Zetia (ezetimibe) is a brand-name oral tablet prescribed for certain types of high cholesterol. Zetia’s cost, with and without insurance, can depend on several factors, such as whether Zetia has a savings program.
As with all medications, the cost of Zetia can vary. Factors that may affect the price you’ll pay include:
- your treatment plan
- your insurance coverage
- the pharmacy you use
- whether Zetia has a savings program (see the “Financial and insurance assistance” section)
To find out what the cost of Zetia will be for you, talk with your doctor, pharmacist, or insurance provider. Or look below in the next section to learn how much you can save by using an Optum Perks coupon.
To save money on your Zetia prescription, explore these Optum Perks coupons.
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The active ingredient of Zetia is ezetimibe. It’s available as the generic drug ezetimibe. A generic drug is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs.
If your doctor has prescribed Zetia and you’re interested in ezetimibe instead, talk with your doctor. They may have a preference for one version or the other. You’ll also need to check with your insurance provider, as it may only cover one or the other.
To find out how the cost of this generic drug compares with the cost of Zetia, talk with your doctor, pharmacist, or insurance provider.
WHY ARE COSTS DIFFERENT FOR BRAND-NAME DRUGS VS. GENERIC DRUGS?Brand-name drugs can be expensive because of the research needed to test their safety and effectiveness. The manufacturer of a brand-name drug can sell it for up to 20 years. When the brand-name drug’s patent expires, multiple manufacturers can create generic versions. This marketplace competition may lead to lower costs for generics. Also, because generics contain the same active ingredients as brand-name drugs, they don’t require the same costly testing.
Here are answers to some frequently asked questions about drug cost and Zetia.
How much does Zetia cost with and without insurance?
What you pay for Zetia if you have insurance compared with what you’d pay without it depends on several factors.
Without insurance, factors that could affect what you pay for this drug include:
- the quantity you’re prescribed (such as a 30-day or 90-day supply)
- whether you apply and qualify for any available savings programs (see the “Financial and insurance assistance” section)
- your Zetia dosage and treatment plan
- the pharmacy you use
These same factors may affect your price for Zetia if you have insurance. But the price you pay for Zetia with insurance will also depend on:
- your specific insurance plan benefits
- any prior authorization requirements you have for drug coverage (see the “Insurance considerations” section)
To learn more about what you’d pay for Zetia with or without insurance, talk with your doctor, pharmacist, or insurance provider (if you have one).
You can also visit Optum Perks for price estimates for this drug when using coupons from their site. Note that Optum Perks coupons cannot be used with insurance benefits or copays. (Optum Perks is a sister site of Medical News Today.)
What will my Zetia cost be with Medicare?
It depends. You can call your Medicare plan provider to learn whether your particular plan covers the cost of Zetia. There are many types of Medicare plans, so your coverage and what you pay for prescriptions will be based on your particular plan’s benefits.
You may also need to obtain prior authorization before your plan will cover the cost of this medication. (For more information, see the “Insurance considerations” section.)
Your doctor may also be able to provide information about your cost for Zetia if you have Medicare.
How much does Zetia 10 mg cost per month compared with ezetimibe 10 mg per month?
The price you’d pay for Zetia versus that of ezetimibe depends on various factors. Ezetimibe is a generic version of Zetia. Typically, generics cost less than brand-name drugs. Zetia and ezetimibe tablets come in one strength of 10 milligrams (mg).
Additional factors that affect your prescription cost can include:
- the length of your treatment
- whether there are payment assistance programs for your prescribed treatment
- whether you’re paying out of pocket or have insurance
To learn more about the cost of brand-name Zetia versus generic ezetimibe for your condition, talk with your doctor, pharmacist, or insurance provider. You can also visit Optum Perks for price estimates.
If you take Zetia long term, you may be able to lower its cost in the following ways.
Getting a 3-month supply
You may be able to get a 90-day supply of Zetia. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor, pharmacist, or insurance provider.
Using a mail-order pharmacy
Zetia may be available through a mail-order pharmacy. Using this type of service may help lower the drug’s cost and allow you to receive your medication without leaving home. Some Medicare plans may help cover the cost of mail-order medications. You may also be able to get a 90-day supply of the drug via mail order.
If you don’t have health insurance, talk with your doctor or pharmacist. They may be able to suggest online pharmacy options that could work for you.
If you need financial support to pay for Zetia, or if you need help understanding your insurance coverage, help is available. For example, some websites provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services. Two such websites are:
To learn more about saving money on prescriptions with or without insurance, check out this article.
Below is information you may want to consider if you have insurance and receive a Zetia prescription.
If you have insurance, your insurance company may require prior authorization before it covers Zetia. This means the company and your doctor will discuss Zetia in regard to your treatment. The insurance company will then determine whether the medication is covered.
If a drug requires prior authorization but you start treatment without the prior approval, you could pay the full cost of the medication. You can ask your insurance company whether Zetia requires prior authorization.
If you’d like resources on high cholesterol, including its health effects and treatment options, see our cholesterol hub.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.