Key takeaways:
Cobenfy (xanomeline / trospium chloride) is a prescription medication that treats schizophrenia in adults. It’s a twice-daily capsule.
On average, a 30-day supply of Cobenfy (xanomeline / trospium chloride) 100 mg/20 mg capsules costs about $2202.01 without insurance. The price you’ll pay may vary by pharmacy, fill quantity, and other factors.
Insurance coverage for Cobenfy depends on your plan type. Most Medicare and Medicaid plans cover it, though prior authorization or step therapy is often required. Coverage is slightly more limited with commercial insurance and Affordable Care Act (ACA) marketplace plans.
There are ways to save on Cobenfy. Copay savings programs and patient assistance programs can help lower your out-of-pocket costs.
Save on related medications
Managing schizophrenia often means juggling regular appointments and ongoing medications. And over time, pharmacy costs can become a meaningful part of your budget — especially since many people take more than one medication at a time.
Cobenfy (xanomeline / trospium chloride) is one newer option you may receive. It’s a prescription medication that treats schizophrenia in adults, and it works differently from older antipsychotics. It may be considered when other treatments haven’t been effective or well tolerated.
Cobenfy is only available as a brand-name medication. Without insurance, the average retail price can reach several thousand dollars per month. The good news is that insurance coverage, manufacturer programs, and pharmacy discounts may help lower out-of-pocket costs.
How much does Cobenfy cost?
Cobenfy’s manufacturer list price is over $1,800 per month. But retail prices may differ from the list price, depending on the pharmacy, wholesaler, and other factors.
Cobenfy comes in three doses, and it’s typically taken twice daily. It’s standard to start with a low dose and increase it after a few days. Here are the average retail prices for a 30-day supply of Cobenfy.
What factors affect the cost of Cobenfy?
What you’ll pay for Cobenfy depends on several factors, including:
Insurance: If you have health insurance, the cost will depend on your plan’s coverage details and cost-sharing requirements. You may have to pay out of pocket for a deductible, copays, or coinsurance.
Dosage: Cobenfy is supplied in a few different doses. The cost may differ depending on which one you’re prescribed and how much you fill at a time.
Pharmacy: Prices for Cobenfy can vary depending on which pharmacy you use. Prices can vary by pharmacy, even within the same neighborhood.
Location: Medication prices vary by geography, too. For example, GoodRx research shows that people living in New Orleans often pay more for prescription medications, while those in Houston tend to see lower prices.
Discounts: You may be able to lower the cost of Cobenfy by using a manufacturer copay savings card or patient assistance program.
Does insurance cover Cobenfy?
Cobenfy is covered by most Medicare and Medicaid plans. But across these insurance types, prior authorization is required for most enrollees. Step therapy requirements are also quite normal, especially for Medicare recipients. In other words, your prescriber may need to confirm that you meet your insurer’s coverage criteria or that you’ve already tried other treatments.
Coverage for Cobenfy is more limited with commercial insurance and Affordable Care Act (ACA) marketplace plans. Just over half of these plans cover the medication, and many require prior authorization or step therapy.
Because requirements can vary significantly from plan to plan, the best way to understand how your insurance covers Cobenfy is to check your plan’s formulary (list of covered medications) or contact your insurer directly.
How different insurance plans cover Cobenfy
The tables below break down the percentage of enrollees who have coverage for Cobenfy by insurance type. It also shows the likelihood of having prior authorization and step therapy requirements.
Insurance type | Enrollees covered for Cobenfy 100 mg/20 mg capsules | Enrollees required to get prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
59.3% | 53.2% | 39.2% | |
Commercial plans (excluding ACA plans) | 58.2% | 32.3% | 34.3% |
Medicare (Medicare Advantage and Part D plans) | 100% | 70.1% | 69.7% |
Medicaid, including state-run and managed care plans | 97.5% | 83.4% | 33.3% |
Source: Managed Markets Insight & Technology, LLC™, as of January 10, 2026 (See methodology below.)
If your insurance doesn’t cover Cobenfy, try these options:
Ask your prescriber about other schizophrenia medications that may be preferred by your plan or cost less out of pocket.
Check to see if you qualify for financial assistance through Cobenfy’s manufacturer copay savings card or patient assistance program.
Request a formulary exception from your insurer. Your prescriber may need to submit paperwork and a letter of medical necessity explaining why Cobenfy is necessary for you.
If your insurer denies your formulary exception request, you have the right to file an appeal.
During the open enrollment period for health insurance, look for a plan that offers better coverage for Cobenfy and your other medications.
