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Why Is Trelegy Ellipta So Expensive

high drug prices

December 31, 2020

Every year, more and more people around the world are discovering that they have chronic obstructive pulmonary disease, or COPD, a group of chronic diseases that cause airflow blockage and breathing-related problems, including emphysema and chronic bronchitis.

COPD is one of the most common chronic lower respiratory diseases (CLRD) around the world — others include asthma, occupational lung diseases, and pulmonary hypertension. According to the World Health Organization, COPD was the third-leading cause of death around the world in 2019, claiming nearly 4 million lives last year. In the United States alone, COPD affects more than 16 million people and has been the country's third leading cause of death by disease for more than half a decade.

With such a prevalent and potentially fatal chronic condition on the rise, prescriptions for COPD medications have also been on the rise. Yet these drugs — specifically the popular Trelegy Ellipta — continue to remain exceptionally expensive, especially when taken long term.

Here is what Trelegy Ellipta costs — and why it is so expensive.

What Is Trelegy Ellipta?

Trelegy Ellipta (fluticasone furoate/umeclidinium/vilanterol trifenatate) is the brand name for a prescription inhalation powder medication used to help individuals breathe easier. Taken daily, Trelegy Ellipta is used long term to treat COPD, including chronic bronchitis, emphysema — both of which are older terms for subtypes of COPD. Trelegy Ellipta can help prevent the symptoms of COPD, including coughing, wheezing, chest tightness, and trouble breathing.

Trelegy Ellipta contains a combination of three separate medications: fluticasone furoate, umeclidinium, and vilanterol trifenatate. Together, these medications work to reduce inflammation and relax muscles in the airways to improve breathing.

Fluticasone Furoate

Fluticasone furoate is an inhalation steroid used in multiple medications, including asthma or COPD inhalers. It prevents the release of substances in the body that cause inflammation, in turn reducing inflammation. In Trelegy Ellipta (and other inhalation medications) this medicine works to relax the muscles in the airways, but primarily serves to reduce swelling in the lungs, helping individuals breathe easier.


Umeclidinium is an anticholinergic, a drug that blocks the action of acetylcholine in the body. Acetylcholine is a neurotransmitter, or a chemical messenger, and this medicine inhibits the transmission of parasympathetic nerve impulses, thereby reducing spasms of smooth muscles, limiting for example, uncontrollable coughing associated with COPD.

Vilanterol Trifenatate

Vilanterol trifenatate is a bronchodilator, a medicine that dilates (opens) the bronchial tubes of the lungs, allowing for more oxygen to travel uninhibited into the body. Like umeclidinium, vilanterol trifenatate also works to relax muscles in the airways, helping limit coughing, wheezing, and chest tightness.

How Do People Develop COPD?

COPD is typically the result of long-term exposure to lung irritants that damage the lungs and airways. In the United States, the most common type of irritant that causes COPD is cigarette smoke, though pipe, cigar, and other types of tobacco smoke can also cause COPD.

Secondhand smoke, air pollution, or chemical fumes or dusts from the environment or workplace can also contribute to COPD. A genetic condition called alpha-1 antitrypsin deficiency may contribute to the development of COPD. Additionally, people with asthma can develop COPD over time.

Because COPD is a progressive illness it takes years to develop. As such, symptoms more commonly appear only after a person reaches the age of 40 or later.

COPD Numbers on the Rise

COPD is one of the most common chronic lower respiratory diseases around the world and as life expectancies around the globe continue to grow, COPD numbers have continued to rise as well.

Roughly 16 million Americans are diagnosed with COPD, though health officials predict that as many as 8 million additional cases go unreported every year. In 2017, the World Health Organization reported 251 million cases of COPD around the globe.

Despite advancements in medications and a growing interest in the disease, COPD-related deaths continue to rise. From 2000 to 2019, the number of deaths increased to nearly 160,000 in the United States and nearly 4 million around the world.

Perhaps the leading factor in the continued rise in COPD cases and deaths is the ever-increasing life expectancy around the globe. In 2019, people were living more than six years longer than they were in 2000. The global life expectancy in 2000 was 67 years while in 2019, that number had climbed to 2019.

Because COPD is a progressive illness, more and more people are living longer to develop the disease every year.

What Trelegy Ellipta Costs in Canada and Internationally vs. the United States

First approved by the Federal Drug Administration and released in the United State in 2017, Trelegy Ellipta is the brand name of a combination of drugs used to treat COPD. Trelegy Ellipta is the combination of three different ingredients — fluticasone furoate, umeclidinium, and vilanterol trifenatate.

On its own, fluticasone furoate is used in various, affordable medications, including over-the-counter medicines like nasal sprays. Umeclidinium and vilanterol trifenatate, however, are expensive ingredients used only in more high-priced inhalation medicines, exactly like Trelegy Ellipta.

In the United States, Trelegy Ellipta presents a couple of challenges for consumers. Firstly, with no generic version of Trelegy Ellipta available at this time, patients are forced to buy in to the brand name medication. A single Trelegy Ellipta inhaler costs around $635.00 dollars in the United States. With 60 daily doses in an inhaler, that's over $10 a dose. Over a year, that cost skyrockets to over $3,800.

At that same 60-dose Trelegy Ellipta inhaler can be had for much less. A 60-day Trelegy Ellipta inhaler costs just $252, about $4 per daily dose.

