Tiotropium

Also known as: Spiriva, Spiriva Handihaler, Spiriva Respimat.

Wholesale (NADAC) cost for every strength and dosage form — the price pharmacies pay, published weekly by CMS. Not your out-of-pocket price.

Wholesale (NADAC) prices — every strength & form

StrengthFormNADAC / unitPackageClass
1.25 MCGInhaler$126.08 / gram$504.33 / 4 GM boxBrand
2.5 MCGInhaler$126.16 / gram$504.64 / 4 GM boxBrand
18 MCGInhaler$11.68 / unit$350.44 / 30 EA boxGeneric
Wholesale (NADAC) — the price pharmacies pay, not your out-of-pocket price. Brand list prices fall after confidential rebates. Box prices are per full package where the size is known.
NADAC week of 2026-07-01 · updated weekly · source CMS

Medicaid & Medicare spending · 2024

In 2024, Medicaid paid $456,463,293 gross for Tiotropium across 826,043 prescriptions (measured, national).

Medicare Part D EST spent an estimated ~$97,041,110 gross (retail pharmacy only; excludes Part B).

Gross program spending, before rebates — not what patients pay out of pocket. Brand net cost is materially lower after confidential rebates; generics are close to net.

Source: Medicaid SDUD 2024 · Medicare Part D 2024 · CMS

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