How to Help Your Patients Save Money on Glutamine (Endari): A Provider's Guide to Savings Programs

Glutamine (Endari) has an average retail price of over $3,200 per 30-day supply. For the sickle cell disease (SCD) patient population — which is disproportionately affected by socioeconomic disparities and barriers to healthcare access — this cost is a serious barrier to treatment adherence.

As a provider, understanding and proactively connecting patients to savings programs is as important as writing the prescription itself. This guide covers every available savings mechanism for Glutamine, organized by insurance type, with specific steps your team can take to help each patient.

Why Cost Is a Critical Barrier — The Data

A 10-month observational study at Montefiore Medical Center found that 33% of patients prescribed L-glutamine never filled the prescription, and 43% discontinued treatment before the study period ended. Insurance-related barriers — including cost — were among the top reasons cited. Only 21% were actively taking the medication at follow-up.

This is not a minor adherence issue — it's a treatment access crisis. For a medication that reduces hospitalizations by 33% in clinical trials, every patient who can't afford to fill their prescription is at preventable risk of a pain crisis and hospitalization.

Program 1: Emmaus Commercial Copay Assistance Program

For your commercially insured patients, this is the first program to discuss. Emmaus Medical offers a copay assistance program that dramatically reduces out-of-pocket costs.

Patient responsibility: As little as $10 per monthly prescription (the first $10 of copay)

Who qualifies: Commercially or privately insured patients; must be U.S. residents; must be 18+ to enroll for themselves or a minor; NOT available to patients on Medicare, Medicaid, or other federally funded programs

How to enroll: Visit endarirx.com/copay-assistance, call 855-723-5646, or complete the application at a participating specialty pharmacy

Your care coordinator or nurse navigator can help patients complete the application at the time of the visit or prior to their first fill.

Program 2: Endari Support Program (Uninsured / Underinsured Patients)

For patients who lack insurance coverage or cannot afford their prescription even with insurance, the Endari Support Program provides access to minimal or no-cost medication.

Managed by: Emmaus Medical in partnership with TheraCom Specialty Pharmacy (part of AmerisourceBergen)

Cost: Minimal to no cost depending on financial eligibility

How to apply: Call 1-855-723-5646 or visit endarirx.com/esp to complete the online application

This program also handles specialty pharmacy linkage and prescription delivery, which removes two major access barriers simultaneously.

Program 3: GoodRx and Pharmacy Discount Cards

For patients who have insurance with high specialty tier copays — or who are uninsured — pharmacy discount cards can offer meaningful savings:

GoodRx: Reduces price to approximately $1,013 for a 30-day supply (71% off retail). Free coupon at goodrx.com/endari. Cannot be combined with insurance.

SingleCare, WellRx, RxSaver: Alternative discount programs that may offer comparable or competitive pricing at specific specialty pharmacies. Advise patients to compare prices before filling.

Program 4: Medicare Part D Strategies

Medicare Part D covers Glutamine, but it's typically on Tier 5 (specialty tier), meaning high cost-sharing until the annual OOP limit is reached. Key 2025–2026 Medicare updates your patients should know:

$2,000 annual OOP cap (effective January 2025): Once a Medicare Part D patient reaches $2,000 in out-of-pocket drug costs, the plan covers 100% of covered medications for the rest of the year. For patients on multiple SCD medications, this cap can be reached relatively quickly.

Medicare Prescription Payment Plan: Available starting 2025. Allows Medicare patients to spread OOP prescription costs over the year rather than paying upfront. This can help patients who would otherwise skip fills at the start of the year.

Low Income Subsidy (Extra Help): Medicare patients who qualify for Extra Help may pay significantly less for Tier 5 medications. Help patients determine eligibility at ssa.gov or through your social work team.

Program 5: Third-Party SCD Financial Assistance

Several non-profit organizations provide financial support for SCD patients that can be used for prescription costs, insurance premiums, or copays:

HealthWell Foundation (healthwellfoundation.org): Provides grants for insurance premiums and copays. Check for open enrollment periods — this program has been temporarily closed at times due to funding constraints.

Patient Advocate Foundation (patientadvocate.org): Health equity fund for SCD patients in areas with high social vulnerability scores. Helps with co-pays and other healthcare costs.

Sickle Cell Disease Association of America (sicklecelldisease.org): Maintains a financial assistance program (when funded) and links to other SCD support resources.

Building a Savings Workflow Into Your SCD Practice

The most effective approach is to integrate financial assistance review into your standard SCD prescribing workflow. Consider:

Assigning a care coordinator to handle copay program enrollment at the time of prescribing

Including insurance type (commercial, Medicare, Medicaid, uninsured) in your PA documentation workflow to pre-identify the right assistance program

Providing patients with a printed resource sheet listing assistance program phone numbers and websites

Following up at the next visit to confirm the prescription was filled and the patient is enrolled in an assistance program

Help your patients find a pharmacy that has Glutamine in stock. Visit medfinder for providers or read our provider's guide to helping patients find Glutamine in stock.