Key takeaways
Vraylar is a prescription medication that is used to treat bipolar disorder, schizophrenia, and major depressive disorder (MDD). It is not available in generic form.
Blue Cross Blue Shield covers Vraylar, but out-of-pocket costs vary by plan.
With a SingleCare discount card, you may be able to significantly lower the cost of Vraylar.
If your healthcare practitioner tells you about an alternative to Vraylar that may be right for you, be sure to check your potential copays and insurance coverage for the new medication.
Vraylar (cariprazine) is a brand-name prescription drug approved by the Food and Drug Administration (FDA) to treat schizophrenia, bipolar depression, mania, and mixed episodes of bipolar 1 disorder. It can also be used with other medications for treating major depressive disorder (MDD). Vraylar is an atypical, or second-generation, antipsychotic. The way Vraylar works isn’t completely clear, but it is believed to regulate serotonin and dopamine, neurotransmitters in the brain.
“For people with schizophrenia, Vraylar may help stabilize the amount of dopamine in the central nervous system and helps reduce symptoms like hallucinations and unusual behaviors or thoughts,” says Bethanie Simmons-Becil, DNP, a psychiatric mental health nurse practitioner and assistant professor of nursing at the University of North Florida in Jacksonville, Florida. Although it can be expensive for some, averaging almost $60 per capsule, insurance can make it much more affordable.
Does Blue Cross Blue Shield cover Vraylar?
Blue Cross Blue Shield covers Vraylar, but specific copays and coinsurance vary by plan. And those copays are determined by factors such as whether Vraylar is a preferred drug and which tier it is on in your prescription drug formulary (list of covered drugs). Lower-tier drugs are cheaper than higher-tier drugs. Generic drugs are typically on tier 1, while brand-name drugs like Vraylar are on higher tiers. Vraylar does not currently have a generic version.
Insurance is complicated and every health plan is different—even plans from the same company. Also, Blue Cross Blue Shield (BCBS) is a system comprised of independent, community-based companies, each with its own policies. For example, Blue Cross Blue Shield of North Carolina puts Vraylar on tier 4 of its essential formulary but tier 5 for its “Blue Medicare PPO” plan. It also has quantity limits of 30 capsules every 30 days. Check with your plan’s formulary, a list of drugs that are covered, or call the member services phone number on the back of your insurance card for an exact idea of how much you’ll be expected to pay.
RELATED: Does Medicaid cover Vraylar? │ How much does Vraylar cost with Medicare?
How much does Vraylar cost?
The average retail price of a one-month supply of Vraylar is around $1,998 for 30 1.5 mg capsules, but Vraylar costs vary greatly from pharmacy to pharmacy.
How to check whether your Blue Cross Blue Shield plan covers Vraylar
You can find out how much Vraylar will cost you in a couple of different ways. Since BCBS has many independent licensees, it also has many formularies. Each formulary has its own requirements and tier system. If you log in to your plan online, you may access your formulary under “Resources” or “Benefits.” Once you access the formulary for your plan, scroll down to find Vraylar.
Another way to find out if your Vraylar is covered by insurance is to call your insurance company and ask. Have your insurance card handy since the representative will probably ask for information like your account and group numbers. Your pharmacist can help as well. They just need your insurance card.
How to save on Vraylar
There are several ways that you may be able to save on your Vraylar prescription. You could pay around $1,298 for 30, 1.5 mg capsules when you use a Vraylar coupon from SingleCare, depending on which pharmacy you choose. You can’t combine SingleCare prescription discount card benefits with insurance, but it may be an affordable option if your coverage is limited.
There are other ways to save on Vraylar as well. If you have commercial or private insurance from BCBS, you may be able to get Vraylar for free with the Vraylar copay card. People with BCBS Medicare plans are ineligible, however.
If your Blue Cross Blue Shield insurance does not cover Vraylar, you may want to consider discussing Vraylar alternatives with your healthcare provider. Some of these alternative medications are available in generic formulations, so their cost could be significantly lower.
“There are not many other drugs on the market that work quite the same way as Vraylar, but there are other medications that are FDA-indicated for the adjunctive treatment of depression or the treatment of bipolar 1 disorder in the atypical antipsychotic class,” Simmons-Becil says. “People should speak with their healthcare provider about all options to help them find a treatment plan that is right for them.”
Sources
- Vraylar highlights of prescribing information, AbbVie (2024)
- Why Vraylar? Abbvie
- The Blue Cross and Blue Shield system, Blue Cross Blue Shield
- Blue Cross and Blue Shield of North Carolina essential formulary, Blue Cross and Blue Shield of North Carolina (2024)
- 2024 comprehensive formulary, Blue Cross and Blue Shield of North Carolina (2024)
- Sign up for the Vraylar savings program, AbbVie