Key takeaways:
Isentress (raltegravir) is a medication used to treat HIV. Without insurance, a typical 30-day supply of Isentress 400 mg costs an average of $2516.11.
Manufacturer copay cards, patient assistance programs, and GoodRx discounts may help lower the cost of Isentress.
Most insurance plans — including Medicaid, Medicare, commercial, and ACA plans — cover Isentress. Prior authorization and step therapy usually aren’t required.
Save on related medications
Isentress (raltegravir) is a medication that treats HIV. It comes in several forms, including an oral tablet, a chewable tablet, and an oral suspension (liquid). A high-dose version called Isentress HD is also available. Isentress is available only as a brand-name medication, so cost is a common concern. Let’s look at how much isentress costs without insurance and ways to help you save money on your prescription.
How much does Isentress cost without insurance?
The manufacturer’s list price for a 30-day supply of Isentress 400 mg and Isentress HD 600 mg (60 tablets) was $2,131 as of November 2025. But the actual cost may be even higher because of wholesale and pharmacy markups.
The chart below shows the average retail price for the most common doses of Isentress.
Which factors affect the cost of Isentress?
Several factors can affect the cost of Isentress, including:
Location: Where you live can affect the cost of your medication. For example, according to GoodRx research, medications are typically more affordable in Denver than in New Orleans.
Pharmacy: Cash prices can vary from one pharmacy to another, even in the same neighborhood. It’s a good idea to check a few options before filling your prescription. Keep in mind that some insurance plans may require you to use a specialty pharmacy to fill this medication.
Dose and dosage form: The form of Isentress you take and your daily dose will play a role in your monthly costs.
Insurance coverage: You’ll typically pay less for Isentress if your prescription insurance covers it. But your copay may vary based on your plan’s formulary (more on that next).
Does insurance cover Isentress?
Almost all Medicare, Medicaid, and commercial insurance plans cover Isentress. It’s also covered by more than 90% of plans purchased through the Affordable Care Act (ACA) marketplace.
Prior authorization isn’t commonly required for Isentress. But up to 15% of commercial, ACA, and Medicaid plans require it for Isentress HD (the high-dose version). This means your prescriber may need to submit information explaining why Isentress is medically necessary before your plan will cover it.
Step therapy also isn’t typically required for Isentress. But up to 10% of commercial and Medicaid plans require it for Isentress HD. This means you’re required to try other treatments (or explain why you aren’t able to take them) before they’ll cover Isentress HD.
If your insurance covers Isentress, the amount you’ll pay depends on where it falls within your plan’s formulary (list of covered medications). Medications are often classified into different tiers within a formulary — a lower tier typically means a lower copay. You can access your plan’s formulary online or by calling the customer service number on your prescription insurance card.
How different insurance plans cover Isentress
The table below breaks down the percentage of enrollees who have coverage for Orilissa by insurance type. It also shows the likelihood of having prior authorization and step therapy requirements.
Coverage for Isentress 400 mg
Insurance type | Enrollees covered for Isentress 400 mg | Enrollees required to get prior authorization | Enrollees required to do step therapy |
93.7% | 0.5% | 0.5% | |
Commercial plans (excluding ACA plans) | 98.9% | 4.2% | 0% |
Medicare (Medicare Advantage and Part D plans) | 100% | 0% | 0% |
Medicaid, including state-run and managed care plans | 100% | 3.8% | 3.5% |
Coverage for Isentress HD 600 mg
Insurance type | Enrollees covered for Isentress HD 600 mg | Enrollees required to get prior authorization | Enrollees required to do step therapy |
93.2% | 5.3% | 0% | |
Commercial plans (excluding ACA plans) | 98.8% | 13.1% | 6.6% |
Medicare (Medicare Advantage and Part D plans) | 100% | 0% | 0% |
Medicaid, including state-run and managed care plans | 100% | 15.9% | 10% |
Source: Managed Markets Insight & Technology, LLC™, as of January 10, 2026 (See methodology below.)
If your insurance doesn’t cover Isentress, consider these options:
Lower your cost with a manufacturer copay savings card, a patient assistance program, or medication discount programs, such as GoodRx. (See below for details.)
Ask your health plan to cover Isentress by submitting a formulary exception request. Your prescriber may need to provide documentation and a letter of medical necessity explaining why this medication is required for your condition.
If the formulary exception request is denied, file an appeal.
Ask your prescriber about switching to an Isentress alternative that your insurance may cover.
Compare insurance plans during the next open enrollment period to find one that offers better coverage for your HIV medications.
Ways to save on Isentress
Here are five ways to save on the cost of Isentress, with or without insurance coverage.
1. Use a GoodRx coupon
GoodRx could help you save over 20% off the monthly cost of Isentress without insurance. To use this discount:
Visit www.goodrx.com or download the app.
Search for “Isentress,” then click or tap “Find the lowest prices.”
Select your prescribed dose and quantity.
Choose if you want to receive the discount information by text or email. You can also take a screenshot on your phone or save it to your phone’s digital wallet.
To avoid delays, provide the discount information to the pharmacy before you go in to pick up your prescription.
2. See if you qualify for a copay savings card
If you have commercial insurance, you may be able to pay as little as $0 per month for Isentress using a savings card from the manufacturer. There is a maximum total program savings of $6,800.
To qualify for the Isentress savings card you must:
Have private or commercial insurance.
Not be enrolled in a government health insurance program, such as Medicare or Medicaid.
Be a resident of the U.S. (including Puerto Rico).
3. Check if you’re eligible for a patient assistance program
If you’re uninsured or underinsured and you meet certain income requirements, you may be eligible for the MerckHelps patient assistance program. It offers Isentress at no cost to those who qualify, which includes the following criteria:
Be a U.S. resident (citizenship not required)
Have limited or no health insurance coverage
Demonstrate financial need and meet income restrictions
You can apply for MerckHelps online, or call 1-800-727-5400 for assistance. Keep in mind that your prescriber will also need to complete paperwork to confirm your eligibility for this program.
4. Tap into your HSA, FSA, or HRA
If you have a health savings account (HSA), a flexible spending account (FSA), or a health reimbursement arrangement (HRA), you can use it to help cover your out-of-pocket costs for Orilissa. These tax-advantaged health accounts let you pay for eligible expenses with tax-free dollars.
Pay directly with your HSA or FSA card at the pharmacy, or cover the cost yourself and submit a request for reimbursement. The funds in an HSA or an HRA typically roll over annually, but you have to use your FSA dollars before the deadline or they’ll expire.
The bottom line
Isentress (raltegravir) is a medication that treats HIV. A typical 30-day supply of Isentress 400 mg costs an average of $2516.11 without insurance. But a manufacturer copay card, patient assistance program, or GoodRx discount can help make your prescription more affordable.
Almost all Medicaid, Medicare, and commercial insurance plans cover Isentress. So do most Affordable Care Act plans. Prior authorization and step therapy typically aren’t required, but they may be more likely if you take Isentress HD. Check with your plan to learn more.
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
HealthCare.gov. (n.d.). Appealing a health plan decision. Centers for Medicare & Medicaid Services.
Medicaid.gov. (n.d.). Managed care. Centers for Medicare & Medicaid Services.
Merck & Co. (n.d.). Isentress raltegravir, Isentress HD raltegravir.
Merck & Co. (2025). Colorado C.R.S. 12-280-308 disclosure.
MerckHelps. (n.d.). The Merck patient assistance program helps those in need. Merck & Co.
Merck Sharp & Dohme. (2024). Isentress- raltegravir tablet, film coated. Isentress- raltegravir tablet, chewable. Isentress- raltegravir granule, for suspension [package insert].
