Yes, the FDA has approved generic versions of Entresto (sacubitril/valsartan), and at least one generic became available in 2024. However, ongoing patent disputes between Novartis and generic manufacturers have complicated the rollout, and widespread availability at lower prices is still developing.
Current Generic Status
The FDA granted final approval to MSN Laboratories for a generic sacubitril/valsartan product in July 2024. The generic is available in the same three dosage strengths as brand-name Entresto: 24mg/26mg, 49mg/51mg, and 97mg/103mg. MSN launched its product “at risk,” meaning it entered the market while patent litigation with Novartis was still unresolved.
Novartis attempted to block MSN’s generic by claiming it infringed a separate patent not listed in the FDA’s official drug patent database (the Orange Book). Both a federal district court and the U.S. Court of Appeals for the Federal Circuit rejected Novartis’s request for an injunction, ruling that the company hadn’t shown it was likely to prove infringement. A key Entresto patent expires in July 2025, and Novartis had also tried to extend protection through November 2026, but a federal judge rejected that effort in July 2025.
With these legal barriers falling, generic competition is expected to increase through 2025 and into 2026. More manufacturers may enter the market as patent protections lapse, which typically drives prices down further.
What Entresto Costs Right Now
Without insurance, brand-name Entresto runs roughly $600 to $900 per month for a 30-day supply (60 tablets), depending on the pharmacy and dose. That’s a significant expense, especially for a medication most people take long-term.
If you have commercial or private insurance, Novartis offers a copay card that brings your cost down to as little as $10 for a 30-, 60-, or 90-day supply. The card has a combined annual savings limit of $4,100. You can enroll through the Novartis website, and the program also includes a 30-day free trial offer available to any U.S. patient regardless of insurance status.
For people on Medicare Part D, the copay card doesn’t apply (federal rules prohibit manufacturer coupons for government insurance). Under Medicare, most people currently pay around $25 to $50 per month, though the exact amount depends on your plan and pharmacy. If you have limited or no prescription coverage, the Novartis Patient Assistance Foundation (1-800-277-2254) may help cover the cost.
Generic pricing hasn’t fully stabilized yet, since market competition is still limited. As more generics launch and compete, you can expect prices to drop well below the brand-name cost.
What Entresto Does
Entresto treats heart failure by tackling the problem from two directions at once. One component (valsartan) blocks a hormonal system that, when overactive in heart failure, causes blood vessels to constrict, blood pressure to rise, and the heart to remodel in harmful ways. The other component (sacubitril) prevents the breakdown of protective proteins your body naturally produces to relax blood vessels, lower blood pressure, and help your kidneys clear excess sodium and water. Blocking neprilysin alone would trigger a rebound in the harmful hormonal system, so the two components work as a pair.
The net effect is that blood vessels relax, the heart pumps against less resistance, fluid buildup decreases, and the heart gradually reverses some of the structural damage caused by heart failure. Entresto also reduces oxidative stress in the heart and has anti-inflammatory and anti-scarring effects on heart muscle tissue.
How Effective Is It
The landmark trial that led to Entresto’s approval, called PARADIGM-HF, compared it head-to-head against enalapril, a well-established heart failure drug. Entresto reduced the combined risk of cardiovascular death or hospitalization for heart failure by 20% compared to enalapril. Cardiovascular death alone was also reduced by 20%. These are meaningful differences on top of an already proven treatment, which is why Entresto became a cornerstone of heart failure therapy.
The benefits held across patients regardless of what other heart failure medications they were taking, including beta-blockers and other standard therapies.
What to Know Before Switching to a Generic
Generic sacubitril/valsartan contains the same active ingredients in the same doses as brand-name Entresto. The FDA requires generics to demonstrate bioequivalence, meaning the drug reaches your bloodstream at the same rate and concentration as the original. You shouldn’t notice any difference in how well it works.
If your pharmacy stocks a generic version, your pharmacist may automatically substitute it unless your doctor has specified “brand only.” If you’re currently using the Novartis copay card and paying $10, switching to a generic might not save you money right away. But if you’re uninsured or paying a high copay, a generic could eventually offer substantial savings. It’s worth asking your pharmacist whether a generic is available at your local pharmacy and what the current price difference looks like.