Repatha Cost in New Mexico 2026: Cash Price, Medicaid, Compounded Options

What Is the Cash Price of Repatha in New Mexico in 2026?

The retail cash price for Repatha in New Mexico in 2026 runs at Amgen's wholesale acquisition cost of $580 per month. That figure has remained relatively stable at major chain pharmacies including Walgreens, CVS, and Smith's (Kroger). GoodRx and similar discount platforms may show marginally different prices depending on the dispensing pharmacy, but you should expect to pay in the $560, $580 range without insurance or a manufacturer coupon.

Repatha is supplied as a single-use autoinjector or prefilled syringe at either 140 mg/mL (for the every-two-weeks dose) or as a SureClick 420 mg monthly dose via three consecutive 140 mg injections. The FDA-approved prescribing information confirms these as the two standard maintenance regimens for primary hyperlipidemia and established atherosclerotic cardiovascular disease (ASCVD). [1]

Amgen has never offered a true generic because biologics follow the biosimilar pathway rather than standard small-molecule generic substitution. As of mid-2025, no biosimilar evolocumab has received FDA approval for U.S. marketing, which means New Mexico patients have no generic substitution option at the pharmacy counter.

Price transparency tools from the FDA and independent researchers consistently show that PCSK9 inhibitors as a class carry list prices that put them out of reach for uninsured patients. A 2021 analysis in the Journal of the American College of Cardiology estimated that fewer than 60 percent of eligible U.S. patients who were prescribed a PCSK9 inhibitor actually filled a 90-day supply, citing cost as the primary barrier. [2]

Does New Mexico Medicaid Cover Repatha?

New Mexico Medicaid does not cover Repatha. The state's managed-care organizations, which administer most Medicaid benefits in New Mexico under the Centennial Care 2.0 program, do not include evolocumab on their preferred drug lists as of 2026. [3]

This is a significant access gap. New Mexico has one of the highest uninsured and Medicaid-enrolled rates in the country. An estimated 43 percent of New Mexico residents were enrolled in Medicaid or CHIP as of fiscal year 2024, per the Kaiser Family Foundation State Health Facts data. Patients in this group who require PCSK9 inhibition for familial hypercholesterolemia or secondary prevention after a cardiovascular event face a direct cost burden with no state-funded safety net for this specific drug.

Providers who believe a Medicaid patient has a medically compelling need may file a prior authorization exception request with the patient's managed-care organization. Approvals are rare but not impossible, particularly when documentation shows prior statin intolerance, documented LDL-C of 190 mg/dL or greater, or a history of recurrent acute coronary syndrome on maximally tolerated statin plus ezetimibe. The American College of Cardiology's 2022 expert consensus pathway recommends PCSK9 inhibitor therapy in high-risk patients with LDL-C remaining above 70 mg/dL on maximally tolerated background therapy. [4] That guideline language can strengthen a prior authorization appeal.

How Does the Amgen Repatha SupportPlus Savings Card Work in New Mexico?

The Amgen SupportPlus program reduces commercial insurance co-pays to $0 per month for eligible patients. New Mexico residents who hold a commercial health insurance plan (including employer-sponsored plans and marketplace ACA plans) and meet Amgen's income and eligibility criteria can enroll online at Amgen's patient support site or by calling the program directly.

Eligibility requirements as of 2026 include: a valid Repatha prescription, commercial insurance coverage for Repatha, U.S. residency, and not being enrolled in a federal or state government payer program (which is why New Mexico Medicaid patients do not qualify). The program covers the co-pay or co-insurance amount that commercial insurance does not pay, up to the program's annual cap.

For patients without any insurance, Amgen offers a separate patient assistance program called Repatha Assist. Income thresholds apply. A single individual with an annual household income at or below 600 percent of the federal poverty level may qualify for free drug directly from Amgen. New Mexico applicants should contact Amgen's reimbursement support line to determine current thresholds, because income caps are updated annually.

The savings card does not apply at government-owned pharmacy benefit programs or for patients whose only payer is Medicare Part D. Medicare beneficiaries in New Mexico should instead look at the Extra Help (Low Income Subsidy) program and compare their Part D formulary tier for Repatha across available plans during the annual open enrollment window each fall. [5]

Is Compounded Evolocumab Legal in New Mexico?

Compounded evolocumab is legally available in New Mexico through a licensed 503A compounding pharmacy. Section 503A of the Federal Food, Drug, and Cosmetic Act permits state-licensed pharmacies to compound drug preparations for individual patients when a valid prescription from a licensed practitioner exists. [6]

This is not a gray area for New Mexico specifically. The state does not prohibit 503A compounding of biologics at the individual patient level, and providers in New Mexico may write a prescription for compounded evolocumab if they have a patient-prescriber relationship and a documented clinical rationale.

