[why98]

All insurance companies are different, but I suspect that most of them don't want to pay for Latuda, a brand-name AP. It costs almost $1500 out of pocket.

My insurance won't fill the prescription. In the past, it's been the only AP that worked for me as in it didn't have terrible side effects and it made me feel better. They say that I have to take old APs and prove that they don't work. The old APs have terrible side effects as you know. Plus they're more likely to cause weight gain.

Have you switched from Latuda from an AP that you like, and if so what AP? Have you ever had this requirement?

[Soupe du jour]

Hi why98. That is such a pity! The only idea I can suggest is to try appealing to the pharmaceutical company directly. You could consider telling them you were grateful about how well it works (emphasize how others are hard to tolerate and don't work as well, making your mood stability harder to maintain), but your insurance company is a barrier to your continued use of it. You could ask them if there is a way for you to afford it without the insurance. It's possible they might (not guaranteed) respond in a helpful way. I know that many pharmaceutical companies do help. Not that they are so charitable in spirit, but it helps with marketing and PR, and for people to stick with brand meds. This may sound cold, but...yea, it's reality. I used to work for a major pharmaceutical company.

Also, I just googled it, and it looks like there will be a generic form of Latuda available sometime in 2023 (or so). That could help with affordability. Or might convince your insurance company to cover...the generic form. I can say there is absolutely nothing wrong with genetic forms, and I'm supremely grateful that all of my meds have been generics for a while. With only the rarest exceptions, generics are equal to brands, except for the price.

[*Beth*]

Your pdoc can submit a TAR explaining to your insurance that you need Latuda because you have tried everything else and only Latuda works for you.

[BeyondtheRainbow]

I get a couple of meds that I can't afford through patient assistance programs. You can find them on the drug manufacturer website. I don't fully meet the requirements so I write a letter that I include with the application explaining that I don't meet the requirements but the drug out of pocket is far beyond what I can afford (the most recent application it was actually more than I get per month on SSDI and I pointed that out). I've never been rejected from one of these programs and I've used a number of them.

[MickeyCheeky]

i don't really understand much about this stuff i think so i don't have much to add myself. i agree with the other wise and wonderful posters about contacting your Pdoc though if you feel like this med is the best for you. Love. i Hope you'll be able to find what you're looking for. Sending many Safe, warm hugs to ALL of you, @why98, your Families, your Friends and ALL of your Loved Ones! Keep fighting and keep rocking NO MATTER WHAT HAPPENS, OK?!

[*Beth*]

Also, the pharma company that sells Latuda may have an assistance program. I got Seroquel free for 5 years from Astra-Zeneca.

[Ursula Shackleton]

Have the doctor's office fight the insurance. Because of all the risks with the older ones, this is a better fit for you, and they should be happier to pay more for the med than pay for all the problems associated with the side effects of another med. The doctor might also have free samples. That's what my doctor did for a while when I was on Latuda.

[why98]

It turns out that 2 20mg per day pills costs a bunch more than a 40mg pill. The ins co wouldn't approve it for that reason. My doctor rewrote the prescription. His office had to call the pharmacy and fight with them to fill it.

It's unbelievable what we have to go through to get treatment. All I want to do is feel somewhat same. 😞

[Nammu]

For some strange reason I don’t get I can no longer get three months of latuda, only one month at a time. Cost me more but it also cost the insurance companies more. It’s cheaper to pay the copay once every three months than every month so I don’t understand their reasoning

[*Beth*]

Ugggh, it's so annoying when insurance companies require stupid dosage amounts - especially, like Nammu said - the insisted-upon dose is more expensive for the insurance company. Where is the logic...

[why98]

Originally Posted by Nammu

For some strange reason I don’t get I can no longer get three months of latuda, only one month at a time. Cost me more but it also cost the insurance companies more. It’s cheaper to pay the copay once every three months than every month so I don’t understand their reasoning

My insurance company only gives a one month supply unless you get mail order. My meds aren't stable enough to do that.

Did you change insurance companies, or did your current ins co just change the rule?

[Nammu]

Originally Posted by why98

My insurance company only gives a one month supply unless you get mail order. My meds aren't stable enough to do that.

