Linzess is one of the very few drugs where the strength does not change the price. AbbVie and Ironwood sell the 72, 145 and 290 mcg capsules at effectively the same number per capsule, so a person taking the low CIC dose pays the same as a person taking the full IBS-C dose. What decides your bill is not the milligrams, it is whether you have a commercial insurance card in your wallet.
That matters because the four prescription drugs in this category sit at wildly different prices, and two of them now have generics while two do not. The spread between the most expensive option and the cheapest is more than twenty-five to one for exactly the same problem. Every figure below was researched on September 3, 2026.
What Does Linzess Cost Without Insurance?
Acquisition costs come from the CMS National Average Drug Acquisition Cost survey. The Linzess, Motegrity, prucalopride and lubiprostone rows are effective August 19, 2026; the brand Amitiza row is a stale April 22, 2026 vintage, which is stated where it is used. List price comes from AbbVie’s own savings page, cash retail from Drugs.com and Cost Plus Drugs, and the Medicare column is the 2024 average spending per prescription claim from the CMS Part D Spending by Drug file. Monthly figures use the FDA-labeled adult dose.
| Drug and 30-day supply at the labeled dose | Low | Average | High |
|---|---|---|---|
| Linzess (linaclotide) 72, 145 or 290 mcg, 30 capsules | $270.47 | $282.48 | $283.83 |
| Linzess with the AbbVie savings card (commercial insurance only) | $30 | $30 | $30 |
| Trulance (plecanatide) 3 mg, 30 tablets | $617.24 | $617.24 | $794.58 |
| Motegrity (prucalopride) 2 mg brand, 30 tablets | $532.50 | $532.50 | $771.31 |
| Generic prucalopride 2 mg, 30 tablets | $12.25 | $37.06 | $475.85 |
| Amitiza (lubiprostone) 24 mcg brand, 60 capsules | $384.67 | $386.93 | $386.93 |
| Generic lubiprostone 24 mcg, 60 capsules | $21.72 | $37.43 | $37.43 |
The columns are not three retail quotes. For each row the low is the cheapest verified published figure, the high is the most expensive, and the middle is the most representative. For Linzess that means $270.47 in federal acquisition cost, $282.48 in AbbVie’s stated wholesale acquisition cost as of January 2026, and $283.83 as the Drugs.com cash counter price. Where a drug has only two published figures, such as Trulance, brand Motegrity and Amitiza, the middle column repeats one of them rather than inventing an average.
Two things jump out. First, Linzess is the cheapest of the three brand-only or brand-preferred options, not the most expensive, which is the opposite of what most people assume from the advertising. Second, the generics are not a little cheaper, they are an order of magnitude cheaper. Generic prucalopride at $12.25 for 30 tablets on Cost Plus Drugs is 1.6% of what Medicare paid per brand Motegrity claim in 2024.
What Drives the Price
No generic exists for linaclotide or plecanatide. CMS acquisition data carries brand Linzess rows at every strength and no generic linaclotide row at all, and the same is true for Trulance, which returns no acquisition-cost row under either its brand or generic name. With no competitor filling the same molecule, the manufacturer sets the number and the pharmacy adds a margin.
Strength does not move the price on the brand drugs. Linzess prices at $9.01237, $9.01984 and $9.01578 per capsule for the 72, 145 and 290 mcg strengths respectively. Motegrity prices at $17.72473 and $17.75001 per tablet for 1 mg and 2 mg. If a prescriber lowers your dose to manage side effects, your bill does not fall.
Dosing frequency does. Linzess, Trulance and Motegrity are all once daily, so a month is 30 units. Amitiza and generic lubiprostone are twice daily for chronic idiopathic constipation, so a month is 60 capsules and the per-capsule price has to be doubled before you compare it to anything else.
Generic entry has been uneven. Prucalopride generics have driven the acquisition cost from $17.75 a tablet for brand Motegrity down to $0.65741 for the generic, a 96% cut. Lubiprostone generics did the same, from $6.44889 to $0.62385 a capsule. Neither linaclotide nor plecanatide has been through that yet.
Where you fill matters more than the drug at the generic end. Drugs.com shows generic prucalopride ranging from $37.06 to $475.85 for the same 30 tablets depending on pharmacy, a nearly thirteenfold spread inside one molecule. That is the single largest controllable variable on this page.
Cash Price vs. Insurance
The manufacturer savings programs on these drugs are aggressively good and completely unavailable to uninsured patients. AbbVie’s Linzess program brings the cost to as little as $30 for a 30, 60 or 90-day supply, up to twelve fills a calendar year, with a maximum annual benefit of $2,280, and it requires commercial insurance. Trulance’s card is the same structure at as little as $25 per fill for up to twelve fills a year, also commercial insurance only.
So the usual self-pay logic inverts here. On most services, paying cash beats running a claim. On the brand drugs in this category, the insured price after a card is $30 and the uninsured price is $284, and no cash discount closes that gap. Note also that AbbVie’s own cost chart carries a mixed vintage: the wholesale acquisition cost is stamped as of January 2026 while the insurance-coverage table beneath it is footnoted as accurate as of January 2022, so treat the coverage percentages as older than the price.
The generics run the other way. Generic lubiprostone and generic prucalopride are cheap enough at a transparent cash pharmacy that insurance often adds nothing, and a plan copay tier can easily exceed the cash price.
How to Pay Less
Ask whether a generic molecule works for you. This is the single biggest lever. Generic prucalopride and generic lubiprostone are both available and both cost under $40 a month at a transparent pharmacy against $270 or more for the brand-only drugs. Which drug is clinically appropriate is a conversation for your prescriber, not a decision to make on price alone, but it is worth raising explicitly.
Price a transparent mail pharmacy before a retail counter. Cost Plus Drugs lists generic prucalopride 1 mg and 2 mg at $12.25 for 30 tablets and generic lubiprostone at $10.86 for 30 of the 24 mcg capsules, both plus shipping. Compare that to the $475.85 top of the Drugs.com retail range for the same prucalopride tablets.
Shop the discount cards before you fill. The pharmacy-to-pharmacy spread on generics in this category is more than tenfold, and card prices move independently of shelf prices. Our guide to comparing prescription discount cards walks through how to price the same prescription several ways in a few minutes.
Apply to the manufacturer’s patient assistance program if you are uninsured. AbbVie directs uninsured Linzess patients to its patient access support program rather than the savings card. These programs generally use household income against the federal poverty level and can supply the drug at no cost. Plan on a few weeks and a prescriber signature.
Use a sliding-scale clinic for the visit, not just the drug. These are prescription drugs, so there is a doctor visit attached to every refill. Federally qualified health centers charge on a sliding scale based on income, and many have in-house 340B pharmacies with sharply lower drug prices. See free and sliding-scale clinics for how to find one.
Push back on the bill if a related procedure lands. Chronic constipation and IBS-C workups often include imaging or a scope, and those bills are far larger than the drug. Our guide to negotiating medical bills covers the scripts, and colonoscopy costs without insurance covers what a scope should actually run as a cash payer.
The Bottom Line
If you are paying cash, Linzess runs about $270 to $284 a month and that number does not move with your dose. Trulance is roughly double it, brand Motegrity is roughly double it, and the two generic molecules in the category cost less than a tenth of it.
Before you accept any of those prices, confirm two things: whether a generic molecule is an option for your situation, and whether the manufacturer’s patient assistance program covers you. If you are also being treated for IBS with diarrhea rather than constipation, the pricing story is completely different, and Xifaxan costs covers it. For reflux drugs that often get prescribed alongside these, see omeprazole and PPI costs.