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How much does Stiolto Respimat cost with Medicare?

Coverage ultimately depends on which tier your Medicare drug plan places Stiolto Respimat
Rosemary Black
By | Aug. 9, 2024 Medically reviewed by Karen Berger, Pharm.D. & Scott Dershowitz, LMSW, CMC
A Medicare card, stethoscope, and notepad: How much does Stiolto Respimat cost with Medicare?
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Stiolto Respimat is a prescription medication that can help people living with chronic obstructive pulmonary disease (COPD) manage their symptoms and make it easier to breathe. It is a maintenance medication that is inhaled and delivered as a soft mist.  Typically, Stiolto Respimat is used once daily. It does not work as a rescue inhaler and is not approved to treat asthma or allergic reactions.

“Stiolto Respimat is inhaled through the mouth through an inhaler device and enters the lungs, which is the part of the body that COPD mainly affects,” says Alyssa M. Wozniak, Pharm.D., clinical assistant professor and director of interpersonal education in the School of Pharmacy at D’Youville University in Buffalo, New York. Stiolto Respimat combines two active ingredients: tiotropium bromide and olodaterol. “Stiolto Respimat is ideal for people who prefer a combination inhaler as a way to reduce the number of daily medications they need to take,” Wozniak adds.

Despite the lack of a cheaper generic alternative to this combination drug, it can be made more affordable if you have insurance or Medicare. With Medicare, you may pay as little as $4 or as much as $70, depending on which tier it’s on in your formulary and other factors. You may even get it for free. However, if your Medicare drug plan doesn’t cover Stiolto Respimat, you may have to pay the average retail price unless you use a SingleCare coupon or qualify for other savings options. 

How much does Stiolto Respimat cost?

The average retail price of Stiolto Respimat is $631 for one inhaler with 60 puffs, which is a one-month supply, considering the typical dosage is two puffs once per day. That’s the price you can expect to pay without insurance or coupons. However, the price depends on which pharmacy you choose, so you may want to do some comparison shopping at different pharmacies.

If you have commercial health insurance, your plan may help cover the cost of Stiolto Respimat. But your out-of-pocket cost will depend on the specifics of your plan. 

Does Medicare cover Stiolto Respimat?

Medicare may cover Stiolto Respimat, but the covered amount may vary. “And there should be other options if Stiolto Respimat is not on your formulary,” Wozniak says. 

Your Medicare Part D or Part C (Medicare Advantage) plan will have a list of covered drugs known as a formulary, which assigns prescription drugs to different tiers. The drug formulary for one Medicare plan may be different from another. For example, one Medicare drug plan might assign Stiolto Respimat to Tier 2 while another might assign it to Tier 4. You’ll spend less for drugs in the lower tiers than for drugs in the higher tiers.

What is the cost of Stiolto Respimat on Medicare?

The best way to learn if your Medicare drug coverage covers Stiolto Respimat is to check your plan’s drug formulary. Aside from the tier it’s assigned to, the pharmacy you use will also determine how much you’ll pay on Medicare. Additionally, your Medicare plan might charge a different copay if you get your prescription from a mail-order pharmacy than if you get it from a brick-and-mortar pharmacy.

The manufacturer of Stiolto Respimat, Boehringer Ingelheim, offers an online copay calculator you can use to determine how much you’ll pay for your prescription as well. If you enter your state of residence and choose your plan from the dropdown list, you’ll see which tier your plan places Stiolto Respimat, sometimes with an estimate of what you can expect to pay. When we used the tool to compare Medicare plans, we found that some placed it on Tier 2 or Tier 3, while some provided no coverage at all. Some Tier 2 copays were as low as $4, and some were as high as $70. 

Despite the tool being a helpful starting point, contacting your Medicare plan provider is the best way to get an accurate idea of what you will have to pay for your prescription. They can take deductibles and other factors (such as which phase of coverage you are in) into consideration to give you the most accurate answer. For example, if you happen to be in the coverage gap, also called the donut hole, you may pay a different amount than what you paid for previous refills during the initial coverage phase. 

The prescription drug law and Stiolto Respimat

The Medicare Prescription Payment Plan, which launches on Jan. 1, 2025, may lower prescription drug costs for people who have Medicare Part D—including both standalone Medicare prescription drug plans and Medicare Advantage plans with prescription drug coverage. The plan offers enrollees the option to pay capped monthly payments for their out-of-pocket prescription drug costs, with the total annual cost not exceeding $2,000 per year. Enrollees can opt-in during Medicare Open Enrollment, starting Oct. 15, 2024, or throughout the year. 

How to save on Stiolto Respimat

If your Medicare prescription drug plan doesn’t cover Stiolto Respimat, or if it covers it but the copay is too high, a SingleCare prescription discount card could help you save. Depending on your choice of pharmacy, you could pay $408 for one inhaler instead of $631. You cannot use Medicare benefits with SingleCare coupons, however.

There are other ways to save on Stiolto Respimat as well, including:

  • The Medicare Extra Help program, which helps people with limited income and resources pay Medicare Part D premiums, deductibles, coinsurance, and other costs
  • The manufacturer’s Stiolto Respimat savings card, with which you may be eligible to pay as little as $35 for Stiolto Respimat, providing your Medicare plan doesn’t cover the drug

“If you have a high copay, don’t have insurance, or need to pay cash for your prescription drugs, speak with your doctor or pharmacist,” Wozniak advises. They may be aware of cost-saving opportunities like coupons or patient assistance programs that can help you save. They may also be able to prescribe more affordable alternatives to Stiolto Respimat to help you manage your COPD symptoms.

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