Xyrem and cost

As with all medications, the cost of Xyrem can vary. Factors that may affect the price you’ll pay include:

• your treatment plan
• your insurance coverage
• the pharmacy you use
• whether Xyrem has a savings program (see the “Financial and insurance assistance” section below)

To find out what the cost of Xyrem will be for you, talk with your doctor, pharmacist, or insurance provider.

Xyrem 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 ingredient 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 Xyrem long term, you may be able to lower its cost in the following way.

Getting a 3-month supply

When you fill your first prescription for Xyrem, it will be for 30 days. After that, you may able to get a 90-day supply of Xyrem. 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 need financial support to pay for Xyrem or help understanding your insurance coverage, help is available. For example:

• A program called JazzCares is available for Xyrem. For more information and to find out if you’re eligible for support, call 1-866-997-3688 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:
  • Medicine Assistance Tool
  • NeedyMeds

To learn more about saving money on prescriptions with or without insurance, check out this article.

Here are answers to some frequently asked questions about drug cost and Xyrem.

How does Xyrem’s cost compare with that of medications such as Xywav?

The price you would pay for Xyrem versus that of Xywav (calcium, magnesium, potassium, and sodium oxybates) depends on various factors.

Some factors that can affect your prescription cost include:

• the length of your treatment
• whether there are payment assistance programs for your prescribed treatment
• whether you’re paying out of pocket or have insurance

To learn more about the cost of Xyrem compared with other treatments for your condition, talk with your doctor, pharmacist, or insurance provider.

How much does Xyrem cost with insurance vs. without it?

What you pay for Xyrem if you have insurance compared with what you’d pay without it depends on several factors.

Factors that could affect what you pay for this drug without insurance include:

• the quantity you’re prescribed (such as a 90-day or 30-day supply)
• whether you apply and qualify for any available savings programs
• your dosage and treatment plan

These same factors may affect your price for Xyrem if you have insurance. But the price you pay with insurance will also depend on:

• your specific plan benefits
• any prior authorization requirements you have for drug coverage

To learn more about what you’d pay for Xyrem with or without insurance, talk with your doctor, pharmacist, or insurance provider (if you have one).

Below is information you may want to consider if you have insurance and receive Xyrem.

If you have insurance, your insurance company may require prior authorization before it covers Xyrem. This means the company and your doctor will discuss Xyrem 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 Xyrem requires prior authorization.

Now that you’ve learned about cost and Xyrem, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance about cost issues related to Xyrem. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you would pay for Xyrem.

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 Xyrem, refer to this article.
• Dosage: Learn about Xyrem and dosage by viewing this article.
• Side effects: For details about Xyrem’s side effects, see this article. You can also look at the Xyrem prescribing information.
• Interactions: You can find out more about what Xyrem interacts with by visiting this article.

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.