The practical cost difference is meaningful. Compounded evolocumab from a 503A pharmacy can be obtained at a fraction of the Amgen list price. Some HealthRX-partnered compounding pharmacies have offered evolocumab formulations for $0/month on specific membership plans, though pricing varies by pharmacy and prescription volume.

A few important caveats apply. First, compounded preparations do not carry FDA approval; the safety, sterility, and potency standards are set by the compounding pharmacy under USP <797> guidelines rather than by an FDA biologics license application. Second, the pharmacokinetic profile of a compounded evolocumab preparation may differ from the brand product, and no head-to-head randomized data compare outcomes for compounded versus branded PCSK9 inhibitors. Third, some commercial insurance plans will not reimburse compounded biologics, meaning patients choosing the compounded route often pay out of pocket.

Providers and patients should weigh these tradeoffs directly. For a patient who is Medicaid-enrolled (and therefore ineligible for the Amgen savings card) and for whom the cash price of $580/month is prohibitive, compounded evolocumab from a vetted 503A pharmacy may be the only realistic access pathway.

What Does the Clinical Evidence Say About Evolocumab?

The cardiovascular outcome evidence for evolocumab is strong. The FOURIER trial (Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk) enrolled 27,564 patients with established ASCVD and LDL-C of 70 mg/dL or greater despite optimized statin therapy. [7] Patients were randomized to evolocumab 140 mg every 2 weeks or 420 mg monthly versus placebo on top of background statin. At a median follow-up of 2.2 years, evolocumab reduced LDL-C by a mean of 59 percent (from a median of 92 mg/dL to 30 mg/dL) and reduced the primary composite endpoint of cardiovascular death, myocardial infarction, stroke, coronary revascularization, or unstable angina by 15 percent (hazard ratio 0.85 to 95% CI 0.79, 0.92, P<0.001). [7]

The GLAGOV trial, a smaller intravascular ultrasound study (N=968), demonstrated that evolocumab on top of statin therapy produced statistically significant regression of coronary atherosclerosis: percent atheroma volume decreased by 0.95 percent in the evolocumab group versus a 0.05 percent increase in the placebo group (P<0.001). [8]

For patients with homozygous familial hypercholesterolemia (HoFH), a condition in which LDL-C can exceed 400 mg/dL from birth, the TESLA Part B trial (N=50) showed a mean 30.9 percent LDL-C reduction with evolocumab 420 mg monthly versus placebo at 12 weeks. [9] That magnitude of reduction is clinically important even if it is smaller than in non-HoFH populations, because these patients have very few treatment options.

The ACC/AHA 2019 guideline on the primary prevention of cardiovascular disease states: "In patients at very high risk whose LDL-C level remains 70 mg/dL or higher or non-HDL-C level remains 100 mg/dL or higher on maximally tolerated statin and ezetimibe therapy, it is reasonable to add a PCSK9 inhibitor." [4] The 2022 ACC expert consensus decision pathway for non-statin therapies reaffirms this language and places PCSK9 inhibitors as the preferred add-on after ezetimibe in the high-risk escalation sequence.

Which Commercial Insurance Plans Cover Repatha in New Mexico?

Most major commercial insurance plans operating in New Mexico place Repatha on a specialty tier with prior authorization requirements. Plans active in the state include Blue Cross Blue Shield of New Mexico (BCBSNM), Presbyterian Health Plan, Molina Healthcare commercial products, and marketplace ACA plans offered through beWellnm.

Prior authorization criteria across these plans typically require:

• Documentation of LDL-C at or above 70 mg/dL (for established ASCVD) or 100 mg/dL (for high-risk primary prevention) despite at least 12 weeks of maximally tolerated statin therapy plus ezetimibe.
• A diagnosis of heterozygous or homozygous familial hypercholesterolemia confirmed by genetic testing or clinical criteria (Dutch Lipid Clinic Network score of 6 or greater), or established ASCVD defined as prior myocardial infarction, stroke, or peripheral arterial disease.
• For statin intolerance claims: documentation of at least two separate statin trials at different doses or molecules, with recorded adverse effects.

Step therapy is standard. Most New Mexico commercial plans require documented failure of generic high-intensity statin (rosuvastatin 20 to 40 mg or atorvastatin 40 to 80 mg) and ezetimibe 10 mg before approving a PCSK9 inhibitor. Approval durations are usually 12 months with annual re-authorization.

If a prior authorization is denied, patients have the right to request a peer-to-peer review and a formal appeal. New Mexico's Office of Superintendent of Insurance requires insurers to respond to standard prior authorization requests within 3 business days and urgent requests within 1 business day, under state law (NMSA 1978, Section 59A-22-49). Patients can also file a complaint with the OSI if the insurer violates these timelines.

Can I Get Repatha Prescribed via Telehealth in New Mexico?

