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With the Patient Assistance Program from IBSA, you can receive your medication at no cost.


| Dosage | Quantity | Retail price | GoodRx price |
|---|
| 30 ampules of 13mcg/ ml | 1 package | $186.54 | $121.83 |
| 30 ampules of 25mcg/ ml | 1 package | $188.56 | $121.83 |
| 30 ampules of 37.5mcg/ ml | 1 package | $183.82 | $121.83 |
| 30 ampules of 44mcg/ ml | 1 package | $183.60 | $121.83 |
| 30 ampules of 50mcg/ ml | 1 package | $188.56 | $121.83 |
| 30 ampules of 62.5mcg/ ml | 1 package | $184.15 | $121.83 |
| 30 ampules of 75mcg/ ml | 1 package | $188.61 | $121.83 |
| 30 ampules of 88mcg/ ml | 1 package | $187.44 | $121.83 |
| 30 ampules of 100mcg/ ml | 1 package | $188.43 | $121.83 |
| 30 ampules of 112mcg/ ml | 1 package | $184.42 | $121.83 |
| 30 ampules of 125mcg/ ml | 1 package | $185.21 | $121.83 |
| 30 ampules of 137mcg/ ml | 1 package | $182.43 | $121.83 |
| 30 ampules of 150mcg/ ml | 1 package | $188.40 | $121.83 |
| 30 ampules of 175mcg/ ml | 1 package | $185.70 | $121.83 |
| 30 ampules of 200mcg/ ml | 1 package | $188.52 | $121.83 |
GoodRx coupon prices last updated on 05/02/26.