Ways to save on Cobenfy
Cobenfy can cost thousands of dollars per month if you don’t have insurance. But there are ways to lower your out-of-pocket costs with and without insurance. If you’re uninsured, you may even be able to get the medication at no cost. Here are four ways you could save.
1. See if you qualify for a copay savings card
With the Cobenfy Co-Pay Assistance Program, some people with commercial insurance may pay as little as $0 per month for their prescription. If you’re eligible, this savings card can help reduce what you pay out of pocket. The program’s annual savings limit depends on your individual situation.
To qualify, you must:
Be 18 years or older
Live in the U.S. or one of its territories
Have a valid Cobenfy prescription
Have commercial insurance
You aren’t eligible for this program if you have Medicare, Medicaid, Tricare, or another form of government-funded insurance.
2. Check if you’re eligible for a patient assistance program
If you don’t qualify for the copay savings card, you may still be able to receive Cobenfy at no cost through the manufacturer’s patient assistance program, called the Bristol Myers Squibb Patient Assistance Foundation. Your prescriber can help you apply.
To qualify, some preliminary eligibility criteria include:
Live in the U.S. or one of its territories
Have a valid Cobenfy prescription
Be uninsured or underinsured (or, if you have Medicare, have already spent at least 3% of your household’s yearly income on prescription medications)
Not qualify for the Medicare Part D Low-Income Subsidy (LIS)
Not qualify for Medicaid
Meet the manufacturer’s income requirements
3. Ask your prescriber about 90-day supplies
Some pharmacies and insurance plans offer discounts when you fill a 90-day supply of medication instead of refilling every month. If that’s an option for you, getting a larger supply of Cobenfy up front may lower your average monthly cost. It can also mean fewer trips to the pharmacy.
In some cases, insurance plans also offer lower copays or coinsurance when you use their preferred mail-order pharmacy for 90-day fills.
Because these discounts vary by plan and pharmacy, it can help to check with both to see what savings options may be available to you.
4. Tap into your HSA or FSA
If you have a health savings account (HSA), flexible spending account (FSA), or health reimbursement arrangement (HRA), you can use those tax-free dollars to cover the cost of Cobenfy.
If you have an FSA, it helps to keep timing in mind. FSA funds are available for a limited period, so any unused money typically needs to be spent by the end of your plan year. HSA funds work a bit differently. HSA money rolls over from year to year, so you can use it whenever you need. There’s no deadline to worry about.
The bottom line
A 30-day supply of Cobenfy (xanomeline / trospium chloride) 100 mg/20 mg capsules costs an average of $2202.01 without insurance. But prices can vary by pharmacy, dosage, and more.
Several options can help lower the cost of Cobenfy, depending on your insurance status. Two of the main opportunities include enrolling in a manufacturer copay savings program or qualifying for a patient assistance program.
Why trust our experts?
Methodology
We obtained national prescription coverage data for each medication from Managed Markets Insight & Technology (MMIT). The data reflects health insurance coverage as of January 2026.
We calculated the percentage of enrollees in plans that cover each medication by dividing the number of enrollees covered for the medication within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel.
We determined the percentage of enrollees in plans with a prior authorization requirement by calculating the proportion of enrollees in plans that required prior authorization for the medication within each channel.
Finally, we measured the percentage of enrollees in plans with a step therapy requirement by calculating the proportion of enrollees in plans that imposed step therapy requirements for the medication in each channel.
These estimates, derived from national MMIT coverage data, provide insight into health insurance coverage for each medication. They take into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total number of enrollees covered by various insurance channels, including ACA plans, commercial (excluding ACA) plans, Medicare, and Medicaid (both state-run and managed care plans).
References
Bristol Myers Squibb. (n.d.). Cobenfy™ (xanomeline and trospium chloride) co-pay assistance program terms & conditions.
Bristol Myers Squibb. (2024). Pricing information.
Bristol Myers Squibb. (2026). Register for support, co‑pay, and more.
Bristol Myers Squibb Patient Assistance Foundation. (n.d.). Available medicines.
Bristol Myers Squibb Patient Assistance Foundation. (n.d.) How do I apply?
E.R. Squibb & Sons. (2026). Cobenfy- xanomeline and trospium chloride capsule, coated pellets [package insert]. DailyMed.
HealthCare.gov. (n.d.). Appealing a health plan decision. U.S. Centers for Medicare & Medicaid Services.
Lähteenvuo, M., et al. (2021). Antipsychotic polypharmacy for the management of schizophrenia: Evidence and recommendations. Drugs.
Medicaid.gov. (n.d.). Managed care. U.S. Centers for Medicare & Medicaid Services.
