Gemtesa

Introduction

Written by Dedra Weiss, PharmD
Medically reviewed by Philip Ngo, PharmD
Updated on July 12, 2024

Gemtesa is a brand-name medication that’s prescribed for overactive bladder in adults. Gemtesa isn’t available in a generic version. The cost of Gemtesa with or without insurance can depend on several factors. It might be lowered by using a coupon. 

Specifically, the Food and Drug Administration (FDA) has approved Gemtesa for use in adults to treat overactive bladder-causing symptoms, including:

• urinary frequency
• urge incontinence
• urgency

Read on to learn about Gemtesa and cost. You’ll also find available coupons and suggestions for ways to save on your prescription. If you’d like more information about Gemtesa, including its uses, refer to this overview article. 

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Cost of Gemtesa

Like other medications, the cost of Gemtesa can vary. Certain factors may affect its price, such as:

• your insurance plan, if you have coverage
• the pharmacy you use
• the quantity prescribed

To find out how much Gemtesa costs, ask your doctor, pharmacist, or insurance provider. They may be able to suggest ways to save money on your prescription, including those described in this article. To find out what you’d pay using savings coupons, read the “Coupons for Gemtesa” section.

Coupons for Gemtesa

Prescription drug coupons can help you save money by lowering the cost of Gemtesa. The Optum Perks coupons above can provide significant savings on your prescription costs.

Note: Optum Perks coupons can’t be used with insurance copays or benefits.

Available app for coupons

To make finding and using these coupons easier, you can download the Optum Perks app. To learn more about this prescription discount app, see this article.

Insurance and other considerations for Gemtesa

Here’s a list of things to consider about the cost of prescription drugs:

• Prior authorization: If you have prescription drug insurance, your insurance company may require prior authorization before it covers the cost of Gemtesa. In this case, your doctor will communicate with your insurance company regarding your prescription for Gemtesa. The insurance company will decide whether to cover the medication. If a drug requires prior authorization and you begin taking it without this, you may have to pay the full price of the drug.
• A 3-month supply: If you’re taking Gemtesa long term, your doctor may suggest a 90-day supply of the medication. This will have to be approved by your insurance company. Getting a 90-day supply could help lower the drug’s cost. It could also save you time having to make trips to your pharmacy.
• Savings accounts: If you’re eligible for a health savings account (HSA) or a flexible spending account (FSA), you can likely use funds from these accounts to pay for your prescription or over-the-counter (OTC) medications. HSA and FSA plans help people save money by using pretax dollars to pay for eligible healthcare expenses, such as prescription and OTC drugs. To learn more about whether you’re eligible for these savings accounts and how to use them, talk with your insurance provider or employer.

Additionally, Gemtesa’s manufacturer offers a coupon to help reduce copay amounts if you have insurance coverage on this drug. You can learn more by visiting the manufacturer’s website.

If you have questions about any of these considerations, ask your doctor or pharmacist. Or contact your insurance company and talk with a representative.

If you don’t have a health insurance plan, let your doctor or pharmacist know. They may suggest online pharmacy options you could use. You can also ask them about ways to obtain health insurance coverage.

Brand names vs. generics

Gemtesa is a brand-name medication. It’s not available in a generic version.

A generic medication is an identical copy of the active ingredient in a brand-name medication. An active ingredient is what makes medication work. Gemtesa contains the active drug vibegron.

Generics usually cost less than brand-name drugs. And they’re thought to be as safe and effective as the brand-name version.

Talk with your doctor or pharmacist if you have questions about generic and brand-name medications.

Why is Gemtesa so expensive compared with generic drugs?

Brand-name drugs such as Gemtesa can be expensive because of the studies needed to test how safe and effective they are.

Makers of a brand-name drug can patent and sell their drug for up to 20 years. When the patent for a brand-name drug expires, other drugmakers can make and sell generic versions.

This competition may help keep the costs of generic medications lower. Also, generic medications contain the same active ingredients as brand-name medications. So they don’t require the same testing, which can be costly.

Currently, Gemtesa isn’t available in a generic version. If you’d like to know more about Gemtesa’s cost, talk with your doctor or pharmacist.

Common questions about Gemtesa and cost

Here are some common questions and answers about Gemtesa.  

Why might Gemtesa not be covered by insurance?

Whether Gemtesa is covered by insurance depends on the type of plan you have. To learn whether it’s covered, talk with your insurance representative. They can tell you if Gemtesa is covered or if it requires prior authorization.

If this medication isn’t covered by your plan, see the section above called “Coupons for Gemtesa” for possible savings options. Also, your pharmacist can tell you the best price for Gemtesa.

Is Gemtesa covered by Medicare?

According to its drug maker, Gemtesa may be covered under Medicare, depending on the type of plan you have. Talk with your insurance representative to find out if it’s covered. They can also tell you exactly how much Gemtesa costs per month with Medicare.

Resources

• Gemtesa (vibegron) tablets, for oral use. (2023). https://gemtesa.com/sites/default/files/gemtesa-prescribing-information.pdf
• Food and Drug Administration. (2024). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm

Disclaimer: Optum Perks 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.