Caplyta (lumateperone) is a brand-name capsule that’s prescribed for schizophrenia and bipolar depression. The cost of the drug with and without insurance can depend on several factors, such as whether Caplyta has a savings program.
Caplyta is approved to treat schizophrenia and depressive episodes caused by bipolar disorder. Caplyta belongs to a drug class called atypical antipsychotics. Caplyta isn’t available in a generic version.
Read on to learn about Caplyta and cost, as well as how to save money on prescriptions. If you’d like other information about Caplyta, refer to this article.
As with all medications, the cost of Caplyta can vary. Factors that may affect the price you’ll pay include:
- your treatment plan
- your insurance coverage
- the pharmacy you use
- whether Caplyta has a savings program (see the “Financial and insurance assistance” section below)
To find out what the cost of Caplyta will be for you, talk with your doctor, pharmacist, or insurance provider.
Note: If you have insurance, your insurance company may require prior authorization before it covers Caplyta. This means the company and your doctor will discuss Caplyta in regard to your treatment. The insurance company will then determine whether the medication is covered. If a drug requires prior authorization but you start treatment without the prior approval, you could pay the full cost of the medication. You can ask your insurance company whether Caplyta requires prior authorization.
Caplyta is only available as a brand-name drug. It doesn’t come in a generic version. A generic drug is an exact copy of the active drug in a brand-name medication.
Generics tend to cost less than brand-name drugs.
WHY ARE COSTS DIFFERENT FOR BRAND-NAME DRUGS VS. GENERIC DRUGS?
Brand-name drugs can be expensive because of the research needed to test their safety and effectiveness. The manufacturer of a brand-name drug can sell it for up to 20 years. When the brand-name drug’s patent expires, multiple manufacturers can create generic versions. This marketplace competition may lead to lower costs for generics. Also, because generics contain the same active ingredients as brand-name drugs, they don’t require the same costly testing.
If you take Caplyta long term, you may be able to lower its cost in the following ways.
Getting a 3-month supply
You may be able to get a 90-day supply of Caplyta. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor, pharmacist, or insurance provider.
If you don’t have health insurance, talk with your doctor or pharmacist. They may be able to suggest online pharmacy options that could work for you.
If you need financial support to pay for Caplyta, or if you need help understanding your insurance coverage, help is available. For example:
- A program called Caplyta savings card is available for Caplyta. For more information and to find out whether you’re eligible for support, text “CAPLYTA” TO 26789, call 800-639-4047, or visit the program website.
- Some websites provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services. Two such websites are:
To learn more about saving money on prescriptions with or without insurance, check out this article.
Now that you’ve learned about cost and Caplyta, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance about cost issues related to Caplyta. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you’d pay for Caplyta.
Here are some other resources you may find helpful:
- Medicare drug coverage. To learn about Medicare coverage for drugs, see these articles about Medicare prescription drug plans, drug coupons and Medicare, and the Medicare drug list.
- More details. For details about other aspects of Caplyta, refer to this article.
- Dosage. Learn about Caplyta and dosage by viewing this article.
- Side effects. For details about Caplyta’s side effects, see this article. You can also look at the Caplyta prescribing information.
- Interactions. You can find out more about what Caplyta interacts with by visiting this article.
- A look at your condition. For more information about bipolar disorder and bipolar depression, see our bipolar disorder hub. To learn more about schizophrenia, see our mental health hub.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.