Nucala (mepolizumab) is an injectable biologic drug for severe eosinophilic asthma and related conditions. It is given once every 4 weeks by subcutaneous injection. Because Nucala is a specialty medicine, its list price is very high and can impose a large financial burden.
In the US, one dose (100 mg) costs around $3,800-$4,900. This means a year of monthly doses could exceed $45,000 if paid fully out-of-pocket. Some conditions, like eosinophilic granulomatosis with polyangiitis (EGPA) or hypereosinophilic syndrome (HES), use a 300 mg dose monthly, which triples the cost.
Because of this, many patients need insurance or assistance programs to afford Nucala. Below, we’ll review both insured and uninsured costs of Nucala in 2026 and explore ways to reduce out-of-pocket spending.
What is Nucala and how is it used?
Nucala is the brand name for mepolizumab, a monoclonal antibody that targets eosinophils. It is approved by the FDA for the following:
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- Severe eosinophilic asthma
- Chronic rhinosinusitis with nasal polyps
- Eosinophilic chronic obstructive pulmonary disease (COPD)
- Eosinophilic granulomatosis with polyangiitis (EGPA)
- Hypereosinophilic syndrome (HES)
The drug is given as an injection under the skin (subcutaneous) every four weeks. For patients age 12 years and older with asthma or nasal polyps, the dose is 100 mg every 4 weeks. For EGPA or hypereosinophilic syndrome, the dose is 300 mg every 4 weeks, administered as three separate 100 mg injections.
How much does Nucala cost?
Costs vary widely based on insurance, location, pharmacy, and whether you qualify for the manufacturer’s financial assistance programs.
Without insurance
If you have no insurance, the cost of Nucala is essentially the full list price per dose. Without any discounts or insurance, each monthly injection could cost roughly $3,800-$4,900.
No generic version of Nucala exists, and a biosimilar (generic biologic) is not expected until the mid-2030s when the patent expires. Because it’s a specialized injectable biologic, Nucala must be obtained through approved specialty pharmacies and is more expensive than typical asthma drugs.
With insurance
If you have insurance, the cost depends on the details of your plan. Many commercial health plans and Medicare Part D plans do cover Nucala, but almost always with a large co-pay or coinsurance because it is a high-priced specialty drug.
Insured patients typically will pay a portion of the cost as determined by their coverage. A 20-40% coinsurance is common for specialty drugs, though exact plan terms vary.
Even when covered, insurers usually require prior authorization to ensure medical necessity. This means that your doctor must document that your asthma is truly refractory and eosinophil-driven, and that other treatments have failed. Once approved, your share might be a co-pay (fixed dollar) or coinsurance (percentage of the drug’s cost).
Some specialty drugs have fixed co-pay programs (e.g., $100 per dose), but Nucala’s high price usually means co-insurance is more common. For illustration, if your coinsurance is 20%, a $3,800 dose would cost you about $760 per injection, totalling about $9,100 per year.
With Medicare
Medicare covers Nucala primarily through the following:
Medicare Part D
Nucala is often covered under Medicare Part D if prescribed for home use (self-administered, at-home injections). In 2026, the average Part D premium is expected to be around $34-$35 per month. Some plans even offer $0 premiums in certain states or for certain beneficiaries. However, premiums vary based on the plan you choose, where you live, and whether you owe a surcharge due to higher income (IRMAA).
Under Medicare Part D, the deductible in 2026 is no more than $615. This is the amount you must pay out of pocket first before your plan starts sharing costs. Your deductible will depend on which plan you choose, but it will not exceed $615, and some plans have no deductible.
After the deductible, your plan applies coinsurance, typically 25%-33% for specialty drugs. With Nucala priced at about $3,800 per month, that means:
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- At 25% coinsurance, your share would be about $950 for one fill
- At 33% coinsurance, your share would be about $1,250 for one fill
However, under the Inflation Reduction Act, Medicare Part D includes a $2,100 annual out-of-pocket maximum for covered prescription drugs. Because Nucala is so expensive, you will likely reach this cap very early in the year.
