Breaking Down The Cost of Vyvanse: Prescription Savings Plan

For Vyvanse, whether you are prescribed the brand-name or generic version, your out-of-pocket costs will be determined by whether or not you have insurance coverage, the amount of your copay for medications as stipulated within your insurance policy if you do have coverage, and if the specific medication is covered by your insurance policy.[2] 

In some cases, an add-on or dedicated prescription savings plan can be beneficial and help you to get the full cost of your medications covered. Most private insurance companies offer it, and so do government-sponsored plans like Medicare.[3] As long as the cost of this add-on plan is less than what you pay for your medication over the course of the year, it can help you keep your overall medical costs low.

Breaking Down the Cost of Vyvanse

Everyone’s insurance coverage is different, and the final cost to the consumer for Vyvanse or the generic version of the drug will vary widely. As long as the stimulant is medically necessary, insurance should cover it if they cover any medication and charge only the usual copay.

If you feel that your insurance policy should cover Vyvanse and they are not, there are steps you can take to appeal the decision.[2]

Ways to Save Money on Vyvanse

There are a number of ways to save money on the cost of a Vyvanse prescription in addition to finding health insurance that offers a good amount of coverage and low co-pays on meds. In most cases, a combination of the following options will provide the best coverage and lowest cost for Vyvanse: 

Try the Generic Version 

In 2023, the Food and Drug Administration approved generic formulations of Vyvanse to be made available for purchase to consumers.[4] However, as of 2024, there are still some shortages of the drug, which may make it difficult to garner savings with this option alone.[5]

Ask About Coupons & Savings Cards 

In the past, Shire (the manufacturer of Vyvanse) has offered savings via coupons or cards to help lower the cost of the medication for those who need it. With the introduction and approval of generic versions of the drug, it is possible that they may offer this option in the future in order to remain competitive. 

Additionally, if you don’t have health insurance or you don’t have enough coverage to manage your medical costs, patient assistant programs may be available through the drug manufacturer for either the brand-name or generic versions.[6]

Check Your Insurance Formulary List

Every insurance plan will include a formulary list that will show in black and white which formulations of which drugs will be covered in full, in part, or not at all. It may be that your insurance plan covers generics only or that they will only cover the brand-name version of certain drugs. In some cases, saving money will be as simple as switching to the formulation approved by your insurance company.

Compare Prices at Different Pharmacies

It may be that different pharmacies will charge different amounts for Vyvanse if the medication is not fully covered by insurance after the copay. Some pharmacies may include Vyvanse or the generic version within their discount prescription program. 

In other cases, you may find that online or mail-order pharmacies can provide savings over in-person pharmacies. Check around and see what options are available to you. 

Look Into Changing the Dosage 

If you are taking a dose of Vyvanse or a generic version of the drug that requires two pills of different milligram amounts, ask about changing your dosage so you only need to take one dosage level, thus cutting down on your costs. 

Use an FSA or HSA

Both a flexible spending account (FSA) and a health savings account (HAS) can help you to save money on prescription and other out-of-pocket medical costs because they use pre-tax dollars. If you are underinsured or have a high copay or deductible, these could be a good option for you.[7]

Dive Into the Details of Your Insurance

Some insurance plans will require that you take certain measures before they agree to cover the costs of Vyvanse. Others may cover the medication for a time and then stop without warning. If you feel like you have followed all the rules of your insurance and the medication is medically necessary, don’t be afraid to appeal any insurance coverage decisions that don’t support your ability to get the medication you need.[2]

Vyvanse Savings Card & Copay Lookup

Some companies offer a Vyvanse Savings Card or coupon rate to help people cover out-of-pocket costs for Vyvanse. Here’s what you need to know: 

• To qualify, you must be able to prove eligibility, usually based on income and current insurance costs.
• To use the card, you simply present it at the time of prescription pickup unless it can be added to the account. 
• The savings may be a set amount of a percentage depending on the details of the program. There may also be limits per year.
• Savings cards usually need to be renewed every year. 
• In some cases, the saved amount may still apply to the overall deductible for your insurance. 
• In most cases, the savings card cannot be combined with other coupons or discounts.

