Last updated: March 2026
How Much Does Methotrexate (Rheumatrex/Trexall) Cost?
Without Insurance
$15 – $80
Average: $48
With Insurance
$0 – $20
Average: $10
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Cost Breakdown by Type
| Type / Procedure | Without Insurance | With Insurance |
|---|---|---|
| 2.5mg Tablets (weekly dose, 30-day) | $15 – $40 | $0 – $10 |
| 7.5-25mg Weekly (30-day supply) | $20 – $80 | $0 – $20 |
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: Covered as Tier 1 generic; first-line DMARD for RA
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.
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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
Oral methotrexate is very affordable at $15 to $80 per month for rheumatoid arthritis doses.
Regular blood tests (CBC, liver, kidney function) every 1 to 3 months are required, adding $50 to $200 in lab costs per visit.
Yes, methotrexate is an immunosuppressant. You should avoid live vaccines and report any signs of infection to your doctor.
Disclaimer: Costs shown are estimates based on national averages and may vary by location, provider, and insurance plan. This information is for educational purposes only and is not medical advice. Consult your healthcare provider and insurance company for exact costs. Read full disclaimer.
Sources: FAIR Health Consumer, Healthcare Bluebook, CMS Medicare Fee Schedules, GoodRx, and published clinical pricing data. Last updated: 2026-03-15.