Repatha is Amgen’s brand name for evolocumab, an injectable PCSK9 inhibitor that lowers LDL cholesterol. Standard dosing is one 140 mg pen every two weeks, which works out to two pens a month, or a 420 mg dose once a month given as three injections back to back.
The cash-price story on this drug changed completely in the last year, and most of what you will find written about it is out of date. Amgen launched a direct-to-patient program in October 2025 that puts a published cash price on the drug for the first time, and that price is now listed on a federal website. Everything below was researched on September 3, 2026.
What Does Repatha Cost Without Insurance?
Three independent sources price the no-program version of this drug, and they do not fully agree. The federal TrumpRx.gov listing shows a pre-discount price of $625.89 for the two-pen box. Drugs.com’s cash price guide lists $578.51 for the same two pens. CMS’s National Average Drug Acquisition Cost survey, which measures what pharmacies actually pay to buy the product, puts it at $281.81 per prefilled syringe and $281.97 per SureClick autoinjector effective August 19, 2026, or about $564 for two.
That spread is normal. Acquisition cost sits below retail, retail varies by pharmacy, and the number a manufacturer publishes as its pre-discount reference sits at the top. The useful takeaway is that a cash payer with no program is looking at somewhere between $564 and $626 a month.
| Repatha option (140 mg/mL) | Low | Typical | High |
|---|---|---|---|
| One month (2 pens), cash price through AmgenNow / TrumpRx.gov | $239.00 | $239.00 | $239.00 |
| One month (2 pens), no program | $563.61 | $578.51 | $625.89 |
| Single pen or syringe | $281.81 | $289.26 | $312.95 |
| Repatha co-pay card (commercial insurance required) | $25.00 | $25.00 | $25.00 |
| Amgen Safety Net Foundation, if you qualify | $0 | $0 | $0 |
| Generic atorvastatin 40 mg, 30 tablets, for scale | $1.11 | $1.11 | $1.11 |
The $239 price is the headline number
On October 6, 2025, Amgen announced AmgenNow and priced Repatha at $239 a month through it, describing that as nearly 60% below the then-current U.S. list price. The program is now listed on TrumpRx.gov, the federal direct-purchase site launched February 5, 2026, where the Repatha page shows a $625.89 original price, a $386.89 discount, and a $239.00 final price, a 62% reduction.
Amgen says the program is open to all U.S. patients with a valid prescription, including the uninsured, people in high-deductible plans, and people enrolled in Medicare or Medicaid who choose to pay cash. Coupons are issued through GoodRx and presented at participating retail pharmacies. No prior authorization and no step therapy apply.
There is a catch worth reading before you enroll. If you have government insurance, Amgen requires you to agree that you will not seek reimbursement, will not count the cost toward your deductible or true out-of-pocket total, will tell your insurer you bought outside the plan, and will buy all your Repatha through the coupon for the rest of the calendar year.
What Drives the Price
Whether you use the cash program at all. This is the entire ballgame. The gap between $239 and the $625.89 pre-discount price is $386.89 a month, or roughly $4,600 a year, and it costs nothing to close except printing a coupon.
There is no biosimilar. Evolocumab is a biologic with no U.S. biosimilar on the market as of September 2026, and CMS’s NADAC file lists no corresponding generic price for any Repatha NDC. Nothing structural is pushing this price down except manufacturer programs.
Which insurance box you fall into. Amgen’s co-pay card is open to commercially insured patients with no income test, and pays down to as little as $25 for a one-month supply or $50 for a three-month supply. It is explicitly not valid for cash-paying patients or for anyone on Medicare, Medicaid, Medigap, VA, DoD or TRICARE. Cash payers and government-insured patients are steered to AmgenNow or to charitable foundations instead.
Your dose and device. The every-two-week 140 mg regimen uses two pens a month. The once-monthly 420 mg regimen uses three injections, so it is a different quantity and a different price. The $239 figure is quoted for a two-count box, so confirm the count before you assume it covers your regimen.