Costs Continuing to Rise?

In addition to COPD, another common respiratory affliction is asthma, which affects millions of people globally. According to a compilation of figures from the Asthma and Allergy Foundation of America, roughly 1 in 13 Americans have asthma. By that count, roughly 25 million people in the United States suffer from asthma, nearly twice the number affected by COPD.

Recently, it was announced that the Federal Drug Administration had approved a new indication for Trelegy Ellipta for the treatment of asthma. The new indication is now readily available for use only for patients 18 years or older for asthma as well as COPD.

The FDA's approval made Trelegy Ellipta the first single inhaler triple therapy approved for the maintenance treatment for both COPD and asthma. It is also the only single inhaler triple therapy available for patients in a once-daily inhalation in the United States.

With these new approvals, it is likely that without competition or a generic alternative to the brand name medication the cost of Trelegy Ellipta could rise over time.

Why is Trelegy Ellipta So Expensive in the United States?

Chronic obstructive pulmonary disease is just one of the most common respiratory diseases around the globe. Another is asthma, which affects millions of people globally. Why then are the medications that so many people in the United States need so prohibitively expensive? The answer, while complicated, can be broken down into some easier-to-understand categories.

Costly Research and Development

The first factor in high medication prices is the cost associated with the research and development of these medications. No one will argue that the coast to develop a drug like Trelegy Ellipta is anything but staggering.

However, the money put into research and development is often not as much as the drug manufacturers would have you believe. Pharmaceutical giants often claim that research and development costs make up the majority of their budget — typically citing costs in the billions — though that appears to not be the case:

[Researchers] found that companies took an average of 7.3 years to win FDA approval, at a median cost of $648 million. Only two drugs had research costs over $1 billion. Adding in the cost of capital at 7 percent increased the median research and development cost to $757 million — less than a third of the Tufts estimate.

Regardless of how much the research actually costs, there's no doubt that it's a cost that the pharmaceutical industry can eat — after all, the big drug makers aren't exactly starving for profit.

A "Hands Off" Government

Most national governments throughout the world have regulations and laws in place limiting the markup on prescription drugs by pharmaceutical companies. In the United States, there are no such rules or regulations.

The United States government has long left the country's healthcare up to the so-called free market. In theory, competitive products, supply and demand, and consumer habits would level the playing field, forcing drug manufacturers to offer prescription medications at competitive prices. Instead, due in large part to drug patents — which we will discuss in a moment — this competition is nearly non-existent, leaving manufacturers to set whatever prices they please. With no generic alternative and a lack of competition, medications like Trelegy Ellipta will continue to be outrageously expensive.

There are dozens of examples of medications being overpriced in the United States. The cost of Trelegy Ellipta is just one of the many examples.

Patent Law Plays Its Part

One of the main contributing factors to sky-high prescription medication costs in the United States is patent law. When a drug manufacturer receives a patent on a drug, they are given a period of time during which they alone can produce and market that drug. This is to help the manufacturer recoup the millions of dollars that went into research on and development of that drug.

An unfortunate side-effect of that patent protection is that it eliminates all competition for that medication. During the time of the patent protection, no other pharmaceutical manufacturer can produce that drug in that way.

During this time, pharmaceutical companies can charge whatever they like without fear of consumers turning elsewhere for their medications.

Likewise, the method of delivery can be patented, too.

This means that drugs like Trelegy Ellipta can end up having long patents, even though the medications in them are older than the combination medication itself.

The Personal Cost

Another reason that drugs like Trelegy Ellipta cost so much is simple: people need it. The effects of COPD can be life-changing and when they are, it is never for the better. If you're struggling to breathe, it's going to impact every part of your life.

When faced with the potentially crippling effects of COPD or handing over your hard-earned money, the choice is made for you. Pharmaceutical companies know this, and when the demand is high and supply controlled by a few manufacturers, costs will soar.

Finding Affordable Trelegy Ellipta Options Abroad

COPD and asthma affect millions of people in the United States alone. Trouble breathing can and will affect every part of a patient's life, from the simplest of acts like climbing the stairs or playing with grandchildren to more trying activities like staying active and maintaining a healthy lifestyle. Many times, those that suffer from COPD do so through no fault of their own.

There is no reason that those suffering the effects of this disease (or any disease) shouldn't be able to get the medication to help treat their symptoms. Many Americans struggling to afford prescription medications have discovered that they can look internationally to find those same medications at far more affordable rates.

Recently, the Canadian Broadcasting Company reported that pharmacists have noticed a "quiet resurgence" in Americans traveling north for medications.

At, we want to help people access the medications they need at a reasonable price. Not only do we strive to have the best price for you, but we look to make it as easy as possible by providing delivery of your prescriptions right to your door. If you need assistance with your order or have any questions at all, our dedicated customer service representatives are always available to help.

Ordering your prescription medications from a certified online Canadian pharmacy site and international drugstore can save you money. To find out how or for more information, contact us today by calling our toll-free number 1-866-539-5330 or send us an email at

The information provided on the website is intended to facilitate awareness about healthcare products and medical conditions generally but it is not a substitute for professional medical attention or advice. You should always speak with a qualified healthcare practitioner before taking any prescription or non-prescription drug.
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