Juliet - my son had a separate rx for the spacer. It ends up the insurance wouldn't cover it so we paid for it ourselves - was about $35 if I remember correctly. And of course next time we were in the hospital they gave us one for free. Your cf clinic may have some extra they can give you. And the benefit of the spacer is that you don't have to worry about timing the inhale exactly to get the correct amount of med, the spacer holds the med in a chamber and then you breathe in a few breaths to get all the med.