How to Help Your Patients Save Money on ZTlido: A Provider's Guide to Savings Programs

ZTlido (lidocaine topical system 1.8%) offers a meaningful clinical advantage over generic lidocaine 5% patches for many patients with post-herpetic neuralgia — but at a retail price of $450-479 per 30-patch carton, cost is a real barrier that drives treatment abandonment. This guide equips providers with a comprehensive toolkit for reducing out-of-pocket costs for every category of ZTlido patient.

Understanding the ZTlido Cost Landscape

To help your patients navigate ZTlido's cost, you first need to understand the pricing landscape:

Retail cash price: $450-479 per 30-patch carton. This is what uninsured patients face at the pharmacy counter without any discount program.

GoodRx price: As low as $360.63 per 30-patch carton (approximately 20% off retail).

SingleCare price: As low as $320.81 per 30-patch carton.

With manufacturer savings card + commercial insurance: As low as $0 per monthly prescription for eligible patients.

With commercial insurance only (without savings card): Typically $40-150 copay depending on tier placement and plan design.

Medicare Part D: Variable; manufacturer savings card does not apply; initial coverage phase copay depends on the plan.

Savings Tool #1: The Scilex ZTlido Savings Card

The ZTlido Savings Card from Scilex Pharmaceuticals is the single most impactful cost reduction tool for commercially insured patients. Key details to share with your team and patients:

Maximum savings: As low as $0 per monthly prescription for eligible patients

Where to get it: ztlido.com/start-saving/ (download and print, or access digitally)

Eligibility: Commercially insured patients; NOT eligible for Medicare, Medicaid, or other government programs

How to use: Patient presents card at pharmacy alongside prescription; pharmacy processes it as a secondary payment

No income requirement: Unlike patient assistance programs, this is a copay card available to any commercially insured patient

Consider printing copies of the savings card URL or adding it to your patient discharge instructions for new ZTlido prescriptions.

Savings Tool #2: Pharmacy Discount Programs (For Uninsured and Medicare Patients)

For patients who don't have commercial insurance — including Medicare and Medicaid beneficiaries — pharmacy discount programs provide meaningful savings:

GoodRx: Patients can use goodrx.com or the GoodRx app to get coupons reducing ZTlido to as low as $360.63 at major pharmacy chains.

SingleCare: Available at CVS, Walgreens, Walmart, and Kroger; pricing as low as $320.81.

Important: These discount programs cannot be combined with insurance. Patients must choose one or the other at the point of sale.

Savings Tool #3: Prior Authorization Strategy to Achieve Insurance Coverage

Many insurers require prior authorization (PA) for ZTlido, often citing step therapy requirements (generic lidocaine 5% first). When PA is approved, this reduces patient cost to their plan copay — typically $40-150 for commercial insurance. Here's a protocol for maximizing PA approval rates:

Check the formulary before prescribing: Confirm ZTlido's tier status and PA requirements on the patient's plan. Use PA requirements to set patient expectations upfront.

Document step therapy completion: If the patient previously failed generic lidocaine 5% patches (inadequate pain control, poor adhesion, skin reactions), document this explicitly in the PA letter.

Cite clinical advantages of ZTlido: Document superior adhesion (supported by open-label studies), lower residual drug load (safety advantage for households with children/pets), and equivalent lidocaine delivery confirmed by crossover PK study.

Include quantitative pain measures: Submit NRS pain scores, functional impact, and quality of life data in the PA to substantiate severity.

Appeal all denials: Initial PA denials for ZTlido are frequently overturned on appeal with adequate documentation. Build an appeals protocol into your workflow.

Savings Tool #4: Provider Samples

Healthcare providers can request ZTlido samples from Scilex Pharmaceuticals. Samples are valuable for:

New patient trials before committing to a full prescription cost

Bridging patients while PA decisions are pending

Demonstrating adhesion advantages vs. generic 5% patches in clinical practice

Contact your Scilex Pharmaceuticals representative (1-866-SCILEX3) or visit ztlido.com to request samples through your practice.

Savings Tool #5: 90-Day Supply via Mail Order

For patients with commercial insurance whose plans include mail-order pharmacy benefits, a 90-day supply can reduce the per-prescription cost. Many plans offer preferred mail-order pricing that is lower than the retail 30-day copay. If you prescribe ZTlido long-term, consider writing prescriptions for 90-day supplies and directing patients to their plan's mail-order pharmacy. Note: patients will need a new prescription specifically written for 90-day fills if their current prescription is for a 30-day supply.

When Cost Cannot Be Resolved: Evidence-Based Alternatives

If ZTlido remains unaffordable despite all available programs, these alternatives offer equivalent or alternative PHN relief at lower cost:

Generic lidocaine 5% patch: $30-80/month; therapeutically equivalent lidocaine delivery; wider pharmacy availability

Generic gabapentin: $10-30/month; FDA-approved for PHN; broadly covered by all payer types

Generic pregabalin: $30-80/month; FDA-approved for PHN; Schedule V; broadly covered

Generic TCAs (amitriptyline, nortriptyline): <$20/month; off-label for PHN; highly affordable; use with caution in elderly

medfinder: Helping Patients Find ZTlido Once Cost Is Resolved

Once cost barriers are addressed through the savings card or insurance coverage, the next challenge is often simply finding ZTlido in stock at a local pharmacy. medfinder is a paid service that calls pharmacies near a patient to locate available stock, then texts results directly to the patient. This reduces callbacks to your office from patients who can't find ZTlido after their insurance approval comes through.

Summary: ZTlido Savings Decision Tree for Providers

Commercially insured: Submit PA → provide ZTlido Savings Card → if denied, appeal with clinical documentation

Uninsured: Recommend SingleCare (~$320) or GoodRx (~$360) pharmacy discount programs

Medicare Part D: Verify formulary tier; consider generic lidocaine 5% patch as primary option if ZTlido not covered

New to ZTlido: Provide samples while PA is pending to avoid treatment interruption

Cost remains prohibitive: Prescribe generic lidocaine 5% patch (equivalent delivery) or gabapentin as first-line oral alternative