What is the cost of Entresto (sacubitril/valsartan) 49mg?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: August 8, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Cost of Entresto 49 mg

The cost of Entresto (sacubitril/valsartan) 49 mg is approximately $289 per month based on average wholesale price, with a National Average Drug Acquisition Cost of approximately $230 per month. 1

Detailed Cost Information

Entresto is available in several dosage strengths, with the 49 mg formulation (containing 49 mg sacubitril and 51 mg valsartan) being a common starting dose for heart failure patients. The cost information breaks down as follows:

  • Average Wholesale Price (AWP): ~$289 per month
  • National Average Drug Acquisition Cost (NADAC): ~$230 per month

Cost Considerations and Access Strategies

The high cost of Entresto can present a significant barrier to access for many patients. Several strategies can help manage these costs:

Insurance Coverage

  • Prior authorization is often required by insurance plans before covering Entresto 1
  • Medicare Part D plans typically place Entresto in Tier 3 (higher copay medications) 1
  • The Inflation Reduction Act may help reduce costs for Medicare patients, though implementation will take time 1

Patient Assistance Options

  • Work with pharmacists, social workers, or patient navigators to identify patient assistance programs 1
  • Price-checker tools (e.g., GoodRx) can help locate retailers with lower costs 1
  • Request price matching if a lower price is found at another pharmacy 1
  • Pharmaceutical company assistance programs may provide 90-day supplies with refills 1

Financial Impact on Heart Failure Management

The cost of Entresto must be considered in the context of its clinical benefits:

  • Entresto has demonstrated significant reductions in mortality and hospitalizations for heart failure patients 2, 3
  • Cost-effectiveness analyses show Entresto compares favorably to other cardiovascular therapies 1
  • The high upfront cost may be offset by reduced hospitalizations and improved outcomes 1

Common Pitfalls in Accessing Entresto

  • Income verification challenges: Many pharmaceutical assistance programs require income documentation, though some accept signed letters from clinicians indicating no known income 1
  • Reordering complications: Patients and clinicians need to be aware of reordering procedures, especially when doses change 1
  • Multiple pharmacy use: Shopping for the best price across multiple pharmacies can prevent a single pharmacist from monitoring all medications, potentially leading to drug interactions or adherence issues 1

For patients who cannot afford Entresto, ACE inhibitors or ARBs may be considered as alternatives with high economic value, though they may not provide the same mortality benefit 1.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Entresto, a New Panacea for Heart Failure?

Cardiovascular & hematological agents in medicinal chemistry, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.