We actually tried the Focalin XR because it had a co-pay assistance card. Which would have dropped the $70 co-pay to $10. However, our insurance has a name-brand penalty rule – so if there is a generic available and you pick the name brand over the generic you have to pay the price difference between the two. Our insurance also tiered EVERY extended release ADHD medication as Tier 3, regardless of whether it was a generic or name brand. There are ZERO tier 2 ADHD meds and Tier 1 is only made up of short acting meds.
So generic was $70 and we could not use the co-pay assistance card, or the name brand was $226 because of the name-brand penalty and with the co-pay card it would have been $166.00.