Praluent is the brand name for alirocumab, an injectable PCSK9 inhibitor developed by Regeneron and Sanofi that lowers LDL cholesterol. It is dosed either as one 75 mg or 150 mg pen every two weeks, or as 300 mg once a month given as two 150 mg pens back to back. Either way, a month of treatment is two pens.
Two things changed the cash math on this drug recently, and they point in opposite directions. Regeneron agreed in April 2026 to sell Praluent directly to patients at a sharply reduced price through a federal website. At the same time, the free-drug program that used to catch uninsured patients closed its doors to anyone new. Everything below was researched on September 3, 2026.
What Does Praluent Cost Without Insurance?
The federal TrumpRx.gov page for Praluent shows a $537.21 pre-discount price for a two-pen box, a $312.21 discount, and a $225.00 final price, a 58% reduction. The White House fact sheet announcing the Regeneron agreement on April 23, 2026 states the same thing in plain language: the price drops from $537 to $225 for patients buying directly through TrumpRx.
Independent reads of the no-program price come in slightly lower. Drugs.com lists $532.65 for two pens in either strength. CMS’s National Average Drug Acquisition Cost survey, which measures what pharmacies pay to stock the product, shows $257.73 per 75 mg pen and $258.02 per 150 mg pen effective August 19, 2026, which is about $516 for a month.
| Praluent option (75 mg or 150 mg pen) | Low | Typical | High |
|---|---|---|---|
| One month (2 pens), cash price through TrumpRx.gov | $225.00 | $225.00 | $225.00 |
| One month (2 pens), no program | $515.46 | $532.65 | $537.21 |
| Single pen | $257.73 | $266.33 | $268.61 |
| MyPraluent co-pay card (commercial insurance required) | $50.00 | $50.00 | $50.00 |
| MyPraluent patient assistance, current enrollees only | $0 | $0 | $0 |
| Repatha, one month cash, for comparison | $239.00 | $239.00 | $239.00 |
The sources disagree by about $22 on the no-program price, which is the usual gap between acquisition cost and a manufacturer’s published reference price. Treat roughly $516 as the floor a well-priced pharmacy could reach and $537 as the number a walk-in cash payer is quoted.
The free-drug program is closed to new patients
This is the detail most pages about Praluent still get wrong. Regeneron’s patient site and its prescriber site both carry the same language: uninsured patients and insured patients with no pharmacy coverage who were already in the MyPraluent Patient Assistance Program can re-enroll to receive the drug at no cost for up to 12 months, and Medicare Part D patients and new enrollees are no longer accepted.
If you are newly uninsured and looking for free Praluent, that door is shut. The $225 cash price and the independent charitable foundations are what is left.
What Drives the Price
Whether you use the direct-to-patient price. The gap between $225 and $537.21 is $312.21 a month, about $3,750 a year, and closing it costs nothing but a coupon at a participating pharmacy.
There is no biosimilar. Alirocumab is a biologic and no U.S. biosimilar is marketed as of September 2026. NADAC lists no corresponding generic price for either pen. The 2019 price cut to a $5,850 annual list price was a voluntary manufacturer decision, and NADAC’s current per-pen figures imply the list price has drifted upward since.
Which insurance box you fall into. The MyPraluent Copay Card is open to commercially insured patients with no income requirement, pays out-of-pocket costs down to as little as $50 a month, and is capped at $3,500 of assistance a year. It is not valid under Medicaid, Medicare, VA, DoD or TRICARE. Uninsured patients get neither the card nor, as of 2026, the patient assistance program.
Strength and dosing schedule. The 75 mg and 150 mg pens carry essentially the same price, so moving from 75 mg every two weeks to 150 mg every two weeks does not change your monthly bill. Moving to 300 mg once a month does not either, because that is still two pens. Ask what changes and what does not before assuming a dose change alters cost.
The pharmacy counter. Cash prices on an identical box varied by about $20 across our reads, and participating-pharmacy lists differ by program. Calling two or three counters is worth a few minutes.
Cash Price vs. Insurance
If you have commercial insurance that covers Praluent, running it through the plan and adding the co-pay card usually wins. The card covers deductibles, copays and coinsurance and can bring an eligible patient to $50 a month, subject to that $3,500 annual cap. Once you exhaust the cap, compare what your plan charges against the $225 cash price, because late in the year the cash route can be cheaper.
Medicare is the genuinely mixed case. Praluent is a Part D drug, and the 2019 Regeneron announcement projected most Part D patients would land between $25 and $150 a month on the lower-priced NDCs. That range is seven years old and plan designs have changed twice since, so treat it as history rather than a quote. Because TrumpRx purchases are self-pay, a Part D member facing high coinsurance can sometimes do better at $225, but the terms require you to agree not to seek reimbursement, not to count the cost toward your deductible or out-of-pocket limit, and to tell your insurer you bought outside the plan. Cash dollars do not count toward the Part D out-of-pocket cap, so run the full-year math.
Praluent 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 taking effect in 2028.
How to Pay Less
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Take the $225 cash price first. It is published on a federal site, it applies regardless of insurance status, and it saves roughly $3,750 a year against the pre-discount price. Confirm the strength and the two-count box match your prescription before you hand over the coupon.
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Price the same box at more than one pharmacy. Retail cash quotes on identical pens moved about $20 across our reads, and participating-pharmacy networks vary. Our comparison of GoodRx vs. SingleCare covers checking two cards on the same drug quickly, and the fair price checker is a fast reality check on any quote.
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Ask whether you were ever enrolled in MyPraluent. Re-enrollment is still open to prior enrollees who are uninsured or have no pharmacy coverage, and it provides the drug at no cost for up to 12 months. If you had a lapse, that is worth a phone call before you pay anything.
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Apply to the independent charitable foundations. Organizations such as the PAN Foundation, HealthWell Foundation, Good Days and The Assistance Fund run cardiovascular funds that can cover copays or, in some cases, the drug itself. They are separate from Regeneron, have their own criteria, and open and close funds through the year, so apply as soon as a fund opens.
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Handle the prescribing and monitoring costs too. PCSK9 inhibitors come with specialist visits and repeat lipid panels. A free or sliding-scale clinic can manage that side at little or no cost, and a routine cash-pay doctor visit typically runs $100 to $300 otherwise.
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If a bill already exists, negotiate it. Specialty pharmacy and infusion-center invoices get reduced more often than people assume. Our guide to negotiating medical bills has the script, and hospital charity care applies when the drug was billed through a health system.
Bottom Line
Budget $225 a month if you use the direct-to-patient cash price and roughly $516 to $537 if you do not. The single most consequential thing an uninsured Praluent patient can know in 2026 is that the free-drug program no longer takes new applicants, which makes the cash price the practical floor rather than a fallback.
It is worth pricing the whole shelf before you settle. Repatha is the direct competitor and sits $14 a month higher on the same federal site, while Leqvio is given twice a year in a clinic and priced per dose instead of per month. On the oral side, CMS prices generic atorvastatin and rosuvastatin at pennies a tablet and ezetimibe at about seven cents, with Nexletol sitting between the generics and the injectables. If cholesterol is one line on a longer cardiac list, our Eliquis and Entresto guides cover the drugs most often filled alongside it.