Gemtesa (vibegron) is a prescription medication used to treat overactive bladder symptoms in adults, such as urgency, frequent urination, and urge incontinence. It works by relaxing the bladder muscle so it can hold more urine and reduce sudden urges. Many patients find it offers good symptom relief with fewer side effects than older medications in the same class.
Cost is one of the most common questions people ask when a doctor recommends Gemtesa. Without insurance or assistance programs, the price can feel high for a daily oral tablet. With coverage, discounts, or manufacturer support, the amount patients actually pay often drops significantly.
This article explains typical Gemtesa pricing, how insurance and assistance programs affect the cost, and practical ways to make it more affordable. The information is for educational purposes only and not medical advice. Prices change over time and vary by pharmacy, location, and individual coverage—always check current costs with your pharmacist or insurance provider.
Gemtesa List Price Without Insurance
The manufacturer’s list price (wholesale acquisition cost) for a 30-day supply of Gemtesa (75 mg tablets, 30-count bottle) is typically around $450–$500. This is the “sticker price” pharmacies see before any discounts or negotiated rates.
Cash-paying customers at retail pharmacies usually pay close to this amount, sometimes $420–$480 after minor pharmacy-level discounts. Online mail-order pharmacies or certain discount networks occasionally offer it slightly lower, but savings are modest without insurance or coupons.
This full retail price applies when no insurance, no manufacturer assistance, and no pharmacy discount card is used. Most people do not pay this amount because better options almost always exist.
Why the List Price Is Rarely the Final Price
- Pharmacies and PBMs negotiate lower rates
- Manufacturer copay cards reduce costs for eligible patients
- GoodRx, SingleCare, and similar cards lower cash prices
- Insurance (commercial or Medicare) changes the equation completely
Very few patients pay the full list price month after month.
Gemtesa Cost With Commercial Insurance
Most commercial (employer-sponsored or marketplace) insurance plans cover Gemtesa as a Tier 3 or Tier 4 drug on their formulary. This usually means a copay of $40–$100 per month, though some plans place it on Tier 2 with copays of $20–$50.
High-deductible plans may require patients to pay the full negotiated price (often $200–$350) until the deductible is met. After the deductible, coinsurance (typically 20–40%) applies until out-of-pocket maximums are reached.
Many patients with commercial coverage pay $0–$60 per month once any prior authorization or step therapy requirements are satisfied. The manufacturer copay card can further reduce this to as low as $0–$10 for eligible patients.
Commercial Insurance Cost Scenarios
- Low copay tier: $20–$50 per month
- Higher tier or coinsurance: $60–$150 per month
- Before deductible met: up to $200–$350 per month
- With manufacturer copay card: often $0–$10 per month
Always verify your plan’s formulary status and cost-sharing rules.
Gemtesa Cost With Medicare Part D
Medicare Part D plans cover Gemtesa under the outpatient prescription drug benefit. It is usually placed on Tier 3 or Tier 4, which means higher copays or coinsurance compared to generics.
In the initial coverage phase, most Part D enrollees pay $40–$100 per month for Gemtesa. Once in the coverage gap (donut hole), patients pay a percentage of the drug’s cost until catastrophic coverage begins. In 2025, the Inflation Reduction Act caps annual out-of-pocket spending on Part D drugs at $2,000, which includes Gemtesa.
Many Medicare beneficiaries pay $0–$50 per month for Gemtesa after reaching the $2,000 cap. Extra Help (Low-Income Subsidy) reduces costs even further—often to $4–$10 per prescription.
Medicare Part D Cost Phases
- Deductible phase: full negotiated price until met
- Initial coverage: copay or coinsurance ($40–$100 typical)
- Coverage gap: percentage of cost until $2,000 out-of-pocket cap
- Catastrophic coverage: $0 for covered drugs after $2,000
The $2,000 cap applies to out-of-pocket spending on covered drugs.
Manufacturer Copay Assistance for Gemtesa
The Gemtesa Savings Program (offered by Urovant Sciences / Sumitovant) provides significant help for eligible commercially insured patients. The card reduces out-of-pocket costs to as low as $0 per month for up to 12 fills per year (maximum benefit $3,600 annually).
Eligibility generally requires commercial insurance and no government coverage (Medicare, Medicaid, VA, etc.). The card is not available to Medicare beneficiaries due to federal rules against manufacturer copay assistance for government plans.
Patients can activate the card online or through their doctor’s office. It is accepted at most major pharmacies and mail-order services.
Who Qualifies for the Gemtesa Savings Card
- Commercial (private) insurance only
- No government coverage (Medicare Part D, Medicaid, etc.)
- Valid prescription for Gemtesa 75 mg
- U.S. resident (including Puerto Rico)
This program makes Gemtesa $0–$10 per month for many insured patients.
