Linzess (linaclotide) is a capsule taken once a day, so its price is a price per capsule multiplied by 30 or 90. There is no published retail cash price we could read on 3 November 2026: GoodRx, SingleCare and Drugs.com all refused an automated read of their Linzess pages, and Mark Cuban Cost Plus Drugs did not list linaclotide. Per this site's method, a refused page is excluded, never quoted from a search snippet.
What remains is better documented than most cash-price surveys: four public datasets, each with a date, each from the agency that collects it. What Linzess does in the body is on our Linzess side effects page.
The four prices, side by side
| Benchmark | Per capsule | 30 capsules | Source and date |
|---|---|---|---|
| List price, 2024 | about $18 | $539 | CMS fact sheet (2024 list price for a 30-day supply) |
| Medicare average spending, 2024 | $17.69 | $531 | CMS Part D Spending by Drug, 2024 (before rebates) |
| National average pharmacy acquisition cost, 21 Oct 2026 | $9.01 | $270 | Medicaid NADAC, as of 21 October 2026 |
| Medicare negotiated price, from 1 Jan 2027 | about $4.53 | $136 | CMS fact sheet, negotiated prices for 2027 |
Per-capsule figures for the list and negotiated prices are our division by 30; CMS publishes them per 30-day supply.
The price that halved on 1 January 2026
NADAC is a weekly survey of what retail pharmacies actually paid wholesalers. Its 2025 and 2026 files for Linzess 290 mcg read:
| NADAC effective date | Per capsule |
|---|---|
| 18 December 2024 | $17.29 |
| 2 January 2025 | $18.16 |
| 17 December 2025 | $18.15 |
| 1 January 2026 | $9.03 |
| 21 October 2026 | $9.01 |
A brand drug's acquisition cost usually tracks its list price, so a 50% overnight drop on 1 January is consistent with a list-price change at the start of 2026. We could not confirm that from the manufacturer: AbbVie's pricing pages refused the automated read. The CMS list-price figure of $539 is a 2024 number and predates the drop.
All three strengths are priced alike: on 21 October 2026 NADAC was $9.01 for 72 mcg, $9.02 for 145 mcg and $9.01 for 290 mcg. The dose a prescriber picks does not change the cost.
Medicare: what it spent, and what it will pay
CMS's Part D dashboard for 2024 records Linzess at $1.98 billion in total spending, 2,506,531 claims and 632,063 beneficiaries — $3,136 per person for the year and $17.69 per capsule, up from $15.17 in 2020 (a compound 3.9% a year). These figures are before manufacturer rebates, which CMS does not publish per drug.
Linzess was one of the 15 Part D drugs selected for the second cycle of Medicare price negotiation. CMS's fact sheet lists the result: $136 for a 30-day supply from 1 January 2027, 75% below the 2024 list price of $539. Of the 15, three carry a larger percentage discount (Janumet 85%, Tradjenta 84%, Breo Ellipta 83%); the smallest is Austedo's 38%. The price applies to what Medicare plans pay; a member's own cost depends on the plan.
CMS also states the rule that could end it: a selected drug leaves the programme when FDA has approved a generic that names it as the reference product and that generic is marketed.
The generic: approved, not yet on the shelf
Drugs@FDA lists three generic linaclotide applications (read 3 November 2026, data updated 30 October 2026):
| Application | Company | Strengths | Approved | Status |
|---|---|---|---|---|
| ANDA 209564 | Mylan | 145, 290 mcg | 9 February 2021 | Discontinued |
| ANDA 209611 | Aurobindo | 145, 290 mcg | 7 February 2023 | Discontinued |
| ANDA 211255 | Actavis | 72 mcg | 24 September 2026 | Prescription |
"Discontinued" in Drugs@FDA means not currently marketed; it says nothing about safety. The same day, FDA's directory of listed drug products (the NDC directory) held linaclotide only as Linzess and as bulk ingredient from seven manufacturers — no finished generic capsule. NADAC had no generic linaclotide row either. So on the record, a generic 72 mcg capsule is approved, and none is listed for sale yet.
The savings card
linzess.com, read 3 November 2026, states that many eligible commercially insured patients "could pay as little as $30" for a 30-day or 90-day prescription, with a maximum savings limit and out-of-pocket costs that may vary. The terms exclude anyone enrolled in Medicare, Medicaid or another federal or state programme — the group that will get the $136 negotiated price instead. For people who cannot pay, the site points to AbbVie's patient access support programme; its terms are not published on the Linzess page.
What these figures do not tell anyone
- A cash price at a given pharmacy. NADAC is an average acquisition cost; pharmacies add a dispensing margin, and none of the cash-price sites we tried could be read.
- Net prices. Manufacturer rebates to insurers are confidential; the Medicare spending figures are gross.
- An insured person's copay. That is set by the plan's formulary tier. Coverage questions go to the insurer, and whether Linzess is the right drug at all is a question for the prescriber.
For how Linzess sits among the other approved peptide drugs, see our FDA-approved peptides census; prices across the peptide market are surveyed on how much do peptides cost.
Sources
- CMS, Fact Sheet: Medicare Drug Price Negotiation Program — Negotiated Prices for Initial Price Applicability Year 2027 (PDF), and the Selected Drugs and Negotiated Prices page (data file dated 2 November 2026), read 3 November 2026.
- CMS, Medicare Part D Spending by Drug, data.cms.gov API, Linzess rows for 2020–2024, read 3 November 2026.
- Medicaid NADAC 2025 and 2026 datasets, data.medicaid.gov API, Linzess 72/145/290 mcg (NDCs 00456-1203-30, 00456-1201-30, 00456-1202-30), as of 21 October 2026, read 3 November 2026.
- Drugs@FDA via openFDA (NDA 202811; ANDAs 209564, 209611, 211255), data updated 30 October 2026; openFDA NDC directory, query
generic_name:linaclotide; both read 3 November 2026. - linzess.com, savings section and offer terms, rendered 3 November 2026.
- Refused or not listing (excluded): goodrx.com/linzess (redirected to a block page), singlecare.com (HTTP 403), drugs.com price guide (HTTP 403), costplusdrugs.com (no linaclotide), all 3 November 2026.