The Cost Breztri of with Medicare

Health Line

13 hours ago

Breztri can cost $400 or more without insurance, but Medicare may cover inhaler drugs for COPD, including Breztri. That said, the specific coverage and costs vary based on your exact plan.
Breztri Aerosphere (budesonide, glycopyrrolate, and formoterol fumarate) is a metered-dose inhaler designed for adults living with chronic obstructive pulmonary disease (COPD).
Medicare might help cover the cost of Breztri for COPD, but it's important to check the specifics of your plan, as there's no nationwide rule for inhaler coverage. Each Medicare Part D or Medicare Advantage Prescription Drug (MAPD) plan may cover different drugs.
However, note that if you need a nebulizer rather than an inhaler, you would typically be covered under Medicare Part B.
How much does Breztri cost with Medicare?
If you don't have insurance, a 5.9-gram (g) Breztri inhaler costs around $400, while a larger 10.7-g inhaler can cost about $700.
Whether your Medicare drug plan covers a Breztri inhaler depends on its formulary, which is a list of covered medications that varies with each plan. If your plan's formulary doesn't include this inhaler, it might offer coverage for a different one instead.
If your plan covers Breztri, the amount you need to pay depends on its tier within the formulary. Higher tiers usually mean a higher cost. However, starting in 2025, you'll pay no more than $2,000 annually out of pocket for drugs through Medicare plans.
Remember, Part D and MAPD plans are managed by private insurance companies, meaning your deductibles, premiums, and copays will depend on your plan. In 2025, the national base beneficiary premium for Part D is $36.78, and according to the Centers for Medicare & Medicaid Services (CMS), the average monthly premium for Medicare Advantage plans is about $17.
If you use a nebulizer and have coverage under Part B, you'll pay 20% of the cost after meeting your annual deductible of $257, as long as you keep up with your monthly premium of $185.
How can I get cheaper Breztri with Medicare?
Typically, you can get cheaper drugs through your Medicare plan by getting a prescription for a generic version. These tend to feature in lower formulary tiers, making them more affordable.
There's no generic version of Breztri, but other medications may be just as effective and more budget-friendly. Your Medicare plan may cover these.
In fact, since Breztri can be expensive, your plan might require prior authorization before they approve coverage. This could involve step therapy, where you're asked to try a different, equally effective but cheaper medication first.
In addition, AstraZeneca, the company that produces Breztri, offers a cost assistance program that may make this drug more affordable for Medicare enrollees. You'll need to visit the manufacturer's website to check your eligibility.
Takeaway
Breztri is a brand-name inhaler designed for long-term management of chronic obstructive pulmonary disease (COPD) in adults. Although Medicare drug plans may cover COPD inhalers like Breztri, coverage is not uniformly required. This means your coverage and cost depend on the specific medication and your specific plan.
Generally, Medicare Part D or a Medicare Advantage Prescription Drug (MAPD) plan provides drug coverage for Medicare, including for covered inhalers. However, if you need to use the drug with a nebulizer, your coverage would fall under Part B.