Medication for ADHD can be costly, even if you have health insurance. There are options, though, that can stop you from breaking the bank to get prescriptions filled. Savings programs can be helpful, especially when you’re familiar with what your insurance does cover. Doing a bit of research before you fill a prescription can significantly lower your out-of-pocket costs.
Max Wiznitzer, MD, a pediatric neurologist in the Neurologic Institute at University Hospitals Rainbow Babies and Children’s Hospital in Cleveland, works with families to find affordable payment options for ADHD medications. Dr. Wiznitzer is co-chair of CHADD’s professional advisory board and serves on the Attention magazine editorial advisory board.
When starting patients on ADHD medication, Dr. Wiznitzer says he prescribes a generic, immediate-release form instead of a name brand, extended-release medication to help save parents money. Generally generic medications cost less than branded, and immediate-release preparations usually cost less than extended release. For patients who may be trying medication for the first time, Dr. Wiznitzer prescribes a generic because sometimes a patient may need to go up in dosage or may need to try another medication, which can be costly.
Dividing pills and other options to save money
Dr. Wizniter says families should pay attention to cost per size of pill as it may save them money. In some instances, non-coated tablets in the immediate release form may be cut into smaller doses. For example, if you are taking 5 mg of a stimulant, asking your doctor for a 20 mg tablet and cutting it into 5 mg sections may provide some savings. Check your insurance plan for coverage to determine if a larger pill size is less expensive. Be sure to discuss with your prescriber what options would work for you when considering pill splitting.
If you can save some money by getting a larger pill and cutting it, Dr. Wiznitzer suggests investing in a quality pill cutter. He cautions that you should only cut scored, immediate-release tablets. Do not cut extended-release tablets, as this changes the effectiveness of these medications. Be sure to talk with your prescriber or pharmacist before cutting any medication.
“All insurance plans can have limits on how many pills they’ll give you and the number of pills you get,” Dr. Wiznitzer says. “Be sure to know what your insurance will cover or if your insurance requires a prior authorization for medication.”
Keep in mind that that once your child turns 18, insurance rules might change and insurance companies might require preauthorizations even if your young adult has been on ADHD medication for years.
Checking your insurance plan’s formulary or preferred medication list can also help you save money. Lower-tier medications are less expensive than higher-tier medications. Ask your doctor to see if a medication from your insurance’s lowest tier, typically a generic medication, is right for you. In some instances, says Dr. Wiznitzer, brand names might be on your insurance’s preferred medication list so be sure to check before you head to your pharmacy.
Discounts and coupons
Using a discount pharmacy card, such as GoodRX, is another way to lower your prescription costs and sometimes may be less than an insurance copay. You can go online to find discount pharmacy cards, check your doctor’s office waiting room, or ask your prescriber or pharmacist for one. For non-stimulants, Dr. Wiznitzer says to look for pharmacies that offer a discount program for these medications. With brand-name medications, there’s always a coupon, so ask your prescriber or pharmacist for one. Many times, the medication manufacturer’s website will provide coupons or discount information. Coupons for brand-name medications may offer a free first prescription or significant discount.
“Another way to save is to make sure that you identify and treat comorbid conditions,” says Dr. Wiznitzer. “Odds are you’ll need less stimulants when you do.”
For example, if you or your child have anxiety along with ADHD, getting treatment for anxiety along with ADHD treatment can decrease the amount of ADHD medication needed. Savings can happen outside the pharmacy by making sure that your child has additional support at home and school.
“If you use educational and behavioral strategies with medication [for your child], research shows that you need a lower dose of the medication,” says Dr. Wiznitzer. “As another way of saving money, make sure they’re in the right educational environment and that everyone knows how to handle an ADHD individual appropriately in order to guide them to develop appropriate behavior patterns.”
Where to find more information on how to afford medications:
- Insurance and Public Benefits—Options for Paying for Medications
- When Medication Costs Too Much: Prescription Assistance
- What ADHD Medication Can and Can’t Do
- 19 Tips for Finding Low-Cost ADHD Treatment
- 25 Money-Saving Tips for Life with ADHD