Leqvio is Novartis’s brand name for inclisiran, a small interfering RNA therapy that lowers LDL cholesterol. It is not a pill and not a self-injected pen. A health professional gives it to you as a single 284 mg subcutaneous injection, and the schedule is one dose to start, a second dose three months later, then one dose every six months for as long as you stay on it.

That delivery model is the whole reason its pricing looks so different from every other cholesterol drug. Leqvio is a buy-and-bill product: the clinic purchases the syringe, administers it, and bills it under the medical benefit. For a cash payer, that means you are negotiating with a medical practice rather than a pharmacy counter, and there are two bills to worry about instead of one. Everything below was researched on September 3, 2026.

What Does Leqvio Cost Without Insurance?

Three independent sources price the drug itself and they agree closely. Novartis publishes a list price for uninsured patients of $3,587.73 per dose on Leqvio.com. Drugs.com lists a cash price of $3,798.36 for the same 284 mg / 1.5 mL syringe. Medicare’s Part B payment limit file for July 1 through September 30, 2026 sets the allowance at $12.905 per milligram, which is $3,665.02 for a 284 mg dose. The whole range spans about 6%.

Leqvio (inclisiran) 284 mg cost itemLowTypicalHigh
One dose, drug only$3,587.73$3,665.02$3,798.36
Injection administration, CPT 96372, Medicare national rate$15.36$15.36$15.36
First year, 3 doses of drug$10,763.19$10,995.06$11,395.08
Maintenance year, 2 doses of drug$7,175.46$7,330.04$7,596.72
Medicare 20% coinsurance per dose, if you have Part B$733.00$733.00$733.00
Leqvio Co-pay Program (commercial insurance required)$0$0$0
Novartis Patient Assistance Foundation, if you qualify$0$0$0

For a reality check on what this actually bills at, CMS’s Medicare Part B spending data for 2024 shows average Medicare spending of $3,377.82 per Leqvio claim and $6,134.60 per beneficiary across the year, spread over 48,298 beneficiaries and $296.3 million in total spending. Those are Medicare-allowed amounts rather than cash prices, but they confirm the per-dose figure is real and not a sticker nobody pays.

The administration fee is a separate bill

The syringe is only part of what you are quoted. Somebody has to inject it, and that is billed separately using CPT 96372, the code for a therapeutic subcutaneous or intramuscular injection. Medicare’s 2026 relative value file assigns that code 0.46 total non-facility relative value units, which at the $33.4009 conversion factor comes to about $15.36 nationally in a physician office.

That is what Medicare pays. A self-pay clinic is not bound by it and will typically charge more, and most practices will also bill an office visit for the same encounter. A hospital outpatient department will usually charge more again than a physician office for identical work. Ask for a single itemized cash quote covering the drug, the injection, and the visit before you schedule anything, because the drug price is the one thing on that list you cannot negotiate much and the other two are the ones you can.

What Drives the Price

It is a medical-benefit drug, not a pharmacy drug. CMS’s NADAC file, which surveys retail pharmacy acquisition costs, has no row for Leqvio at all. There is no retail cash price to shop, no discount card that applies, and no pharmacy-counter comparison to run. Where you get the injection is the closest thing to a shopping decision you have.

There is no direct-to-patient cash program. Leqvio is not listed on TrumpRx.gov, and the Novartis agreement with the U.S. government announced December 19, 2025 names Mayzent, Rydapt and Tabrecta as the medicines getting direct-to-patient platforms. Its two main competitors both took the opposite path, which is why they now have published cash prices under $250 a month and Leqvio does not.

Where you get it. A cardiology office, a primary care practice, a hospital outpatient clinic and an infusion center will not quote the same total for the same injection. Hospital-based departments are usually the most expensive.

Your dosing year. A first year needs three doses and a maintenance year needs two. That is a roughly $3,600 swing depending on which year you are in, so a quote for “a year of Leqvio” means very different things to a new patient and an established one.

