My Support Forums - View Single Post - Someone with intel please explain how pharmaceutical pricing and savings works!

sarahsweets · Sep 26, 2021 at 12:43 AM

Hey @WastingAsparagus are you still dealing with the latuda issues? I will share this only because I just helped my daughter with it:

Copay Savings and Support | Latuda(R) (lurasidone HCl)

Quote:

LATUDA $15 Copay Savings Card
Eligibility
To use the card, a patient must be 18 years old or older, with a valid prescription for LATUDA

For a patient between the ages of 10 and 17 with a valid prescription for LATUDA, an adult (Legal Guardian) must use the card on the patient's behalf

LATUDA Copay Savings Program Terms and Conditions
By using this card, you acknowledge that you currently meet the following eligibility requirements:

You must be 18 years of age or older to accept this offer. This offer is valid only for eligible patients and legal guardians of eligible patients. Patients must have a valid prescription for LATUDA within LATUDA's approved indications

Offer not valid if prescription is paid in part or full by any state or federally funded health care program, including but not limited to Medicare, Medicaid, VA, DOD, or TRICARE, or where prohibited by law

This card is valid for up to $400 off a 30-day supply or up to $1200 off a 90-day supply. The card is further limited to twelve 30-day supply uses or four 90-day supply uses in a calendar year with a valid prescription

Offer is limited to one per person and may not be used with any other offer

This program is not health insurance. The amount of the benefit cannot exceed the patient's out-of-pocket expenses. Acceptance of this offer must be consistent with the terms of any drug benefit provided by a health insurer, health plan, or other third-party payer. If requested or required by any such payer, the patient must report the use of this card. The patient must deduct the value of the savings received under this program from any reimbursement request submitted to the patient's insurance plan, either directly or on the patient's behalf

For California and Massachusetts residents, benefits pursuant to this card will terminate automatically upon the introduction of a therapeutically equivalent product

Offer valid only in the United States and Puerto Rico. Void where prohibited by law, taxed, or restricted

Sunovion reserves the right to rescind, revoke, or amend this offer at any time without notice. This offer is not transferable and may not be sold, purchased or traded, or offered for sale, purchase or trade

*Must meet eligibility requirements. For commercially insured patients, this Copay Savings Card covers out-of-pocket expenses with a maximum benefit of $400 for a 30-day supply or $1200 for a 90-day supply. The card allows up to twelve 30-day supply uses or four 90-day supply uses in a calendar year with a valid prescription. Please see full terms and conditions.

Message & Data Rates may apply. Message frequency varies. Terms & Conditions apply: Latuda Savings Program | Text Alerts. Once enrolled, text HELP for help. Text STOP to end.

Quote:

Originally Posted by WastingAsparagus

There are certain medications that are just expensive, unfortunately (based on nothing, really). I had Latuda prescribed for me and there was literally no option to get it cheaply.

If I understand correctly, in this case, IF your insurance will cover it YET the copay is UP TO $400, THEN the manufacturer will give you a coupon to pay as little as $25.

I did some research on this. I believe the key is getting your insurance to cover it (even if it is still a high copay). Then, after that, you can use the manufacturer coupon card. I hope this helps somewhat.

Getting your insurance to cover it (this might be having your doctor call them, appealing it if they deny it, etc.) might be the hardest part.