Pharmacy Discount Cards and Cash-Pay Savings
Even without insurance or manufacturer assistance, discount cards can lower the cash price. GoodRx, SingleCare, RxSaver, and similar platforms often reduce the price to $350–$420 for a 30-day supply.
Some independent pharmacies and mail-order services offer cash prices below the average retail amount. Comparing prices across several cards and pharmacies can save $50–$150 per fill.
These discounts do not work with insurance—you must choose one or the other at the pharmacy counter.
Popular Discount Cards for Gemtesa
- GoodRx
- SingleCare
- RxSaver
- ScriptSave WellRx
- PharmacyChecker-verified mail-order pharmacies
Always present the card before paying.
Ways to Make Gemtesa More Affordable
Choose the longest manufacturer savings card benefit period if eligible. Ask your doctor’s office to help with prior authorization or formulary exceptions if your plan places Gemtesa on a high tier.
Compare pharmacy prices every refill—small differences add up over time. Some patients save by using mail-order through preferred pharmacies in their insurance network.
If you have Medicare and high drug costs, apply for Extra Help (LIS) through the Social Security Administration. This program dramatically lowers Part D costs for qualifying individuals.
Practical Steps to Reduce Gemtesa Costs
- Activate the manufacturer savings card if commercially insured
- Use GoodRx or similar cards when paying cash
- Ask your doctor about samples or bridge supplies
- Check for pharmacy-specific discounts
- Apply for Extra Help if on Medicare and low income
These actions help many patients pay far less than the list price.
Conclusion
With commercial insurance and the manufacturer savings card, most eligible patients pay $0–$10 per month for Gemtesa. Medicare Part D beneficiaries typically pay $40–$100 per month in the initial coverage phase, with costs dropping further after reaching the $2,000 annual out-of-pocket cap or qualifying for Extra Help. Without any coverage or assistance, cash prices hover around $420–$480 per month, though discount cards can reduce that amount. Exploring every available savings option—insurance benefits, manufacturer programs, discount cards, and pharmacy shopping—makes Gemtesa much more affordable for the majority of users. This article is for informational purposes only and not medical advice. Contact your insurance provider, pharmacist, or doctor for current pricing, coverage details, and eligibility for assistance programs specific to your situation.
FAQ
How much does Gemtesa cost per month with commercial insurance?
With most commercial plans and the manufacturer savings card, patients pay $0–$10 per month for up to 12 fills per year. Without the card, copays usually range from $40–$100 depending on tier placement.
How much is Gemtesa with Medicare Part D?
In the initial coverage phase, most Part D enrollees pay $40–$100 per month. After reaching the $2,000 annual out-of-pocket cap, the cost drops to $0 for covered drugs. Extra Help reduces costs further.
Does Medicare Part B cover Gemtesa?
No. Gemtesa is an oral tablet and is covered under Medicare Part D (prescription drug benefit), not Part B. Part B covers physician-administered drugs, but Gemtesa is self-administered.
Can I use the Gemtesa savings card if I have Medicare?
No. The manufacturer copay card is not available to Medicare beneficiaries due to federal rules. Medicare patients must rely on Part D coverage, Extra Help, or other assistance programs.
How can I get Gemtesa for free or very low cost?
Medicare patients with low income may qualify for Extra Help (LIS), which lowers Part D costs to $4–$10 per prescription. Contact your local State Health Insurance Assistance Program (SHIP) or the Social Security Administration to apply.
What is the cash price for Gemtesa without insurance or discounts?
The cash price at most retail pharmacies is around $420–$480 for a 30-day supply. Using GoodRx, SingleCare, or similar discount cards can reduce it to $350–$420 in many locations.
Does GoodRx work for Gemtesa?
Yes. GoodRx and similar discount cards often lower the cash price to $350–$420 per month. These cards cannot be used with insurance—you must choose one or the other at the pharmacy.
Is there a generic version of Gemtesa available?
No generic version of vibegron (Gemtesa) is currently available. It remains brand-only, which keeps the list price higher than older overactive bladder medications that have generics.
Can I use my HSA or FSA to pay for Gemtesa?
Yes. Gemtesa is a qualified medical expense, so funds from a health savings account (HSA) or flexible spending account (FSA) can be used to pay for it. Confirm with your plan administrator.
What should I do if I cannot afford Gemtesa?
Contact your doctor or pharmacist about the manufacturer’s patient assistance program (if eligible), apply for Extra Help (Medicare), or use discount cards. Many patients find ways to reduce the cost to $0–$50 per month with the right resources.
Dr. Usman is a medical content reviewer with 12+ years of experience in healthcare research and patient education. He specializes in evidence-based health information, medications, and chronic health topics. His work is based on trusted medical sources and current clinical guidelines to ensure accuracy, transparency, and reliability. Content reviewed by Dr. Usman is for educational purposes and does not replace professional medical advice.