The pharmacy. Even inside a discount program, participating pharmacies differ. Retail cash prices in our reads spanned about $60 a month on an identical product, so it is worth calling more than one counter.
Cash Price vs. Insurance
If you have commercial insurance that covers Repatha, running it through the plan and stacking the co-pay card is almost always the cheaper path. Amgen cites IQVIA claims data from calendar 2025 showing about 88% of commercial prescriptions cost the patient $50 or less, and the co-pay card can bring an eligible patient to $25 a month.
Medicare is the genuinely awkward case. Amgen reports that about 84% of Medicare prescriptions cost $50 or less per month and that Part D Low Income Subsidy enrollees can expect $12.65 or less, but Part D cost sharing varies a lot by plan and by which benefit phase you are in. Because AmgenNow accepts Medicare enrollees who pay cash, a Part D member in a high coinsurance tier can sometimes beat their own plan at $239. The tradeoff is that cash dollars do not count toward the Part D out-of-pocket cap, so run the whole-year math rather than one month.
Repatha has not been selected for Medicare price negotiation. It does not appear on the CMS lists of drugs with negotiated prices for 2026 or 2027, nor on the 15 Part B and Part D drugs CMS selected on January 27, 2026 for negotiated prices effective in 2028. There is no negotiated benchmark coming for this molecule in the near term.
How to Pay Less
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Start with the $239 cash coupon before you do anything else. It is published, it is open to everyone with a prescription, and it is roughly $4,600 a year cheaper than paying retail. Print it, take it to a participating pharmacy, and confirm the count on the box matches your prescription.
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Price the same box at three pharmacies anyway. Cash prices on an identical two-pen box varied by about $60 across our reads. Our comparison of GoodRx vs. SingleCare walks through checking more than one discount card on the same drug in a couple of minutes, and the fair price checker is a fast sanity check on any quote you are handed.
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Apply to Amgen Safety Net Foundation if money is tight. The Foundation provides Amgen medicines at no cost to people who have lived in the U.S. or its territories for at least six months, have no insurance coverage, and meet product-specific income guidelines. Amgen states the Foundation provides access to every patient who qualifies.
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Ask about the independent foundations too. Amgen SupportPlus points uninsured and government-insured patients to the PAN Foundation, HealthWell Foundation, Good Days, The Assistance Fund, Patient Advocate Foundation and NeedyMeds. These are separate organizations with their own criteria and their own funding cycles, so apply early in the year when funds are open.
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Do not forget the visit that generates the prescription. A PCSK9 inhibitor is a specialist-managed drug, and the appointments and lipid panels add up. A free or sliding-scale clinic can handle prescribing and monitoring at little or no cost, and a routine cash-pay doctor visit typically runs $100 to $300 if you go that route.
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If a bill already landed, treat it like any other medical bill. Specialty pharmacy invoices are negotiable more often than people expect. Our guide to negotiating medical bills covers the phone script, and hospital charity care applies if the drug was billed through a health system rather than a retail counter.
Bottom Line
Budget $239 a month if you use the direct-to-patient cash price and roughly $564 to $626 if you walk in with nothing. That gap is the single largest decision a cash payer makes on this drug, and it takes about five minutes to act on.
Before you commit to an injectable at all, it is worth knowing what the rest of the shelf costs. Generic atorvastatin and rosuvastatin are priced by CMS at roughly a penny to four cents a tablet, ezetimibe at about seven cents, and Nexletol sits between those and the injectables. Among the injectables, Praluent is the direct competitor and currently carries a lower cash price at $225 a month, while Leqvio is dosed twice a year in a clinic and priced per dose rather than per month. If your cholesterol drug sits alongside other cardiac prescriptions, our Eliquis and Entresto guides cover the two most commonly filled with it, and the coronary calcium score test is the cash-priced scan people most often ask about in the same conversation.