Private Insurance

Every private insurance policy will have different expectations and standards regarding the deductible, copays, formulary options, and coinsurance. Each of these factors will impact the cost of Vyvanse or a generic version.[8] 

• If your insurance doesn’t include Vyvanse or a generic version on their formulary list, your cost will be higher.  
• Depending on the details of your insurance plan, your copay may be fixed, or it may be a percentage of the costs. 
• For plans with a high deductible, you may pay the full cost of your Vyvanse prescription until you have paid the full deductible.

Medicaid

A joint federal and state program, Medicaid can help people with a low income to get the insurance coverage they need to manage their medical costs. Though Medicaid programs are run by the state and federally required to cover prescription drugs, states have the ability to create a unique formulary list.[9]

• Because Medicaid is for low-income individuals, copays are generally very low, especially for generic drugs. 
• There may be limitations, such as quantity limits or need for prior authorization. Vyvanse may be only $1 to $3 per prescription. 
• Prescriptions for children and pregnant women may not require a copay. 
• You have the ability to appeal the decision if Medicaid determines that your prescription is not valid for coverage and you believe it should be. 

Medicare

Different Medicare plans cover different prescription drugs for people ages 65 and over and some younger people living with disabilities. For example, Medicare Part B offers the most limited coverage of prescription drugs, while Part C Medicare Advantage Plans offer wider coverage and Part D focuses solely on prescription drugs.[10]

• Each Medicare part offers a different formulary listing. Vyvanse may be on different tiers of coverage in different plans. 
• You may need to pay for the cost of medication until you reach the annual deductible, depending on the plan. 
• After the deductible, a copay and coinsurance payment will typically need to be paid but will be relatively low. 
• You may experience a coverage gap where there is a temporary limit placed on the coverage provided for prescriptions. 
• After you spend a certain amount in out-of-pocket costs to cover prescriptions, catastrophic coverage kicks in, and your coinsurance and copays decrease for the rest of the year. 

Discounts 

While the manufacturer of Vyvanse, Shire, no longer provides discounts for the drug and generic versions are already cheaper, it may be possible to qualify for prescription discount programs. You may also be able to find coupons or discounts at local or online pharmacies. 

Factors That Impact The Cost of Vyvanse

The cost of Vyvanse is not a straightforward number that applies to all situations. There are a number of factors that can impact the final cost you pay for the medication each year, and most of them are variables you can adjust as needed. These are some of them:

Name Brand or Generic

Name-brand versions of Vyvanse are more expensive than the generic versions unless generic versions are not covered by your insurance provider and brand-name Vyvanse is covered. If you were prescribed the version that is not optimally covered by your insurance, you can ask your doctor to change the prescription. 

Type of Insurance Coverage & Benefits

Different types of insurance provide different amounts of coverage. Formulary lists will be different across programs, and some may offer discounts for using specific versions of drugs. Copays and coinsurance costs will also impact the overall cost of Vyvanse, as will the cost of monthly fees and deductibles. 

Dosage Requirements

If two pills are required to create a single dose of Vyvanse, the cost of the medication will be higher than if a single pill will do the job. Altering the dose so that only one pill is needed can lower costs by half in some cases. Don’t do this without talking to your doctor.

Pharmacy Choice

Some pharmacies will be more expensive than others, and it pays to look around and compare prices. Some places will offer a preferred customer card that offers incentives for filling multiple prescriptions, discounts for moving your regular prescription to their pharmacy, or coupons. 

In some cases, online pharmacies may offer better deals due to lower overhead costs. 

Discount Options 

Outside of pharmacies, there may be add-on insurance options that offer higher discounts than the cost of their premiums, provide coupons for specific medications, or otherwise help people to save money on their medication costs.