Safinamide (Xadago): Cost, CMS NADAC & Insurance Coverage
What it's for: Once-daily reversible MAO-B inhibitor approved as adjunctive treatment to levodopa/carbidopa in patients experiencing 'OFF' episodes. (Source: FDA Prescribing Information (NDA 207145) & Michael J. Fox Foundation)
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Cost Across Insurances Matrix for Safinamide
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.
| 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 27505011030 Safinamide (Xadago) | $1,120 – $1,290 / 30 days (30 tablets) $1,120 – $1,290 / 30 days (30 tablets) Source: CMS NADAC 2026 & Retail Pharmacy Cash Benchmarks (Oct 2026) Date: Oct 2026 | NADAC: $1,089.77 – $1,093.77 / 30 tablets (30-day supply) XADAGO 50 MG TABLET ($36.45907/EA) & XADAGO 100 MG TABLET ($36.32581/EA) • Medicare Part D patient cost: 25%–50% coinsurance until hitting the $2,100 annual Part D out-of-pocket cap ($0 thereafter) 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 4 Non-Preferred Brand; Prior Authorization + Step Therapy (rasagiline/selegiline) 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: Anthem Blue Cross 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026 | Not published Tier 4 / Specialty; 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 Excluded or Tier 4 with Prior Authorization + Step Therapy. 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 Non-Preferred Brand; 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 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: Cigna 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026 | Not published Non-Formulary (requires formulary exception after generic selegiline and rasagiline). 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 ONLY with approved Medi-Cal Rx Prior Authorization documenting failure/intolerance of generic selegiline and rasagiline. Source: CA DHCS Medi-Cal Rx Contract Drug List (CDL) & PA Policy Date: Oct 2026 |
National Average Drug Acquisition Cost (NADAC)
Medicare Part D Tier, Prior Auth & $2,100 Cap
Payer-by-Payer Formulary & Prior Authorization Notes
Tier 4 Non-Preferred Brand; Prior Authorization + Step Therapy (rasagiline/selegiline) required.
Tier 4 / Specialty; Prior Authorization + Step Therapy required.
Excluded or Tier 4 with Prior Authorization + Step Therapy.
Non-Preferred Brand; Prior Authorization + Step Therapy required.
Tier 4; Prior Authorization + Step Therapy required.
Non-Formulary (requires formulary exception after generic selegiline and rasagiline).
$0 copay ONLY with approved Medi-Cal Rx Prior Authorization documenting failure/intolerance of generic selegiline and rasagiline.