Did you change insurance companies, or did your current ins co just change the rule?

My current insurance just changed the rule, but only for the latuda. I still get a three month supply of all other meds. But latuda was the only name brand that I pay a higher price for. All my other needs are tier one.

[sarahsweets]

Originally Posted by why98

All insurance companies are different, but I suspect that most of them don't want to pay for Latuda, a brand-name AP. It costs almost $1500 out of pocket.

My insurance won't fill the prescription. In the past, it's been the only AP that worked for me as in it didn't have terrible side effects and it made me feel better. They say that I have to take old APs and prove that they don't work. The old APs have terrible side effects as you know. Plus they're more likely to cause weight gain.

Have you switched from Latuda from an AP that you like, and if so what AP? Have you ever had this requirement?

I do not take latuda but tell your doctor you want to discuss having her work on an appeal to your insurance company. I know this because mine played the same game I ended up taking it to my husband’s employer. yea they are demanding proof you need the medicine that you already take. But talk to your doctor. Do you know that latuda has a patient assistance program and it can be as little as 5$. Do you want me to post a link ?

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[scatterbrained04]

I feel for you. I like Latuda as well, been on it for years. My insurance covers it but at a $200/month copay. I use the manufacturers drug discount card to get it down to $15. I don't think I could stay on it if I had to pay $200.

I hope your doctor can help you get it covered. It pisses me off when insurance companies become barriers to treatment.

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[sarahsweets]

Patient Support Program | Latuda(R) (lurasidone HCl)

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[sarahsweets]

Latuda Patient Assistance Programs - Apply Now | Simplefill

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[why98]

Originally Posted by scatterbrained04

I feel for you. I like Latuda as well, been on it for years. My insurance covers it but at a $200/month copay. I use the manufacturers drug discount card to get it down to $15. I don't think I could stay on it if I had to pay $200.

I hope your doctor can help you get it covered. It pisses me off when insurance companies become barriers to treatment.

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One time my doctor gave me a prescription for Latuda and a discount card. The card was only for a few refills. Are you saying that if you're in the discount program you only have to pay $15 each time you get it refilled? How do they qualify you for the program?

[why98]

Originally Posted by Soupe du jour

Hi why98. That is such a pity! The only idea I can suggest is to try appealing to the pharmaceutical company directly. You could consider telling them you were grateful about how well it works (emphasize how others are hard to tolerate and don't work as well, making your mood stability harder to maintain), but your insurance company is a barrier to your continued use of it. You could ask them if there is a way for you to afford it without the insurance. It's possible they might (not guaranteed) respond in a helpful way. I know that many pharmaceutical companies do help. Not that they are so charitable in spirit, but it helps with marketing and PR, and for people to stick with brand meds. This may sound cold, but...yea, it's reality. I used to work for a major pharmaceutical company.

Also, I just googled it, and it looks like there will be a generic form of Latuda available sometime in 2023 (or so). That could help with affordability. Or might convince your insurance company to cover...the generic form. I can say there is absolutely nothing wrong with genetic forms, and I'm supremely grateful that all of my meds have been generics for a while. With only the rarest exceptions, generics are equal to brands, except for the price.

Thank God about the generic form coming soon. Most of my meds are generic and I don't see a difference between them and the brand name drugs.

Do pharmaceutical companies actually listen to their customers?

[why98]

Originally Posted by sarahsweets

Patient Support Program | Latuda(R) (lurasidone HCl)

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@sarahsweets, thank you for the link. I'll keep this in case something bad happens with my refill.

[scatterbrained04]

Originally Posted by why98

One time my doctor gave me a prescription for Latuda and a discount card. The card was only for a few refills. Are you saying that if you're in the discount program you only have to pay $15 each time you get it refilled? How do they qualify you for the program?

Yes, I've only ever paid $15 for it for years. Their discount card covers up to $400 off your copay. But I think you have to have health insurance coverage for the Rx. I don't think it'd help anyone who flat out doesn't have coverage. Maybe they have a patient assistance program for that though? Worth calling them to ask.

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


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