I am on a very limited budget and my co-pays on prescriptions have gone up. I am benefiting from the ADHD medication I am taking, but if prices go up any more, I will have to go without. Do you have ideas on how to make my prescription drug bill more affordable?
by William Dodson, M.D.
The cost of ADHD stimulant medications is high, and the cost of the better extended-release delivery systems is even higher. The cause of the high prices is the costs of federal and state regulation. Stimulants are labeled C-II controlled substances, so there is no way around that added cost. The two most common brand-name formulations — Adderall XR and Concerta — went generic 18 months ago, but this has not brought down the cost of the generic forms.
The cheapest way to get two of the better formulations—Vyvanse (vyvanse.com) and Focalin XR (focalinxr.com) is to qualify for one of their “care plans,” which will provide 30 capsules free every month. Go to their respective websites to download their application forms under the tab labeled “Patient Assistance.” It is unclear what will happen to these programs when the Affordable Care Act is fully implemented, or when Focalin XR goes generic later this year. The programs are available now, however, so get moving.
Another way to lower medication expenses is to divide larger dosage sizes into smaller ones to fit your needs. In the U.S., all dosage sizes of a given product cost the same. An Adderall IR 5 mg. tablet costs the same as the 30-mg. size.
If your dose is 15 mg., you can cut a 30-mg. tablet in half, cutting your medication costs in half, as well. (Some formulations can’t be cut without ruining the time-release mechanism. These include Concerta, Intuniv, Kapvay, and the beaded delivery systems.)
Vyvanse, which comes in capsule form, can be dissolved in water. It is apparently stable indefinitely without refrigeration. Let’s say your optimal dose is 30 mg. You can buy the 60-mg. size for the same price, pull a capsule apart, and dissolve it in a small water bottle. White powder will fall to the bottom; this is filler, not medication. Drink half and save the rest for your next 30-mg. dose.
—William Dodson, M.D., head of the Dodson ADHD Center, Greenwood Village, Colorado