Gemtesa (vibegron) is the newer of the two beta-3 adrenergic agonists approved for overactive bladder, cleared by the FDA on December 23, 2020 and now sold by Sumitomo Pharma America after its acquisition of Urovant Sciences. It is a daily maintenance drug for a chronic condition, so its price is not a one-time problem.
It is also brand-only, with no generic and none on the horizon, which puts a hard floor under what anyone can pay. This guide uses figures read on September 3, 2026 from CMS NADAC (August 19, 2026 vintage), the CMS Medicare Part D Spending by Drug dataset, Sumitomo’s own published pricing and program terms, the Drugs.com cash price guide and SingleCare.
What Does Gemtesa Cost Without Insurance?
The table below covers the cash channel, the pharmacy’s own acquisition cost, and the two manufacturer programs. Acquisition cost is included so you can see how thin the markup actually is on this one.
| Gemtesa 75 mg, no insurance | Low | Average | High |
|---|---|---|---|
| Cash price, 30 tablets (one month) | $452.42 (SingleCare card price) | $511.85 (Drugs.com price guide) | $684.80 (SingleCare stated average retail) |
| Cash price, 90 tablets (three months) | $1,519.75 (Drugs.com price guide, $16.89 per tablet) | $1,519.75 (the only published 90-count cash figure found) | $2,054.40 (three months at SingleCare’s stated average retail) |
| Pharmacy acquisition cost, 30 tablets | $493.76 (CMS NADAC, $16.45858 per tablet, effective August 19, 2026) | $500.89 (Sumitomo published wholesale acquisition cost) | $511.85 (lowest published retail cash price, Drugs.com) |
| Simple Savings Card (commercial insurance only) | $0 per 90-day supply | $10 per 30-day supply | $95 per 30-day supply when the plan does not cover Gemtesa |
| Sumitomo Pharma America patient assistance, if you qualify | $0 | $0 | $0 |
The striking thing in that table is how little room there is. CMS NADAC says the average pharmacy pays $493.76 for the 30 tablets that Drugs.com sells for $511.85, a markup of about 3.7 percent. Compare that to a cheap generic, where the counter price is often twenty times acquisition cost. Almost the entire price of Gemtesa is set upstream by the manufacturer, not by your pharmacy.
Sumitomo publishes the list price directly: “The Wholesale Acquisition Cost (WAC), also known as the list price, for a 30-day supply of GEMTESA (vibegron) 75 mg tablets is $500.89,” footnoted “as of August 2024” on the page read September 3, 2026. That is a two-year-old vintage stated by the manufacturer itself, which is worth knowing when you compare it to today’s NADAC figure.
What Drives the Price
There is no generic, and there will not be one soon
Drugs.com’s generic availability page, last updated July 9, 2026, states that the FDA has not approved a generic version of Gemtesa. A CMS NADAC query on VIBEGRON returns zero rows, which is what a brand-only molecule looks like in that dataset.
The patent picture backs that up. The earliest listed drug-substance and drug-product patent expiry is December 23, 2034, with method-of-use patents assigned to Urovant Sciences running to March 22, 2040 and July 6, 2042. Waiting for a generic is not a plan.
The savings card is not for you if you are paying cash
This is the single most misread thing about Gemtesa pricing. Sumitomo’s Simple Savings Program looks generous on the surface: as little as $10 for a 30-day supply or $0 for a 90-day supply if your plan covers the drug, or $95 for a 30-day supply if your plan does not cover it.
But the published program terms are explicit. The offer is not valid for patients on Medicare, Medicaid or any other federal or state program, and term 5 states in plain language that it “is not valid for cash-paying patients.” Every tier of the card requires commercial insurance. The program runs through December 31, 2026 and Sumitomo reserves the right to change or end it without notice.
The maximum savings limits are worth knowing if you do have commercial coverage: $421 per 30-day supply or $1,263 per 90-day supply on covered claims, and $454 per 30-day supply on not-covered claims. The card is valid for up to 12 fills of a 30-day supply or 4 fills of a 90-day supply, and expires one year from activation.
Which pharmacy and which discount card
Because acquisition cost is so close to retail, the pharmacy-to-pharmacy spread on Gemtesa is narrower than on a generic, but it is not zero. SingleCare states an average retail price of $684.80 against a card price of $452.42, and Drugs.com’s cash guide lands at $511.85 in between. Discount-card rates are renegotiated constantly and vary by chain and location, so treat the $452.42 as proof that a sub-$500 price exists rather than as a guaranteed quote.
