The price of any new, brand-name medication can be a significant concern for patients, and vonoprazan is no exception. As a novel potassium-competitive acid blocker (PCAB), vonoprazan is the active ingredient in the brand-name drug Voquezna, which was approved by the FDA for the treatment of erosive esophagitis and non-erosive gastroesophageal reflux disease (GERD). While it offers a new mechanism of action compared to traditional proton pump inhibitors (PPIs), its cost can be a barrier for many. This article breaks down the various factors that influence the price of vonoprazan.
The High Retail Price of Vonoprazan (Voquezna)
The most straightforward figure to consider is the retail price for a patient without insurance. The average retail cost for a 30-tablet bottle of 20mg Voquezna is consistently reported to be in the $800 to $900 range, and sometimes higher, depending on the pharmacy. This high list price is typical for new, patented brand-name drugs, which must recoup the significant research and development costs invested by the manufacturer.
Factors influencing retail price
- Pharmacy location: Prices can fluctuate based on the specific pharmacy chain and its location.
- Dosage: While the search results show consistent pricing for 20mg tablets, costs can vary based on the prescribed dosage and tablet count.
- Lack of generic competition: Since there is no FDA-approved generic version of vonoprazan available in the US, there is no competitive pressure to drive down the price.
Using Insurance and Savings Programs to Lower Costs
For most patients, the out-of-pocket cost for vonoprazan will be determined by their insurance coverage and any available savings programs. These options can significantly reduce the financial burden.
Options for commercially insured patients
- Manufacturer Savings Card: The manufacturer of Voquezna, Phathom Pharmaceuticals, offers a savings card for eligible commercially insured patients. This program can reduce the monthly copay to as little as $25. It is crucial to note that this program has specific eligibility criteria and is not available for patients with government-funded insurance like Medicare or Medicaid.
- Commercial Coverage: In July 2024, Phathom Pharmaceuticals announced that major pharmacy benefit managers (PBMs) like CVS Caremark added Voquezna to their national commercial formularies, expanding access to many commercially insured individuals. A patient's final copay or coinsurance amount will still depend on the specifics of their plan.
Savings for uninsured and cash-paying patients
- Prescription Discount Cards: Services like SingleCare and GoodRx offer significant discounts off the retail price. Recent data indicates that these coupons can bring the cost of a 30-day supply down to a range of $560 to $680. This can represent hundreds of dollars in savings for patients without insurance or with high deductibles.
- Online and International Pharmacies: Some online pharmacies, particularly those based in Canada or other countries, may offer generic versions of vonoprazan at a much lower price. Patients should exercise caution and ensure they are using a licensed, reputable international pharmacy. For example, some sites list 100-tablet supplies of generic vonoprazan for significantly less than the US brand-name cost.
Comparison Table: Voquezna vs. a Standard PPI
To put the cost of vonoprazan into perspective, here is a comparison with a common, widely available PPI, omeprazole.
| Feature | Vonoprazan (Voquezna) | Omeprazole (Prilosec) |
|---|---|---|
| Mechanism | Potassium-Competitive Acid Blocker (PCAB) | Proton Pump Inhibitor (PPI) |
| Retail Price (30-day supply) | High ($800-$900+) | Low (Generic often under $20) |
| Generic Available in US? | No | Yes, widely available |
| Manufacturer Savings Card | Yes (for eligible commercial insurance) | No (for generics) |
| Discount Card Price (Estimate) | Moderate ($560-$680+) | Very Low (often minimal cost) |
| Medicare/Government Coverage | Varies by plan, often limited | Covered by most plans |
Cost for Combination Therapies (Voquezna Paks)
Vonoprazan is also used in combination with antibiotics to treat H. pylori infections. These therapies are co-packaged as Voquezna Dual Pak (with amoxicillin) and Voquezna Triple Pak (with amoxicillin and clarithromycin). As these include multiple medications, the cost is different from the single-ingredient tablet.
- Voquezna Dual Pak: The cost for one carton can be over $800, though discount cards can bring the price down.
- Voquezna Triple Pak: Cost for the triple therapy is also high, but manufacturer savings cards and discount programs are available for these combination packs as well.
The Role of Cost-Effectiveness in Pricing
While the per-pill price of vonoprazan is higher than that of generic PPIs, some health economic studies from other countries suggest it can be cost-effective for treating conditions like refractory esophagitis due to potentially higher efficacy. These analyses consider not just drug cost but also factors like healing rates, symptom relief, and healthcare utilization over time. However, this is distinct from the immediate, out-of-pocket price faced by a patient.
Conclusion
The cost of vonoprazan tablets is substantial, particularly for those without robust commercial insurance. With retail prices often exceeding $800, access without financial assistance is challenging. However, several avenues exist to manage this high cost. Eligible commercially insured patients can utilize manufacturer savings cards to reduce their copay significantly. For cash-paying patients, prescription discount cards can provide hundreds of dollars in savings, though the final price remains elevated. The current lack of a US generic means patients cannot yet benefit from the typically much lower prices of generic versions. Patients should consult their healthcare provider and pharmacist, as well as investigate savings programs, to find the most affordable option for their treatment plan.
For more information on savings, visit the manufacturer's program page: VOQUEZNA Savings Card.
