Entresto is the brand name for sacubitril/valsartan, a two-drug combination tablet used in heart failure. It is taken twice a day, so a 30-day supply is 60 tablets. Discount sites usually quote 30-tablet or 60-tablet prices, and mixing the two is the fastest way to double or halve your estimate by accident.
Entresto is one of the few drugs on this site where the price collapsed inside a single year. A generic reached the U.S. market, Novartis retired the Entresto co-pay program, and CMS removed the drug from the Medicare negotiation program going forward. The result is a cash market where the same molecules sell for anywhere from about $15 to nearly $1,000 a month depending entirely on what you ask for and where. This guide prices it as verified on September 1, 2026.
What Does Entresto Cost Without Insurance?
Mail-order figures come from Cost Plus Drugs and the federal TrumpRx site. Retail counter figures come from SingleCare’s live Entresto page, updated September 2, 2026. Medicare figures come from the CMS Maximum Fair Price data file and fact sheet.
| Option | Low | Average | High |
|---|---|---|---|
| Generic sacubitril/valsartan, 30 tablets, Cost Plus Drugs | $7.48 (24/26 mg) | $8.62 (97/103 mg) | $9.15 (49/51 mg) |
| Generic sacubitril/valsartan, 60 tablets, TrumpRx | $15.22 | $17.52 | $18.50 |
| Generic sacubitril/valsartan, 60 tablets, retail counter | $104.87 (Walmart) | $238.20 (Walgreens) | $760.25 (Kroger) |
| Generic sacubitril/valsartan, 60 tablets, SingleCare card price | $67.73 (CVS) | $151.46 (Walgreens) | $574.18 (Kroger) |
| Brand Entresto 24/26 mg, 60 tablets, retail counter | $858.00 (CVS) | $871.80 (Walmart) | $928.80 (Walgreens) |
| Entresto 30-day supply, Medicare negotiated price (Part D only) | $295 | $295 | $295 |
SingleCare puts the national average retail price for brand Entresto at $979.99 for 60 tablets of the 24/26 mg strength, higher than any of the four chains it lists individually. Against a $15 mail-order generic, the honest headline is that the brand price is now almost entirely avoidable.
The generic changed everything
Cost Plus Drugs lists all three strengths of generic sacubitril/valsartan, each in 30-tablet quantities: $7.48 for 24/26 mg, $9.15 for 49/51 mg, and $8.62 for 97/103 mg, against a stated retail comparison of $358.80. Because the drug is taken twice daily, two of those bottles is a month, so roughly $15 to $18.
TrumpRx, the federal pricing site, prices the same generic at $9.50 for 30 tablets across all three strengths, with 60-tablet prices of $15.22 to $18.50 and 90-tablet prices of $17.70 to $22.72. The site describes the discount against retail as up to 97%.
Those two independent channels agree closely, which is a good sign that roughly $15 to $19 is the real floor for a month of therapy in September 2026.
Novartis retired the co-pay program
Novartis’s own Entresto financial support page now says the ENTRESTO Co-Pay Program has been discontinued and that financial assistance through that program is no longer available. Patients are told to speak with their health care provider about options for continued access. This is the standard manufacturer response to generic entry: once the brand loses volume, the copay subsidy that protected the brand’s insured share stops making commercial sense.
Practically, that removes the one route that used to make brand Entresto affordable for commercially insured patients. If your plan still steers you to the brand, ask what the generic costs on your formulary before you accept a brand copay.
What Medicare negotiated, and why it is ending
CMS negotiated a Maximum Fair Price of $295 for a 30-day supply of Entresto, effective January 1, 2026, down 53% from a 2023 list price of $628. Entresto accounted for $3.4 billion in Part D gross covered drug costs across about 664,000 Part D users in 2023. Novartis said at the time that it agreed to the price only to avoid what it called untenable alternatives, and noted that 98% of Medicare beneficiaries taking Entresto could already access it without prior authorization at an average of $29 per month.
That negotiated price now has an expiration date. CMS’s Maximum Fair Price data file shows every Entresto national drug code deselected from the negotiation program with an end date of December 31, 2026, and the 2027 inflation-adjusted figure of $302.98 end-dated alongside it. As KFF explains, a drug stops being a selected drug once a generic version is approved and marketed. The generic arriving is exactly what took Entresto out.
For cash payers, none of this is the operative number anyway. The $295 Medicare price applies to Part D enrollees at the counter, not to the uninsured, and it is more than fifteen times the mail-order generic price.
