Medication Cost Is One of the Biggest Barriers to Adherence — Here's How to Help

You've determined that Amitiza (Lubiprostone) is the right treatment for your patient's chronic constipation, IBS-C, or opioid-induced constipation. But when they get to the pharmacy, the price tag may stop them from filling the prescription.

Medication adherence and cost are tightly linked. Studies consistently show that patients who face high out-of-pocket costs are significantly more likely to abandon prescriptions at the pharmacy counter, skip doses, or discontinue treatment early. For a maintenance medication like Amitiza, this directly undermines clinical outcomes.

This guide provides a practical overview of the savings programs, generic options, and cost-reduction strategies available for Amitiza in 2026 — and how to integrate cost conversations into your prescribing workflow.

What Patients Are Paying for Amitiza

Understanding the cost landscape helps you anticipate barriers before they arise:

• Brand-name Amitiza: $400 to $530 for 60 capsules (30-day supply of 24 mcg twice daily)
• Generic Lubiprostone: $60 to $150 for the same quantity
• Insurance copays (brand, Tier 3): Typically $40 to $100+ per month depending on plan
• Insurance copays (generic, Tier 2): Typically $15 to $50 per month
• Uninsured cash price (generic): $60 to $150 with discount cards

The patent expiration of Amitiza around 2024-2025 and the subsequent entry of generic Lubiprostone has improved the cost picture significantly. However, limited generic manufacturers mean prices haven't dropped as dramatically as they have for some other medications.

Insurance Hurdles

Most commercial and Medicare Part D plans cover Amitiza or generic Lubiprostone, but common requirements include:

• Prior authorization — Required by most plans. Your office will need to document the diagnosis and previous treatments tried.
• Step therapy — Many plans require documented failure of first-line treatments (Polyethylene Glycol, Docusate, fiber supplements) before approving coverage.
• Quantity limits — Some plans limit dispensing to 60 capsules per 30 days.

Building step therapy documentation into your initial workup streamlines the prior authorization process later.

Manufacturer Savings Programs

Takeda previously offered a manufacturer savings card for Amitiza that reduced copays for commercially insured patients. As the medication has transitioned to generic availability, these programs have evolved:

• Check amitiza.com for current savings offers from Takeda
• Mallinckrodt Patient Assistance Program — Available for qualifying uninsured or underinsured patients who meet income requirements. Applications are typically processed within 2 to 4 weeks.

For the most up-to-date information on manufacturer programs, direct your staff to check the manufacturer websites or contact their medical affairs departments.

How to Help Patients Access These Programs

• Keep printed applications in the office for the Mallinckrodt Patient Assistance Program
• Assign a staff member to manage prior authorizations and assistance program applications
• Flag patients on your EHR who may qualify based on insurance status or reported financial hardship

Coupon and Discount Cards

For patients paying out of pocket or facing high copays, prescription discount cards can significantly reduce costs — especially for generic Lubiprostone:

Top Discount Card Options

• GoodRx — Widely used; often brings generic Lubiprostone below $100 for a 30-day supply
• SingleCare — Competitive pricing at many chain pharmacies
• RxSaver — Compares prices across local pharmacies
• Optum Perks — Another reliable option for cash-pay patients
• BuzzRx — Free discount card with no registration required

These cards are free, require no enrollment, and can be used by insured patients when the discount price is lower than their copay. Remind patients that they can compare prices across pharmacies — cost can vary by $50 or more for the same medication at different locations.

For patients, we recommend directing them to our patient savings guide for Amitiza.

Generic Alternatives and Therapeutic Substitution

Generic Lubiprostone

The most straightforward cost reduction is prescribing generic Lubiprostone. Ensure your prescriptions allow generic substitution (avoid writing "dispense as written" unless there's a clinical reason for brand). Generic Lubiprostone is bioequivalent and costs 60% to 85% less than brand Amitiza.

Therapeutic Alternatives

If cost remains prohibitive even with generic Lubiprostone, consider therapeutic substitution within the same or adjacent drug classes:

• Linzess (Linaclotide) — GC-C agonist for CIC and IBS-C. Once daily dosing. Generic availability may vary. Comparable efficacy for CIC and IBS-C, approved for both men and women.
• Trulance (Plecanatide) — Another GC-C agonist for CIC and IBS-C. Once daily, can be taken with or without food.
• Motegrity (Prucalopride) — 5-HT4 agonist for CIC. Different mechanism; once daily. May be preferred for patients who haven't responded to secretagogues.
• Movantik (Naloxegol) — PAMORA for OIC specifically. Once daily. Works through opioid receptor antagonism in the gut.

When switching between agents, consider the patient's insurance formulary — a drug that's "more expensive" at retail may actually cost the patient less if it's on a preferred tier. Check the plan formulary before making substitutions.

For a detailed comparison, see our alternatives to Amitiza guide.

Additional Patient Assistance Resources

For patients with financial hardship, several independent programs may help:

• NeedyMeds (needymeds.org) — Comprehensive database of patient assistance programs, discount cards, and disease-specific resources
• RxAssist (rxassist.org) — Directory of manufacturer and independent assistance programs
• RxHope (rxhope.com) — Connects patients with pharmaceutical company assistance programs
• Community health centers — FQHCs often have in-house assistance navigators and 340B pricing that can significantly reduce medication costs

Building Cost Conversations Into Your Workflow

Proactively discussing cost at the point of prescribing prevents downstream adherence problems. Here are practical strategies:

At the Time of Prescribing

• Ask about cost concerns directly — "Before I send this prescription, is cost going to be a barrier for you?" Many patients won't volunteer this information without prompting.
• Prescribe generic by default — Write for Lubiprostone rather than Amitiza unless clinically indicated otherwise.
• Mention discount cards — "If your copay is high, check GoodRx or SingleCare — sometimes the discount price is lower than your insurance copay."
• Provide the Medfinder savings guide — Give patients a resource they can explore on their own.

At Follow-Up Visits

• Ask about adherence — "Have you been able to fill and take your Lubiprostone consistently?"
• Screen for cost-related non-adherence — Patients who report "sometimes skipping doses" or "stretching the prescription" may be rationing due to cost.
• Reassess the formulary — If the patient's insurance changed (e.g., new plan year), the cost picture may have shifted. A drug that was affordable last year may not be this year.

Office Systems

• Integrate prior authorization tracking into your EHR workflow
• Keep a reference sheet of current savings programs and discount card options
• Train front desk and nursing staff to recognize cost barriers and escalate to the prescriber
• Use Medfinder for Providers to help patients locate pharmacies with Amitiza in stock at competitive prices

Final Thoughts

Prescribing the right medication is only half the equation — ensuring your patient can actually afford to fill it completes the picture. With generic Lubiprostone now available, Amitiza has become significantly more accessible. But for patients on fixed incomes, those without insurance, or those stuck on high-deductible plans, cost remains a real barrier.

By incorporating cost discussions into your prescribing workflow, staying aware of available savings programs, and leveraging tools like Medfinder for Providers, you can help more patients stay on therapy and achieve better outcomes.