Does Medicare cover Trintellix?

In this article:

• How much does Trintellix cost?
• Does Medicare cover Trintellix?
• How to save on Trintellix

In this article

• How much does Trintellix cost?
• Does Medicare cover Trintellix?
• How to save on Trintellix

Trintellix is a brand-name prescription drug containing the active ingredient vortioxetine. It is an antidepressant approved by the Food and Drug Administration (FDA) to treat major depressive disorder in adults. Currently, there are no generic alternatives available for Trintellix. 

Medicare typically covers Trintellix, but there may be some barriers to work through. Additionally, how much you pay out of pocket depends on whether you have Part D prescription drug coverage and, if so, what tier Trintellix is on in your plan’s formulary. With or without insurance or Medicare, there are additional ways to reduce out-of-pocket expenses for Trintellix.

How much does Trintellix cost?

Without private insurance or Medicare prescription drug coverage, the cost of Trintellix varies depending on the pharmacy and location. As of the time this article was published, the average retail price of Trintellix for 30, 20 milligram (mg) tablets is $678. 

As a brand-name drug, Trintellix may be more expensive than generic alternatives. Takeda Pharmaceuticals Inc. holds the patent for Trintellix, which is expected to expire in 2026, when a generic version may become available.

Does Medicare cover Trintellix?

Medicare prescription drug coverage, including Medicare Part D and Medicare Advantage, may help cover the cost of Trintellix. However, coverage depends on the specific plan’s formulary, which is the list of covered drugs. You can contact your insurance provider to see if Trintellix is included in your plan’s formulary.

Private insurance and Medicare plans often require prior authorization for certain drugs, including brand-name medications like Trintellix. Prior authorization is needed when the healthcare provider must obtain approval from the insurance company before the medication can be dispensed. In addition, insurance plans may only provide coverage for on-label uses, which are uses approved by the FDA.

In some cases, insurance plans may also implement step therapy protocols. Step therapy is a process that requires a patient to try one or more lower-cost medications (often generics) before the plan will cover the prescribed drug. If the initial treatments are not effective or cause adverse effects, then Trintellix may be approved for coverage.

How much does Trintellix cost on Medicare?

Many Medicare plans cover Trintellix, but the exact cost can vary. For example, some plans might offer coverage that significantly reduces the cost. Prices vary by plan, whether the plan covers the drug, and what stage of annual Medicare drug coverage you are currently in (the deductible phase, initial coverage phase, coverage gap, or catastrophic phase). According to the manufacturer, the average out-of-pocket costs per month for Trintellix with Medicare Part D plans are around $40. The price would be considerably lower if you qualify for Extra Help, the federal low-income subsidy for eligible Medicare beneficiaries. 

How to save on Trintellix

For many people, paying for brand-name medications like Trintellix can be challenging. However, various options may help you save on out-of-pocket costs for Trintellix, especially if you don’t have insurance coverage. Whether you have insurance or not, resources like discount cards, savings programs, and patient assistance can help make this medication more affordable. Here are some of the options you can look into.

Use a SingleCare discount card

A SingleCare discount card can offer significant savings on Trintellix. By presenting this card at participating pharmacies, patients access coupons for up to 80% off the retail price. The card is free to use, with no eligibility or enrollment requirements. Search for Trintellix on the SingleCare website and see the available discounts in your area. Depending on your choice of pharmacy, you may pay as little as $425 instead of $678 for 30, 20 mg tablets. Although you can use SingleCare coupons if you’re on Medicare, such as if your drug copay is too high or if Medicare doesn’t cover Trintellix, you can’t use Medicare benefits and a SingleCare coupon together.

Use a mail-in rebate

Patients who have trouble using their pharmacy’s savings card or have already purchased their medication can apply for a mail-in rebate. If eligible, you can request a rebate for the full payment made for Trintellix. To learn more about submitting a rebate request, visit patientrebateonline.com or contact the program at 866-279-0287.

Apply to patient assistance programs

Patient assistance programs provide Trintellix at a reduced cost or even for free. Programs like Takeda Help At Hand and the HealthWell Foundation may help those with low income or no insurance. Eligibility requirements vary but typically include factors like income levels and insurance status. These programs may help lower prescription costs for qualifying patients.

Medicare Extra Help is also available for eligible beneficiaries who need help paying for their Medicare Part D copays, coinsurance, and other costs. 

Compare prices at pharmacies

Pharmacy prices for Trintellix can vary. It may be a good idea to compare prices at different pharmacies, including local options and U.S.-licensed mail-order pharmacies. Using network pharmacies associated with your insurance company may also help reduce costs.

Consult a healthcare provider for potential alternatives

Speaking with a healthcare provider about possible Trintellix alternatives may also help save on prescription costs. Providers may suggest different medications, including generic drugs, that are cheaper but still effective. Exploring other options may uncover more affordable solutions for managing depression.