Key Takeaways
- Gemtesa is a brand-name prescription drug used to treat overactive bladder in certain adults. There is currently no generic version of the drug available. (Generics tend to cost less than brand-name drugs.)
- A few ways to help save on long-term costs for Gemtesa include getting a 90-day supply and using a mail-order pharmacy. Check with your insurance, doctor, or pharmacist to explore these options.
- The Gemtesa Simple Savings Program is available through the manufacturer. If you qualify, this program could help make Gemtesa more affordable.
Several factors can affect the price you’ll pay for Gemtesa. These include:
- your treatment plan
- your insurance coverage
- the pharmacy you use
- available financial assistance for Gemtesa (see the “Financial and insurance assistance” section)
To find out your cost for Gemtesa, talk with your doctor, pharmacist, or insurance provider. This section also has information about how much you can save by using an Optum Perks coupon.
Gemtesa coupons and savings
To help get the best price for your Gemtesa prescription, explore these Optum Perks coupons.
Gemtesa comes as a brand-name drug only. It’s not currently available in a generic version. A generic contains an exact copy of the active drug in a brand-name medication but tends to cost less.
Why is there such a cost difference between brand-name drugs and generics?Years of research and testing are needed to ensure that brand-name drugs are safe and effective. This testing can make the drugs expensive. The manufacturer of a brand-name drug can sell the drug for up to 20 years. After that, other drugmakers can create generic versions. This competition in the market can lead to lower costs for generics. And because generics have the same active ingredients as brand-name drugs, they don’t need to be studied again. This can also lead to lower generic costs.
If you take Gemtesa long term, you may be able to lower your costs in the following ways:
Look into getting a 90-day supply of your medication: You may be able to get a 90-day supply of Gemtesa if approved by your insurance company. This could reduce your number of trips to the pharmacy and help lower the cost of Gemtesa per month. If you’re interested in getting a 90-day supply of this drug, talk with your doctor, pharmacist, or insurance provider.
Use a mail-order pharmacy to get your medication: Using a mail-order pharmacy might help lower your cost for Gemtesa. Plus, you could get your medication without leaving home. Some Medicare plans may help cover the cost of mail-order drugs. You may also be able to get a 90-day supply of the drug through mail order. If you don’t have health insurance, talk with your doctor or pharmacist. They may be able to suggest online pharmacy options that could work for you.
If you need financial support to pay for Gemtesa or help understanding your insurance coverage, assistance is available. For example:
- A program called Gemtesa Simple Savings Program is available for Gemtesa. For more information and to find out whether you’re eligible for support, call 833-876-8268 or text “GEMTESA” to 436872. You can also visit the program website.
- Some websites provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services. Two such websites are:
You can also learn more about saving money on prescriptions with or without insurance.
The following are answers to some frequently asked questions about Gemtesa and cost.
How much does Gemtesa cost with insurance?
The cost of Gemtesa with insurance depends on various factors. These include:
- your specific plan benefits
- if you qualify for a savings program (for details, see the “Financial and insurance assistance” section)
- your copay amount (your share of the cost of a medication).
To learn about the cost of Gemtesa with insurance, talk with your insurance provider or your doctor. They can let you know what you can expect to pay for Gemtesa.
Why might my insurance company not cover Gemtesa?
Your insurance company might not cover Gemtesa for several reasons:
- Drug formulary: Some insurance companies don’t include Gemtesa in their formulary. A drug formulary is a list of covered medications.
- Prior authorization: Your insurance company may need prior authorization before it covers the drug. (To learn more, see the “Insurance considerations” section.)
- Brand name: Gemtesa is a brand-name medication, and it doesn’t have a generic version. Brand-name drugs can be expensive, so your insurance company may prefer to cover similar drugs that may have a lower cost. (For more information, see the “Brand-name vs. generic” section.)
- Step therapy: Your insurance plan may require you to try less expensive treatments first before approving coverage for Gemtesa. These may include solifenacin (Vesicare) and oxybutynin (Ditropan XL, Oxytrol, Gelnique).
If you have questions about why your insurance plan doesn’t cover Gemtesa, be sure to talk with your insurance plan provider. You can also talk with your doctor or pharmacist.
If your insurance doesn’t cover Gemtesa, you can visit Optum Perks to get price estimates for Gemtesa when you use coupons from the site. (Optum Perks is a sister site of Healthline.) Optum Perks coupons cannot be used with any insurance copays or benefits.
Is Gemtesa covered by Medicare?
It’s possible. To find out whether your Medicare plan covers the cost of Gemtesa, call your plan provider. Many different types of Medicare plans are available, and your cost and coverage depend on your individual plan benefits.
Keep in mind that your plan may require prior authorization before it covers Gemtesa. (For details, see the “Prior authorization” section.)
You can also ask your doctor about the cost of Gemtesa if you have Medicare.
How does the cost of Gemtesa compare with that of similar drugs, such as Myrbetriq?
The cost of Gemtesa compared with the cost of Myrbetriq (mirabegron) can depend on several factors.
For example, Gemtesa comes in a different form than Myrbetriq, which may affect the cost. Gemtesa is an oral tablet, while Myrbetriq comes as an extended-release tablet and granules to mix into a liquid solution you drink.
In addition, Myrbetriq extended-release tablets are available in a generic form. Generics typically cost less than brand-name drugs.
Other factors that may affect how much you pay include:
- whether any coupon cost savings programs are available for the drug you’re prescribed
- whether you have insurance or are paying out of pocket
- how long your treatment lasts
If you have questions about the cost of Gemtesa compared with that of similar medications, talk with your doctor, pharmacist, or insurance provider. They can share more details on treatment costs based on your specific situation.
Visit Optum Perks to get price estimates for Gemtesa and Myrbetriq when you use coupons from the site. (Optum Perks is a sister site of Healthline.) It’s important to note that Optum Perks coupons cannot be used with any insurance copays or benefits.
Optum Perks is owned by RVO Health. By clicking on this link, we may receive a commission. Learn more.
If you have insurance, you may need to get prior authorization before your insurance provider will cover Gemtesa. This means your insurer and your doctor will discuss Gemtesa in regard to your treatment. Then, the insurance company will determine whether the drug is covered. If Gemtesa requires prior authorization and you don’t receive it before you start treatment, you could pay the full cost of the drug.
Be sure to ask your insurance company whether Gemtesa requires prior authorization.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.