Last updated: March 2026
How Much Does Letrozole (Femara) Cost?
Cost Breakdown by Type
| Type / Procedure | Without Insurance | With Insurance |
|---|---|---|
| Letrozole 2.5mg Tablet (30-day) | $10 – $30 | $0 – $10 |
| Letrozole 2.5mg Tablet (5-day fertility cycle) | $5 – $15 | $0 – $5 |
What Affects the Cost
- Brand-name vs. generic availability
- Insurance formulary tier placement
- Pharmacy choice (retail vs. mail-order vs. Costco)
- Manufacturer savings cards and coupons
- Dosage and quantity prescribed
- Geographic location
Insurance Coverage
Typical coverage: Tier 1 generic — covered for breast cancer; also used off-label for fertility
Most insurance plans use a tiered formulary: Tier 1 (generic) $0-$15 copay, Tier 2 (preferred brand) $25-$75, Tier 3 (non-preferred brand) $50-$150, Tier 4 (specialty) $100-$500+. Prior authorization may be required for certain medications. Step therapy may require trying cheaper alternatives first.
How to Save Money
- Always ask for generic when available — saves 50-90%
- Use GoodRx, RxSaver, or similar discount cards
- Costco pharmacy is open to non-members and often has lowest prices
- Mark Cuban's Cost Plus Drugs offers transparent low pricing
- Manufacturer patient assistance programs provide free medication to qualifying patients
- HSA/FSA funds can cover medication costs tax-free
Related Procedures & Costs
Frequently Asked Questions
Letrozole costs $10 to $40 per month without insurance for breast cancer treatment. For fertility use (5-day course), costs may be as low as $5 to $15.
Letrozole is an aromatase inhibitor used to treat hormone receptor-positive breast cancer in postmenopausal women. It is also widely used off-label to stimulate ovulation for fertility treatment.
For postmenopausal breast cancer, letrozole is often preferred over tamoxifen as it may be more effective with a different side effect profile. However, tamoxifen is preferred for premenopausal patients.