Here is what it typically looks like in practice:
Month 1
|
| Month 2
By now, you have already paid around $1,400-$1,600. You only pay until your total reaches $2,100. So in Month 2, you pay only the remaining $400-$700. |
| Month 3
Once you hit $2,100, you pay $0 for Nucala. You only need to continue paying your monthly Part D premium. |
CMS data show that Medicare Part D plans paid a total of $193 million for Nucala in 2022, up from $132 million in 2021, which reflects both the drug’s high price and growing use.
Medicare Part B
Nucala may also be covered under Medicare Part B when it is administered by a healthcare professional in a clinic, infusion center, or doctor’s office. These are the standard costs in 2026 under Part B:
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- Monthly Part B premium: $202.90-$689.90
- Annual Part B deductible: $283
- Coinsurance after deductible: 20% of the Medicare-approved amount
Premiums are paid every month and do not reduce the drug price. The deductible and coinsurance apply to covered services and drugs.
Unlike Medicare Part D, Part B does not have an annual out-of-pocket maximum for prescription drugs. That means, your 20% share does not stop after a certain amount. Over a full year, your out-of-pocket cost could be roughly $9,000 or more, depending on dosing frequency and approved pricing.
If you have a Medigap plan, it may cover some or all of the 20% coinsurance, significantly lowering or even eliminating your out-of-pocket costs for Nucala.
With Medicaid
If you are enrolled in Medicaid and Nucala is approved for you, your out-of-pocket cost is usually very low. In most cases, the monthly cost is $0, and the copay (if there’s any) is usually $1-$4 per dose. Many people pay nothing at all.
Medicaid works very differently from Medicare. As long as Medicaid approves the medication, the state pays almost the entire cost.
How Nucala’s dosing affects cost
Because each 100 mg injection costs roughly $3,800, the dosing schedule directly drives the expense. Patients who need 300 mg per month or three injections will pay about three times more per month than those on 100 mg.
For example, if one 100 mg dose costs $3,837 by list price, three doses would be $11,512 per month. Even at the 100 mg dose, a full year (12 doses) could exceed $44,000 at list pricing. These do not include any administration fees for in-office shots or pharmacy dispensing costs, which can add a small amount.
Tips and strategies to save money on Nucala
Because Nucala is so expensive, it is wise to explore all savings options. Below are strategies and resources to help lower your out-of-pocket costs:
1. Use the GSK Copay Program
If you have private insurance, enroll in the Nucala Copay Program. This can reduce your cost to $0 per dose (until its limit). Note that the program covers up to $9,450 per year or up to $15,000 for some plans.
It is intended for US residents, including those living in Washington, DC, Puerto Rico, and the US Virgin Islands, who are not enrolled in any government-funded prescription drug programs.
To qualify, you must have commercial medical or prescription coverage, and you cannot be covered by state or federal drug assistance plans, such as:
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- Medicare
- Medicaid
- VA benefits
- Tricare
- Medicare-eligible through a retiree or employer-sponsored government-subsidized plan
You can apply in one of two ways. You may complete the enrollment process with help from your healthcare provider, or you can apply online through the program’s website. After you apply, the program will review your information and let both you and your provider know whether you qualify.
Your eligibility is reviewed each year, so you will need to reapply annually if you want to keep receiving copay assistance.
2. Enroll in GSK’s Patient Assistance (GSKForYou)
If you have low income and limited insurance, apply to the GSK Patient Assistance Program. Qualifying patients get Nucala free through this program.
You may qualify for this program if your income falls within the required financial limits and you either do not have insurance or you have Medicare and meet the program’s additional rules. You must live in the US or Puerto Rico, and for certain specialty or oncology medications, residency in the US Virgin Islands may also be accepted.
You also need to be receiving care from a healthcare provider who is licensed to practice in the US.
