Expect cash prices near $4,116 for 30 tablets of Rezdiffra before discounts, with annual list estimates around $47k–$49k.
Sticker price matters when you’re paying cash for a specialty medicine. With this therapy, list pricing is published publicly and updated by the manufacturer for state transparency forms. The short version: each 30-tablet bottle is listed at about $4,115.90 as of January 2025, and dosing is once daily, so most people think in monthly and yearly numbers. Below you’ll find the current list pricing, why totals differ across sources, and practical ways to bring that bill down if you’re paying out of pocket.
Quick Cash Price Snapshot
The manufacturer’s Connecticut price transparency filing lists the wholesale acquisition cost (WAC) per 30-tablet bottle at the same amount across strengths. That makes monthly planning straightforward for most prescriptions filled through specialty pharmacies.
| Tablet Strength | WAC Per 30 Tablets | What That Means Per Month |
|---|---|---|
| 60 mg | $4,115.90 | About $4,116 before any discounts |
| 80 mg | $4,115.90 | About $4,116 before any discounts |
| 100 mg | $4,115.90 | About $4,116 before any discounts |
Source: the January 2, 2025 Connecticut prescriber form lists WAC of $4,115.90 per 30 tablets for all three strengths. WAC is a published list price to wholesalers; a patient’s final price can land higher or lower depending on pharmacy contracts and any savings applied.
What Rezdiffra Costs Without A Plan: Real-World Ranges
Two numbers circulate online. At launch in March–April 2024, coverage bulletins and trade press quoted a yearly list around $47,400. In state updates, the per-bottle WAC noted above translates to about $49,391 for twelve 30-tablet fills. Both figures describe list pricing, not what every cash payer actually spends.
Why the gap? List pricing can shift after launch, and calculations depend on whether you use an annual figure from early communications or multiply the current per-bottle listing by twelve months. Here are the reference points:
- Launch communications and payer bulletins set expectations near $47,400 per year.
- Current state transparency shows $4,115.90 per bottle (30 tablets), which equals ~$49,391 over 12 fills without any discounts.
How Dose And Body Weight Affect Your Monthly Spend
Dosing is once daily and based on actual body weight: 80 mg daily if under 100 kg, 100 mg daily if 100 kg or more. With a 30-count bottle and daily dosing, most people need one bottle each month. The equal WAC across strengths means the cash spend is similar either way, unless your prescriber adjusts dose due to drug interactions.
When Dose Changes Can Change The Math
Certain medicines interact with this therapy and can lead to a lower prescribed dose (for example, when used with moderate CYP2C8 inhibitors). In those cases the prescriber may switch you to a lower-strength tablet once daily, which still maps to one 30-count bottle per month in routine care.
Why Cash Prices Vary Between Pharmacies
This medicine is a limited-distribution specialty drug. That means a small network of specialty pharmacies handles most fills. Coupon cards you might use for common generics usually don’t apply here, and retail chains often route the script to a specialty partner. Expect the quote you get to reflect the specialty pharmacy’s contract terms rather than a typical “walk-up” discount price.
Can You Lower The Out-Of-Pocket Bill Without Insurance?
Yes—there are a few realistic paths. The manufacturer runs a dedicated program that reviews each case. While copay cards target people with commercial insurance, the same portal can connect uninsured patients with case managers who screen for patient-assistance options and specialty-pharmacy pathways.
Manufacturer Help You Can Tap
- Madrigal Patient Support: enroll to get a case manager who can review affordability options, navigate the specialty network, and check eligibility for patient assistance based on income and diagnosis.
- Copay Savings Card (for those with commercial coverage): people who do carry private insurance may pay as little as a small monthly amount with the copay program; while that doesn’t fit the “no insurance” scenario, it matters if your status changes during treatment.
Other Savings Moves That Work In Practice
- Ask for the specialty pharmacy that quotes the lowest cash rate: your prescriber can usually route the script to another in-network specialty pharmacy if pricing differs.
- Request a 30-day supply to start: this keeps the first bill predictable while your case manager works on longer-term support.
- Check for foundation grants: disease-area funds open and close; your case manager will know if any are active for liver fibrosis related to MASH/NASH.
Where Official Sources Put Today’s Price
If you want a link you can show to a pharmacy or benefits office, two references are especially helpful and non-promotional:
- FDA Prescribing Information (for dosing and strengths).
- ICER health-benefit price benchmark (typical cost-effectiveness range $39,600–$50,100 per year).