What Drives the Price
Brand versus generic. This is the entire story. Brand Entresto at $858 to $928.80 for 60 tablets versus generic sacubitril/valsartan at $15 to $19 through mail order is a spread of roughly 60 to 1 for the same two active ingredients.
Which pharmacy fills it. SingleCare’s September 2, 2026 data shows the identical generic at $104.87 at Walmart and $760.25 at Kroger for 60 tablets. Even with a discount card applied, the range was $67.73 to $574.18. Nothing about the product differs; only the pharmacy’s cash price does.
Mail order versus walk-in. Cost Plus Drugs and TrumpRx both land near $15 to $19 a month. The cheapest retail counter in SingleCare’s sample was five to seven times that. If you can wait for shipping, mail order wins decisively here.
Quantity. TrumpRx’s 90-tablet generic prices of $17.70 to $22.72 are barely above its 60-tablet prices, so filling larger quantities lowers the per-tablet cost meaningfully. Always ask for the per-tablet math.
Strength, but only a little. Cost Plus prices the three strengths within $1.67 of each other per 30 tablets, so a dose change should not move your bill much on the generic.
Cash Price vs. Insurance
With the manufacturer co-pay program gone, insurance is now the more complicated route, not the simpler one. If your commercial plan covers generic sacubitril/valsartan at a standard generic tier, your copay is probably in the $0 to $20 range and using insurance is fine. If your plan still has you on brand Entresto with a specialty or non-preferred copay, compare that copay against a $15 mail-order generic before you fill.
Medicare Part D enrollees had a negotiated $295 brand price in 2026 that is set to stop applying after December 31, 2026. If you are on Part D and taking brand Entresto, that is a concrete reason to talk to your prescriber and your plan about the generic before the 2027 plan year begins. Under the 2026 Part D redesign, out-of-pocket costs are also capped for the year, so where you land in the benefit matters.
For anyone paying cash, the arithmetic is not close. A $15 to $19 monthly generic makes discount cards, coupons, and negotiation almost beside the point. If a pharmacy quotes you hundreds of dollars for a generic fill, that is a pharmacy problem, not a drug problem. Run the quote through our fair price checker and then take it somewhere else.
How to Pay Less
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Ask for the generic by name. Sacubitril/valsartan is available in all three strengths. A prescription written for brand Entresto with no substitution allowed is what keeps people paying $900 a month, and that is a conversation to have with your prescriber.
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Buy through a transparent mail-order pharmacy. Cost Plus Drugs lists $7.48 to $9.15 per 30 tablets with prices published on the page. TrumpRx starts at $9.50 for 30 tablets. Either is roughly $15 to $19 for a 60-tablet month.
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Price three local pharmacies before you settle for a walk-in fill. The spread on the same generic was seven-fold in SingleCare’s September 2026 sample. Our comparison of GoodRx vs. SingleCare shows how to check both cards on the same drug, strength, and quantity in about two minutes.
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Fill 90 days at a time where you can. TrumpRx’s 90-tablet generic prices are only a few dollars above its 60-tablet prices, so the per-tablet cost drops sharply at larger quantities.
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Get the visits covered too. Heart failure care means regular follow-up. A free or sliding-scale clinic can handle prescribing and monitoring at little or no cost, a cash-pay doctor visit generally runs $100 to $300, and the echocardiogram or EKG that comes with it is priced separately in our guides.
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Challenge a hospital or pharmacy bill that ignores published prices. When the manufacturer, a national mail-order pharmacy, and a federal website all publish a number, a bill many times higher is worth disputing in writing. Our negotiation script has the language.
Bottom Line
Budget $15 to $19 a month for generic sacubitril/valsartan bought through Cost Plus Drugs or TrumpRx, $68 to $574 a month if you use a discount card at a walk-in pharmacy, and $858 to $980 a month if you fill brand Entresto at retail with nothing applied. The generic is the same two active ingredients, it is stocked in every strength, and it is the reason Novartis ended the co-pay program and CMS pulled the drug out of Medicare price negotiation after 2026.
If you are on Medicare and still filling brand Entresto at the $295 negotiated price, that price is scheduled to stop applying at the end of 2026, so plan ahead for the 2027 plan year. For the other cardiovascular and diabetes drugs in the same first negotiation cycle, see our guides to Eliquis, Xarelto, Jardiance, Farxiga, and Januvia.