If approved, you could pay nothing for your Nucala injections. This is essentially a free-drug program for those who truly need it.
3. Seek help from independent foundations
Apply to organizations like the PAN Foundation or HealthWell Foundation, which may grant financial aid for Nucala. These nonprofits offer aid for patients to cover co-pays, coinsurance, or even insurance premiums.
For example, PAN’s program may assist those with income up to 400-500% of the federal poverty level.
4. Use government support programs
For Medicare Part D beneficiaries, check if you qualify for Extra Help (Low-Income Subsidy) to cut drug costs. Each state’s Medicaid office may also offer a pharmaceutical assistance program to low-income residents. Many state and federal programs have online information or helplines (see Medicare.gov and Medicaid.gov).
5. Take advantage of the Gateway program
If you and your doctor are considering Nucala, you can ask about the Gateway to Nucala program for help understanding your insurance coverage. This program is designed to review how your insurance plan covers Nucala and provide an estimate of what your out-of-pocket costs may be.
To begin, you will complete the patient portion of the enrollment form, and your doctor will fill out and submit the prescriber section. Once the form is received, the program reviews your insurance benefits and may contact you to discuss coverage details or next steps. Note that this program does not guarantee insurance approval or coverage.
If your insurance covers the medication, your plan typically pays part of the cost, and you are responsible for the remaining amount, often referred to as a copay or out-of-pocket expense. If you have more than one type of insurance, this may also affect your coverage and costs.
If you do not have insurance and meet certain eligibility requirements, you may qualify for the Patient Assistance Program, which can provide Nucala at no cost. In some cases, patients with Medicare Part D or other insurance may also qualify under specific circumstances.
If you have questions, you can contact 1-844-4-NUCALA (1-844-468-2252) or your insurance provider for further clarification.
6. Ask for a 90-day supply fill
If your plan allows, getting a 90-day refill (three monthly doses) at once can save money. Some insurers charge only one copay for a 90-day supply instead of three separate copays. Even for injectable drugs like Nucala, doctors can often write the prescription for 3 doses, which a specialty pharmacy will dispense together.
Studies show that 90-day supplies of medications often reduce total copay spending compared to monthly refills.
Bottom line
Nucala remains a costly therapy in 2026, but numerous programs can reduce or eliminate out-of-pocket expenses. Patients with insurance can often get the drug at $0 per dose up to certain limits by using the copay card. Those with limited means may qualify for free medication through patient assistance programs.
Foundations and government plans offer additional support. By combining insurance coverage, manufacturer help, and strategic choices, you can greatly lower your monthly cost of Nucala. It is important to work with healthcare providers, pharmacists, and insurance representatives to navigate these options and keep treatment affordable.
Related Articles
Frequently Asked Questions
Sources
Cubanski, J., Koma, W., & Neuman, T. (2025, August 9). The Out-of-Pocket cost burden for specialty drugs in Medicare part D in 2019. KFF. https://www.kff.org/medicare/the-out-of-pocket-cost-burden-for-specialty-drugs-in-medicare-part-d-in-2019/
How much does Medicare drug coverage cost? (n.d.). Medicare. https://www.medicare.gov/health-drug-plans/part-d/basics/costs
2026 Medicare Parts A & B Premiums and Deductibles | CMS. (2025, December 23). https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
Humana Inc. (2025, December 1). How much does Medicare Part D cost in 2026? https://www.humana.com/medicare/medicare-resources/medicare-part-d-cost
Taitel, M., Fensterheim, L., Kirkham, H., Sekula, R., & Duncan, I. (2012). Medication days’ supply, adherence, wastage, and cost among chronic patients in Medicaid. Medicare & medicaid research review, 2(3), mmrr.002.03.a04. https://doi.org/10.5600/mmrr.002.03.a04
Pricing information for NUCALA | GSKForYou. (n.d.). https://gskforyou.com/gsk-pricing-information/nucala/
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