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Key takeaways
Latuda is a brand-name antipsychotic medication approved to treat schizophrenia and bipolar depression.
Medicaid may cover Latuda if it is prescribed for schizophrenia or bipolar depression, but you may have to try a lower-cost alternative first or prove it is medically necessary.
The generic version of Latuda is lurasidone, and some state Medicaid plans may cover the generic version instead since it is less expensive.
Latuda is the brand name for lurasidone, a prescription medication that is used to treat a variety of mental health conditions. The Food and Drug Administration (FDA) approved Latuda to treat schizophrenia in people 13 years and older, as well as bipolar depression associated with bipolar I disorder in people 10 years and older. It can also be prescribed to treat depressive episodes in adults with bipolar I disorder who are also taking lithium or valproate.
“Some people with bipolar disorder may use Latuda to keep their mood stabilized even when they are not experiencing depression,” says Talisa M. Marchese, Pharm.D., BCPS, BCPP, a clinical assistant professor in the Department of Pharmacy Practice at D’Youville University School of Pharmacy in Buffalo, New York. “And it may help decrease delusions or hallucinations for a person with schizophrenia,” she says.
Latuda works by affecting the neurotransmitters (chemical messengers) serotonin and dopamine in different parts of the brain. It is considered a second-generation antipsychotic, also known as an atypical antipsychotic. Your state Medicaid agency may cover Latuda or its generic version, lurasidone, but coverage varies, and you may need prior authorization. We’ll cover what you need to know about Medicaid coverage for Latuda below.
How much does Latuda cost?
“Without insurance, Latuda can be expensive,” Dr. Marchese says. Drug prices fluctuate and vary by pharmacy, but the average retail price of Latuda is $1,863 for 30, 40 mg tablets. The exact price of Latuda without insurance will depend on your choice of pharmacy, the dosage you are on, and the quantity prescribed.
Latuda is a brand-name drug so it tends to be more costly than lurasidone, the generic version. Without insurance or coupons, the typical cash price for brand-name Latuda is $1,863 for 30, 40 mg tablets.
Does Medicaid cover Latuda?
Medicaid covers outpatient prescription drugs like Latuda and lurasidone. But that doesn’t mean it will automatically pay for every medication your healthcare provider prescribes. It ultimately depends on whether the drug is on your state Medicaid plan’s formulary. If it is, you may pay nothing for Latuda, or you may pay just a few dollars, depending on the level of Medicaid assistance you receive.
RELATED: Is Latuda covered by Medicare?
What to do if Medicaid doesn’t cover Latuda
If your Medicaid plan doesn’t cover Latuda, you have options. For example, your Medicaid agency may require you to prove that you need Latuda instead of a lower-cost alternative. If so, your healthcare provider may have to prove that Latuda is medically necessary. They’ll do this through a process called prior authorization. Or, they may require you to try other lower-cost medications first to see if they work, a process called step therapy.
Alternatively, your healthcare provider may prescribe generic lurasidone if Medicaid doesn’t cover Latuda since lurasidone is less of a financial burden. They may also consider Latuda alternatives such as Abilify (aripiprazole) or Risperdal (risperidone), according to Dr. Marchese.
“All patients respond differently to these medications,” Dr. Marchese says. “If one is not effective, then another may work well for a patient. There are different side effect profiles for all medicines. If one causes side effects, another may not.”
RELATED: Vraylar vs. Latuda
How to save on Latuda
You may be able to save on Latuda with a SingleCare prescription discount card. The card is free and provides digital access to coupons you can use at pharmacies across the country. With a SingleCare Latuda coupon, you could pay $1,374 instead of $1,863 for 30, 40 mg tablets of brand-name Latuda. If you opt for generic lurasidone, though, you could pay just $22 instead of $1,339 for 30, 40 mg tablets.
Regardless of Medicaid coverage, talk to your healthcare provider about all of your options before weighing the benefits of taking brand-name Latuda versus taking generic lurasidone or another Latuda alternative.
Sources
- Latuda prescribing information, Sunovion Pharmaceuticals Inc. (2022)
- Neurotransmitters: Key factors in neurological and neurodegenerative disorders of the central nervous system, International Journal of Molecular Science (2022)
- Prescription drugs, Centers for Medicare & Medicaid Services
