24-Hour Transdermal Dopamine Agonist PatchNDC: 50474080103 (1mg) / 50474080203 (2mg) / 50474080603 (8mg)

Rotigotine Transdermal System (Neupro Patch): Cost, CMS NADAC & Insurance Coverage

What it's for: Once-daily skin patch providing continuous 24-hour transdermal dopamine agonist delivery — particularly valuable when swallowing difficulties (dysphagia) or nocturnal/early-morning akinesia limit oral pills. (Source: FDA Prescribing Information (NDA 021829) & Parkinson's Foundation)

30-Day Retail Cash Range

$880 – $1,060 / 30 days (box of 30 patches)

Source: CMS NADAC 2026 & Retail Pharmacy Cash Benchmarks (Oct 2026)

CMS NADAC Baseline (As of 2026-10-28)

$846.76 – $847.42 / 30 patches (30-day supply)

Per unit: $28.22517 – $28.24732 / patch

2026 Medicare Part D Patient Cost

$47–$100 copay or 25%–40% coinsurance until hitting the $2,100 annual Part D cap

Tier 3 (Preferred Brand) or Tier 4 (Non-Preferred Brand)

1. Published Prices(Cash & Medicare)2. Plan-Adjusted(Payer MRF Rate)3. Verified Price(Real-Time 270/271 Check)

Accuracy Level — Tier 1 Published Prices: You are currently viewing general published hospital cash prices, Medicare baselines, and multi-payer ranges. Add your insurance card to unlock Tier 2 plan pricing and Tier 3 verified benefit checks.

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Cost Across Insurances Matrix for Rotigotine Transdermal System

Tier 1: General Published Rates Across 9 InsurancesEvery cell labeled with official Source + Date • “Not published” shown honestly where proprietary

Hospital procedure cells are extracted from 14 Bay Area hospital MRFs (45 CFR § 180.50, Oct 2026); medication cells use CMS NADAC (as of 2026-10-28) & CY 2026 Medicare Part D / Medi-Cal Rx rules.

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Parkinson's Service / Medication	Self-Pay / Cash Price Hospital MRF / Retail Cash	Medicare Rate 2026 CMS / NADAC / Part D	Anthem Blue Cross MRF Negotiated / Formulary	Blue Shield of CA MRF Negotiated / Formulary	UnitedHealthcare MRF Negotiated / Formulary	Aetna MRF Negotiated / Formulary	Cigna MRF Negotiated / Formulary	Kaiser Permanente MRF Negotiated / Formulary	Medi-Cal (CA Medicaid) CA DHCS / Medi-Cal Rx
MedicationNDC 50474080103 Rotigotine Transdermal System (Neupro Patch) Drug Guide →	$880 – $1,060 / 30 days (box of 30 patches) $880 – $1,060 / 30 days (box of 30 patches) Source: CMS NADAC 2026 & Retail Pharmacy Cash Benchmarks (Oct 2026) Date: Oct 2026	NADAC: $846.76 – $847.42 / 30 patches (30-day supply) NEUPRO 1 MG/24 HR PATCH ($28.23329/EA), NEUPRO 2 MG/24 HR PATCH ($28.24732/EA), NEUPRO 8 MG/24 HR PATCH ($28.22517/EA) • Medicare Part D patient cost: $47–$100 copay or 25%–40% coinsurance until hitting the $2,100 annual Part D cap Source: CMS NADAC 2026 (data.medicaid.gov Dataset fbb83258-11c7-47f5-8b18-5f8e79f7e704) & CMS CY 2026 Medicare Part D Public Formulary File (Oct 2026) Date: 2026-10-28	Not published Tier 3/4; Step Therapy (oral pramipexole/ropinirole) or clinical exception for dysphagia. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: Anthem Blue Cross 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026	Not published Tier 4; Prior Authorization + Step Therapy required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: Blue Shield of CA 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026	Not published Tier 3/4; Step Therapy required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: UnitedHealthcare 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026	Not published Tier 3/4; Prior Authorization / Step Therapy required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: Aetna 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026	Not published Tier 3/4; Step Therapy required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: Cigna 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026	Not published Non-Formulary (requires formulary exception, typically granted for documented severe dysphagia or perioperative NPO status). Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: Kaiser Permanente 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026	$0 patient copay $0 copay with Medi-Cal Rx Prior Authorization documenting dysphagia or failure of oral CDL dopamine agonists. Source: CA DHCS Medi-Cal Rx Contract Drug List (CDL) & PA Policy Date: Oct 2026

Official CMS NADAC Acquisition Cost Baseline

National Average Drug Acquisition Cost (NADAC)

Published Status: Published in CMS Retail Community Pharmacy Survey

NDC & Description: 50474080103 (1mg) / 50474080203 (2mg) / 50474080603 (8mg) — NEUPRO 1 MG/24 HR PATCH ($28.23329/EA), NEUPRO 2 MG/24 HR PATCH ($28.24732/EA), NEUPRO 8 MG/24 HR PATCH ($28.22517/EA)

NADAC Per-Unit Rate: $28.22517 – $28.24732 / patch

Typical 30-Day Regimen (1 patch (2 mg, 4 mg, 6 mg, or 8 mg / 24 hr) applied once daily (30 patches / 30-day supply)): $846.76 – $847.42 / 30 patches (30-day supply)

Effective Date / As-of Date: Effective 2026-10-21 (Verified as of 2026-10-28)

Source: CMS NADAC 2026 (data.medicaid.gov Dataset fbb83258-11c7-47f5-8b18-5f8e79f7e704)

CY 2026 Medicare Part D Formulary Rules

Medicare Part D Tier, Prior Auth & $2,100 Cap

Formulary Tier: Tier 3 (Preferred Brand) or Tier 4 (Non-Preferred Brand)

Prior Authorization: Yes on ~65% of Part D plans (or Step Therapy requiring trial of oral pramipexole or ropinirole unless dysphagia/NPO status is documented)

Step Therapy: Yes — trial of at least one oral non-ergot dopamine agonist (pramipexole or ropinirole)

Quantity Limits: 30 patches per 30 days

2026 Patient Out-of-Pocket: $47–$100 copay or 25%–40% coinsurance until hitting the $2,100 annual Part D cap

Source: CMS CY 2026 Medicare Part D Public Formulary File (Oct 2026)

California Commercial Payers & Medi-Cal Rx

Payer-by-Payer Formulary & Prior Authorization Notes

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Anthem Blue Cross

Tier 3/4; Step Therapy (oral pramipexole/ropinirole) or clinical exception for dysphagia.

Blue Shield of California

Tier 4; Prior Authorization + Step Therapy required.

UnitedHealthcare (UHC)

Tier 3/4; Step Therapy required.

Aetna

Tier 3/4; Prior Authorization / Step Therapy required.

Cigna

Tier 3/4; Step Therapy required.

Kaiser Permanente

Non-Formulary (requires formulary exception, typically granted for documented severe dysphagia or perioperative NPO status).

Medi-Cal Rx (CA Medicaid)

$0 copay with Medi-Cal Rx Prior Authorization documenting dysphagia or failure of oral CDL dopamine agonists.