medicaid programs cover it, but the process for authorization and the list of approved suppliers can differ significantly. Contact your state Medicaid office or ask your home infusion pharmacy for help navigating coverage.

Coupons and Discount Cards

Traditional prescription discount cards (GoodRx, SingleCare, etc.) are designed for retail pharmacy medications and generally do not work for injectable products dispensed through home infusion pharmacies. Trace elements are specialty injectables — they aren't stocked at CVS or Walgreens, and they aren't priced through standard retail discount programs.

That said, some strategies can still help:

• Ask your home infusion pharmacy about pricing. Different pharmacies may have different GPO contracts and can offer varying prices for the same product.
• Compare home infusion providers. If you're out-of-network or paying cash, getting quotes from multiple providers can reveal significant price differences.
• Ask about compounded alternatives. 503B compounding pharmacies may offer trace element solutions at lower prices than branded Tralement, particularly for uninsured patients.

Patient Assistance Programs

American Regent, the manufacturer of Tralement, does not currently offer a traditional patient savings card or copay assistance program for this product. However, several external resources can help:

The Oley Foundation

The Oley Foundation is a nonprofit organization dedicated to supporting patients on home parenteral and enteral nutrition. They offer:

• Financial assistance referrals
• Insurance navigation help
• Peer support from other patients on home PN
• Educational resources about managing nutrition therapy costs

NeedyMeds

NeedyMeds maintains a database of patient assistance programs, including programs for injectable medications and specialty supplies. Search for trace elements or parenteral nutrition to find relevant programs.

State Pharmaceutical Assistance Programs (SPAPs)

Some states offer pharmaceutical assistance programs that can help with costs for medically necessary injectable medications. Check with your state health department or social worker.

Hospital Financial Assistance

If you receive your PN through a hospital-affiliated home infusion program, ask about the hospital's charity care or financial assistance program. Under the Affordable Care Act, nonprofit hospitals are required to have financial assistance policies for patients who qualify.

Other Ways to Save

Consolidate Your PN Supplies

Working with a single home infusion pharmacy for all your PN components — including trace elements, vitamins, lipids, and amino acids — can sometimes result in better overall pricing than sourcing components from multiple providers.

Optimize Your Insurance Benefits

• Review your plan's out-of-pocket maximum. If you're on long-term PN, you may hit your annual max early in the year, after which your plan covers 100% of costs.
• Check whether your plan offers a specialty tier with fixed copays for injectable medications.
• If you're on Medicare, look into Extra Help / Low-Income Subsidy (LIS) programs that can reduce Part D costs (though trace elements are usually Part B).

Ask About Shortage Pricing

During shortage periods, some wholesalers increase prices. If your home infusion pharmacy passes these increases along, ask whether they have access to alternative distributors or GPO contracts that may offer more stable pricing.

Final Thoughts

The cost of Copper Sulfate/Manganese Sulfate/Selenious Acid/Zinc Sulfate is just one piece of the parenteral nutrition puzzle, but it's an important one. Most patients will find that insurance covers the majority of the cost, but navigating coverage — especially prior authorizations and medical benefit vs. pharmacy benefit distinctions — takes effort.

If you're struggling with costs, don't go it alone. Reach out to the Oley Foundation, check NeedyMeds, and work with your care team to find the most cost-effective supply strategy. And use Medfinder to find the best available pricing and stock near you.

For more information, read our guides on the 2026 shortage update and alternatives if you can't find this medication.