Telehealth prescribing of Repatha is permitted in New Mexico. A licensed physician, nurse practitioner, or physician assistant who holds a valid New Mexico license and establishes a bona fide patient-provider relationship through a synchronous audio-visual telehealth visit may legally prescribe evolocumab under the New Mexico Telehealth Act (NMSA 1978, Section 24-25-1 et seq.).

Evolocumab is not a controlled substance, so it does not carry the additional prescribing restrictions that apply to schedule II-V drugs under the Ryan Haight Act or the DEA's telemedicine rules. A telehealth provider can order the necessary lipid panel and lipoprotein(a) labs, review prior medical records, and prescribe Repatha in a single visit if the clinical indication is established.

HealthRX providers can initiate or continue evolocumab therapy for New Mexico patients via telehealth. The workflow typically involves: an initial video visit, review of recent lipid panel (within 90 days), cardiovascular risk stratification using the ACC/AHA Pooled Cohort Equations or FRS, prior authorization submission to the patient's insurer, and coordination with an in-state or mail-order pharmacy.

What Are the Cheapest Ways to Get Repatha in New Mexico?

For most New Mexico patients, the cost path depends on insurance status. Here is a practical breakdown by payer situation:

Commercially insured patients: Apply for the Amgen SupportPlus savings card before filling the first prescription. If the insurer approves Repatha, the savings card can bring co-pay to $0/month. The card is stackable with commercial insurance but not with Medicare or Medicaid.

Medicare Part D enrollees: Compare Part D plans during open enrollment each fall using Medicare.gov's plan finder. Repatha's tier placement varies by plan. Extra Help (Low Income Subsidy) can reduce specialty tier cost-sharing to a few dollars per month for qualifying low-income beneficiaries.

New Mexico Medicaid enrollees: Medicaid does not cover Repatha. Options include: (1) filing a prior authorization exception with documentation of compelling clinical need; (2) applying for Repatha Assist (Amgen's free drug program) if income-eligible; (3) asking a compounding-friendly telehealth provider about compounded evolocumab via a 503A pharmacy.

Uninsured patients: The list cash price is $580/month at retail. The Amgen Repatha Assist program covers drug cost for uninsured patients with household income at or below 600% FPL. Compounded evolocumab from a licensed 503A pharmacy is the other realistic pathway.

All patients: Requesting a 90-day supply from a mail-order pharmacy rather than a 30-day retail fill often reduces dispensing fees modestly, though the drug cost itself tracks list price closely.

Understanding Evolocumab's Mechanism and Why LDL-C Reduction Matters

Evolocumab is a fully human monoclonal antibody that inhibits proprotein convertase subtilisin/kexin type 9 (PCSK9), a serine protease that degrades hepatic LDL receptors. By blocking PCSK9, evolocumab allows more LDL receptors to recycle to the liver cell surface, which increases LDL-C clearance from circulation. [1]

Statins lower LDL-C by 30 to 50 percent at high intensity doses. Ezetimibe adds roughly 15 to 20 percent on top. Evolocumab, when added to maximally tolerated statin plus ezetimibe, can reduce LDL-C by an additional 50 to 60 percent, bringing some high-risk patients to LDL-C values below 20 mg/dL. [7]

The cardiovascular benefit of LDL-C reduction is linear across the range studied in major trials. The Cholesterol Treatment Trialists (CTT) meta-analysis of 170,000 patients across 26 statin trials found that each 1 mmol/L (approximately 38.7 mg/dL) reduction in LDL-C reduced major vascular events by 22 percent. [10] Evolocumab-sized LDL-C reductions therefore carry substantial predicted event reduction in high-risk patients, which is precisely what FOURIER confirmed prospectively.

New Mexico has a cardiovascular disease death rate of 167.7 per 100,000 (age-adjusted, 2022 CDC WONDER data), slightly above the national rate of 162.7, making access to effective LDL-C-lowering therapy a real public health issue for the state. [11]

Monitoring and Administration for New Mexico Patients

Evolocumab is given by subcutaneous injection. The 140 mg dose is injected once every two weeks using a single autoinjector. The 420 mg monthly dose requires three consecutive 140 mg injections administered within 30 minutes at the same visit.

Injection sites include the abdomen, thigh, or upper arm. Patients should rotate sites and avoid areas of active skin irritation. The autoinjector should be allowed to reach room temperature for 30 minutes before injection. Amgen's Repatha patient support materials include video instructions that a prescribing telehealth provider can share directly.

Baseline and follow-up labs are important. Lipid panel at baseline, then 4 to 12 weeks after initiation to confirm LDL-C response, then every 3 to 12 months. Hepatic function testing is not required by the FDA label, unlike with statins. Adverse events in clinical trials were generally mild; injection-site reactions occurred in 3.2 percent of evolocumab patients versus 2.9 percent of placebo patients in FOURIER, and neurocognitive events were evaluated in the EBBINGHAUS substudy (N=1,974), which found no significant difference in cognitive function between groups at 19 months. [12]