What insurers actually pay
CMS’s Medicare Part D Spending by Drug dataset gives a useful benchmark for what a large payer pays after rebates are excluded from the calculation. In 2024, Part D spent $945.1 million on Gemtesa across 320,270 beneficiaries and 1,361,795 claims, averaging $694.00 per claim, $15.88 per tablet and $2,950.91 per beneficiary for the year. The per-claim figure runs above the 30-tablet cash prices above because Part D claims averaged about 44 tablets each (59.5 million dosage units across 1.36 million claims), not 30.
Cash Price vs. Insurance
If you have commercial insurance and Gemtesa is on the formulary, use it and stack the Simple Savings Card on top. That is the cheapest path by a wide margin and there is no scenario in which cash beats a $10 covered copay.
If you have commercial insurance and Gemtesa is excluded from your formulary, the card’s not-covered tier at $95 per 30-day supply still beats every cash price in the table, so enroll before you pay out of pocket. Ask the pharmacy to run it as a secondary payer with a valid other-coverage code, which is what the program’s pharmacist instructions call for.
If you are uninsured or on Medicare or Medicaid, the card is off the table entirely and your two real options are the patient assistance program or the cash market. Money spent at a cash or discount-card price generally does not count toward a deductible, which is a fair reason to run the claim first if you have a plan you expect to exhaust this year. Our comparison of GoodRx vs. SingleCare covers how the card channel prices brand-only drugs like this one.
How to Pay Less
1. Apply for the Sumitomo patient assistance program first if you are uninsured. Gemtesa is a covered product under the SMPA Patient Assistance Program, which supplies the drug at no cost. The published eligibility criteria are an FDA-approved indication, US residence, being uninsured or inadequately covered, being unable to afford the medication, having no other financial support available, and annual household income at or below $46,950 for a household of one or $63,450 for two, plus $16,500 per additional member. Those thresholds appear both on smpa-pap.com and in the program’s own FAQ document dated October 2025. Enrollment runs up to 12 months and you re-apply annually. Your prescriber submits the application; the support line is 1-833-876-8268.
2. If you have commercial insurance, enroll in the Simple Savings Card even when the drug is not covered. The not-covered tier at $95 per 30-day supply is the second-cheapest number available on this drug and most patients never find it because the marketing leads with the $10 covered tier.
3. Ask for a 90-day fill. Drugs.com prices 90 tablets at $1,519.75, or $16.89 per tablet against $17.06 on the 30-count. That is a small unit saving, but it also means one dispensing fee instead of three, and the savings card’s 90-day tier is the only route to a $0 fill.
4. Compare the class on price before you commit to a brand-only drug. Generic mirabegron, the generic form of Myrbetriq and the other beta-3 agonist, runs $230.49 to $375.12 for 30 tablets depending on the pharmacy. Older overactive bladder generics such as oxybutynin and solifenacin are cheaper still. Which drug is right for you is a clinical question for your prescriber, but the price gap is large enough to raise at the appointment.
5. Check a federally funded health center. Many community health centers operate pharmacies at 340B pricing and charge on an income-based sliding scale, which can change the math on a brand-only drug more than any coupon will. Our guide to free and sliding-scale clinics explains how the tiers work and who qualifies.
6. Handle the urology bills separately from the prescription. The workup behind an overactive bladder diagnosis, such as urodynamic testing or a cystoscopy, often costs more than a month of the drug. If one of those bills has already arrived, our walkthrough on negotiating medical bills covers what to ask for and how to get it in writing, and the negotiation script gives you the wording.
The Bottom Line
Expect roughly $450 to $685 a month for Gemtesa if you are paying cash, with $511.85 for 30 tablets on the Drugs.com guide as the most representative single figure as of September 2026. There is very little markup to negotiate away, because the pharmacy’s own acquisition cost is $493.76 for those 30 tablets.
That makes Gemtesa unusual: the answer is not to shop harder, it is to get out of the cash channel entirely. If you are uninsured and under the income thresholds, the Sumitomo patient assistance program takes the price to zero. If you are commercially insured, the Simple Savings Card takes it to $10 or $95. Everyone else is comparing a brand-only drug against generic mirabegron at half the price, which is a conversation to have with the prescriber rather than the pharmacist.