The ICER range isn’t a pharmacy price tag; it’s a value benchmark used by payers and policy groups when judging whether the list price sits near typical thresholds.
Putting The Numbers Together
Here’s how the usual math plays out for someone paying cash at a specialty pharmacy today, before any patient-assistance help:
- Per 30 tablets (any strength): about $4,116 listed to wholesalers.
- Per year at 12 fills: about $49,391 if the current per-bottle listing applies across the year.
- Earlier launch-year communications: yearly list often quoted at about $47,400.
How Coverage Status Changes The Bill
If you’re moving between no coverage and a new plan, the same support hub is still your first stop, since specialty authorization rules and pharmacy networks can be confusing. When coverage is active, the program’s copay card (for eligible people with private insurance) can drop out-of-pocket sharply. Without coverage, the same team screens you for patient-assistance enrollment and can coordinate fills through a participating specialty pharmacy.
What Your Prescriber And Pharmacy Need From You
Fast approvals and better quotes usually come down to complete paperwork. Bring these to your appointment or upload to the support portal:
- Proof of income and household size for patient-assistance screening.
- Diagnostic documentation confirming noncirrhotic MASH/NASH with moderate to advanced fibrosis (F2–F3), since specialty pharmacies and assistance programs require the FDA-approved use.
- Current medication list, because some drugs trigger a lower dose and the pharmacy needs that on file.
Second Look: Ways To Cut The Cash Price
Here’s a compact reference you can share with your care team. It groups the realistic paths for people paying without an active plan.
| Savings Option | Who It Helps | What To Expect |
|---|---|---|
| Manufacturer Patient Support | Uninsured adults with the FDA-approved diagnosis | Case-by-case assistance; help routing to a specialty pharmacy and screening for grants |
| Foundation Grants | People who meet income and diagnosis rules | Periodic funds; your case manager checks availability and handles paperwork |
| Specialty Pharmacy Shopping | Anyone paying cash | Different pharmacies in the network may quote different cash totals; ask your prescriber to route to the best option |
Clear Answers To Common Cost Questions
Is There A Cheaper Strength?
No. The current list shows the same WAC per 30-tablet bottle for 60 mg, 80 mg, and 100 mg. Dosing is once daily, so strength doesn’t change the basic monthly cash quote.
Can A Discount Card At A Retail Chain Bring The Price Down?
Not likely. This therapy runs through a limited specialty network, so ordinary coupon cards aren’t usually accepted. Your case manager can still look for specialty-level programs and grants.
Why Do Some Articles List A Lower Annual Number?
Many early reports used the launch-year annual list near $47,400. State transparency updates list per-bottle WAC figures; multiplying those by 12 lands near $49,391. Both are “list,” not negotiated cash quotes.
How We Built These Estimates
The numbers here rely on three primary sources. Dosing and tablet strengths come from the official FDA label. The launch-year annual figure appears in payer and trade press bulletins published at approval. Current per-bottle WAC pricing comes from a 2025 state transparency form posted by the manufacturer. Together, those sources let you plan monthly and annual cash exposure with realistic guardrails. Citations:
- FDA label: dosing by body weight, strengths 60/80/100 mg.
- Launch-year list pricing near $47,400.
- Current WAC per 30 tablets $4,115.90 across strengths.
- Value benchmark range from ICER ($39,600–$50,100 per year).
Action Plan If You’re Paying Cash
- Ask your prescriber to enroll you with the manufacturer’s support hub the same day the script is written. This opens the door to patient assistance and foundation checks.
- Request quotes from more than one in-network specialty pharmacy. Your prescriber can route the script to the pharmacy that offers the best cash option.
- Start with a 30-day fill. That limits upfront cash while the case manager chases longer-term help.
- Keep documents handy. Proof of income, ID, and diagnosis notes speed up patient-assistance decisions.
- If you later gain commercial coverage, switch to the copay program. People with private insurance can often bring monthly costs down sharply via the official card.
Final Takeaway On Cash Pricing
Plan for a list price near $4,116 per 30-tablet bottle and an annual list in the high-$40k range before any savings. Because this is a specialty drug with limited distribution, the most effective way to reduce the bill is to enroll with the manufacturer’s support hub, ask your prescriber to route the prescription to the most favorable specialty pharmacy, and keep eligibility paperwork ready. Those steps give you the best shot at lowering out-of-pocket costs while staying on therapy.