No generic or biosimilar. Inclisiran has no U.S. copy on the market as of September 2026, so nothing structural is pulling the price down.

Cash Price vs. Insurance

This is the rare drug where insurance almost always wins decisively, and it is worth being blunt about that. Novartis reports that 9 out of 10 patients have confirmed coverage under the medical benefit, that 75% of commercial patients paid less than $10, and that 86% of commercial patients who used the Leqvio Co-pay Program paid $0.

Traditional Medicare covers it under Part B, which means the standard 20% coinsurance applies, or $733.00 on a $3,665.02 allowed amount. Novartis notes that patients with a supplemental Medigap or retiree plan may pay as little as $0, and that patients without supplemental coverage are responsible for that 20%. Medicare Advantage costs vary by plan. Novartis also tells traditional Medicare patients they will not have to wait for their doctor to get plan approval before starting.

The Leqvio Co-pay Program is commercial-insurance-only. Its terms state the offer is not valid under Medicare, Medicaid, TRICARE, VA, DoD or any other federal or state program, and per-treatment maximums and an annual benefit cap apply. If you are uninsured, that program is not available to you at any price.

Leqvio has not been selected for Medicare price negotiation. It is absent from the CMS lists of drugs with negotiated prices for 2026 and 2027, and from the 15 Part B and Part D drugs CMS selected on January 27, 2026 for negotiated prices effective in 2028. That matters because 2028 is the first year physician-administered Part B drugs are eligible at all.

How to Pay Less

  1. Apply to the Novartis Patient Assistance Foundation before you pay anything. NPAF is an independent nonprofit that provides Novartis medicines free of charge to eligible patients, and Leqvio is on its supported medicines list. You must live in the U.S. or a U.S. territory, be treated by a licensed U.S. provider on an outpatient basis, and meet income guidelines, which differ in Alaska and Hawaii. Novartis says you get a decision letter within four weeks.

  2. Get the quote itemized into three numbers. Drug, injection administration, and office visit. The drug is close to fixed, but the administration fee and the visit are where a self-pay discount lives. Our fair price checker helps you judge whether the visit portion is reasonable, and a standard cash-pay doctor visit runs $100 to $300.

  3. Ask a physician office rather than a hospital outpatient department. Same injection, same code, different price structure. If a hospital is the only option available, our guide to hospital price transparency explains how to pull that facility’s posted cash rate before you go.

  4. Ask about the clinic’s self-pay discount in writing. Practices that buy and bill expensive drugs almost always have a prompt-pay or self-pay policy, and it is rarely offered unprompted. Our guide to negotiating medical bills covers the conversation, and hospital charity care applies if a health system is doing the billing.

  5. Check the independent charitable foundations. Cardiovascular funds at organizations like the PAN Foundation, HealthWell Foundation and Good Days can cover cost sharing for people who do not qualify for the manufacturer program. Funds open and close during the year, so apply as soon as one opens.

  6. Do not skip the routine-care side. A free or sliding-scale clinic can handle the prescribing decision and the lipid panels that go with it, which is often the quietly expensive part of staying on a specialty cholesterol drug.

Bottom Line

Budget roughly $3,600 to $3,800 for each dose of Leqvio, plus whatever your clinic charges to administer it, which Medicare prices at about $15 but a self-pay practice will set higher. Over a year that is about $10,800 to $11,400 to start and $7,200 to $7,600 to maintain.

The twice-yearly schedule is the genuine advantage here, but on a pure cash basis Leqvio is currently the most expensive way to buy PCSK9-targeted LDL lowering, because it is the one product in the category without a published direct-to-patient price. Repatha is $239 a month and Praluent is $225 a month at their federal cash prices, which is roughly $2,700 to $2,900 a year against Leqvio’s $7,200 or more. On the oral side, CMS prices generic atorvastatin and rosuvastatin at pennies a tablet, ezetimibe at about seven cents, and Nexletol between the generics and the injectables. If your cardiologist ordered a coronary calcium score alongside all this, that has its own cash price worth checking.