What is the cost of ivabradine (Corlanor) if insurance does not cover it?

Cost of Ivabradine Without Insurance Coverage

Ivabradine (Corlanor) costs approximately $4,500 per year without insurance coverage, which translates to roughly $375 per month or $12.50 per day at wholesale acquisition cost. 1

Detailed Cost Breakdown

Out-of-Pocket Pricing

• Annual wholesale acquisition cost: $4,500 1
• Monthly cost: Approximately $375 (calculated from annual cost)
• Daily cost: Approximately $12.50 (calculated from annual cost)

Cost Context Compared to Other Heart Failure Medications

• Ivabradine is significantly more expensive than generic heart failure medications like metformin ($2-5/month) or sulfonylureas ($2-11/month) 2
• However, cost-effectiveness analyses demonstrate that ivabradine compares favorably to other accepted cardiovascular therapies when considering reduced hospitalization costs 3

Financial Assistance Options

Patient Assistance Programs

• Standard coverage: 90-day supplies with 3 refills providing 1 year of coverage 3
• Income verification alternatives: Many pharmaceutical companies accept signed letters from clinicians indicating the patient has no known income, which can substitute for official income documentation 3
• Reordering considerations: Refills/reorders cannot be requested before 60 days post-approval date, and dose changes may require new applications 3

Price Comparison Strategies

• Use price-checker tools (e.g., GoodRx) to locate retailers with lowest medication costs 3
• Request price matching if another pharmacy offers lower costs 3
• Work with pharmacists, social workers, or patient navigators to identify copay assistance programs 3

Cost-Effectiveness Considerations

Economic Value

• Incremental cost-effectiveness ratio: Compares favorably to other accepted cardiovascular therapies at adoption 3
• Budget impact: Results in net cost savings of $0.01-$0.04 per member per month when accounting for reduced hospitalizations 1
• UK analysis: £8,498-£13,764 per quality-adjusted life year gained, well below cost-effectiveness thresholds 4
• Italian analysis: €17,435 per quality-adjusted life year gained, with 87-93% probability of cost-effectiveness 5

Hospitalization Cost Offsets

• Average HF hospitalization cost: $37,507 per event 1
• Avoided hospitalizations: Approximately 0.76 hospitalizations prevented per patient, saving $3,421 in hospitalization costs 5
• Total cost reduction: Despite medication acquisition costs, ivabradine reduces total healthcare costs by $474,499-$991,256 in commercial populations and $4.3-$13.8 million in Medicare populations annually 1

Common Pitfalls to Avoid

Prior Authorization Challenges

• Prior authorization is frequently required and can serve as a significant barrier to obtaining ivabradine 3
• Include specific documentation: HF phenotype (HFrEF), NYHA functional class, recent LVEF measurement, evidence of maximized beta-blocker therapy, and resting heart rate >70 bpm 3
• Work with pharmacy professionals to jointly address prior authorization requirements 3

Medication Access Barriers

• Do not assume automatic coverage: Newer HFrEF therapies like ivabradine often have higher monthly costs and require more time and effort to obtain 3
• Avoid using multiple pharmacies: This prevents pharmacist oversight of drug interactions, medication synchronization, and adherence monitoring 3
• Consider generic alternatives first: Use generic equivalents for guideline-directed medical therapy whenever possible before adding ivabradine 3