Cost Is an Adherence Barrier — And Providers Can Help

For patients prescribed Amphetamine XR, cost is often the difference between filling the prescription and abandoning it. Brand-name Amphetamine XR formulations like Dyanavel XR and Adzenys XR-ODT have no generic equivalents, and cash prices can range from $170 to $735 per month. Even insured patients frequently face high copays, prior authorization hurdles, or non-formulary status.

As a prescriber, you're in a unique position to help patients navigate these financial challenges before they lead to treatment discontinuation. This guide covers what your patients are actually paying, available savings resources, generic alternatives, and how to integrate cost conversations into your clinical workflow.

What Patients Are Paying for Amphetamine XR

Understanding the cost landscape helps you anticipate barriers:

• Cash price (no insurance): $170–$735/month depending on formulation and dose
• Insurance coverage: Brand Dyanavel XR and Adzenys XR-ODT are frequently placed on Tier 3 or non-formulary. Most commercial plans require prior authorization and step therapy — typically requiring a trial of generic Adderall XR or generic Vyvanse first.
• Medicare Part D: Coverage varies. These brands are typically not preferred, and patients in the coverage gap face significant out-of-pocket exposure.
• Generic amphetamine alternatives: Generic amphetamine sulfate IR tablets run $26–$50/month. Generic Adderall XR (mixed amphetamine salts ER) is available for approximately $17–$50/month.

Many patients don't mention cost concerns unprompted. A patient who repeatedly "forgets" to fill their prescription or asks about dose reductions may actually be struggling with affordability.

Manufacturer Savings Programs

Tris Pharma, the manufacturer of Dyanavel XR and Adzenys XR-ODT, offers a savings card program:

• Commercially insured patients: May pay as little as $20 per prescription
• Cash-paying patients: May pay as little as $50 for the first prescription
• Enrollment: Available at coupon.trisadhd.com

Key limitations to be aware of:

• Not valid for patients covered by Medicare, Medicaid, TRICARE, or other government-funded programs
• Annual or per-fill maximums may apply
• Patients must re-enroll or verify eligibility periodically

Consider having your front desk or care coordinators proactively share this information at the time of prescribing. A printed card or a link texted to the patient's phone increases the likelihood they'll actually use it.

Coupon and Discount Cards

Beyond the manufacturer program, several third-party discount platforms can help reduce out-of-pocket costs. These are particularly useful for uninsured or underinsured patients:

• GoodRx — Widely used, shows prices at nearby pharmacies and provides printable or digital coupons
• SingleCare — Free discount card accepted at most major chains
• RxSaver — Price comparison tool with coupon functionality
• Optum Perks — Discount card backed by UnitedHealth Group
• BuzzRx — Another free coupon card with widespread pharmacy acceptance

Discount cards work best for generic formulations. For brand-name Dyanavel XR and Adzenys XR-ODT, the manufacturer savings card will typically offer a better price than third-party coupons.

For a comprehensive breakdown of savings options, direct patients to our patient-facing guide on saving money on Amphetamine XR.

Patient Assistance Programs

For patients who are uninsured or face financial hardship, these resources may help:

• NeedyMeds (needymeds.org) — Comprehensive database of patient assistance programs, coupons, and discount options
• RxAssist (rxassist.org) — Directory of pharmaceutical company assistance programs
• RxHope (rxhope.com) — Helps patients apply for free or reduced-cost medications directly from manufacturers

Tris Pharma does not have a widely publicized standalone patient assistance program for uninsured patients, but the manufacturer savings card may partially offset costs for cash-paying patients. For patients who cannot afford brand Amphetamine XR even with assistance, switching to a generic alternative is usually the most practical solution.

Generic Alternatives to Consider

When brand Amphetamine XR is unaffordable or unavailable, several generic alternatives can provide effective ADHD treatment at a fraction of the cost:

• Generic Adderall XR (mixed amphetamine salts ER): $17–$50/month. The most commonly prescribed generic amphetamine-based extended-release medication. Available as capsules.
• Generic amphetamine sulfate IR: $26–$50/month. Immediate-release tablets requiring multiple daily doses. Less convenient but very affordable.
• Generic Vyvanse (lisdexamfetamine): Now available in generic form. Prodrug with lower abuse potential and smooth, long-acting profile.
• Generic methylphenidate ER (Concerta equivalent): A different stimulant class. Good option for patients who don't respond well to or can't tolerate amphetamines.

When switching from brand Amphetamine XR to a generic alternative, remember that formulations are not interchangeable on a mg-per-mg basis. Dose conversion requires clinical judgment, and patients should be monitored during the transition. For a more detailed comparison of alternatives, see our guide to Amphetamine XR alternatives.

Building Cost Conversations into Your Workflow

The most effective cost interventions happen proactively, not reactively. Here are strategies for integrating cost awareness into your prescribing workflow:

At Initial Prescribing

• Ask about insurance coverage before writing the prescription. A quick formulary check can prevent a denied claim and a frustrated patient.
• Discuss cost upfront. "This medication can be expensive — let me share some ways to bring the cost down."
• Provide savings card information at the point of prescribing, not as an afterthought. Print the Tris Pharma savings card link (coupon.trisadhd.com) on an after-visit summary or hand it directly to the patient.
• Consider starting with a generic if the patient's insurance requires step therapy anyway. This avoids delays and demonstrates formulary compliance for future brand requests.

At Follow-Up Visits

• Check in on cost. "Are you having any trouble affording your medication?" Patients who can't afford refills often present as "non-adherent" or "not responding to treatment."
• Review the prior authorization landscape. If a patient needs brand Amphetamine XR specifically (e.g., can't swallow capsules, needs a liquid formulation), be prepared to write a letter of medical necessity.
• Track the shortage situation. The ongoing stimulant shortage means even affordable generics may be hard to find. Directing patients to Medfinder for Providers can help them locate pharmacies with available stock.

Systemize It

• Add a "medication affordability" prompt to your EHR visit template
• Train medical assistants to distribute savings card information when stimulants are prescribed
• Keep a cheat sheet of patient assistance program contacts at the nurse's station or in your EHR quick-reference
• Build a list of preferred pharmacies in your area that reliably stock ADHD medications

Final Thoughts

Medication cost is one of the most modifiable barriers to ADHD treatment adherence. By proactively addressing cost at the point of prescribing — whether through manufacturer savings cards, generic alternatives, or simple conversations about affordability — you can significantly improve the likelihood that your patients actually fill and stay on their medications.

For more clinical resources on managing Amphetamine XR prescribing during the ongoing shortage, see our provider's guide to the Amphetamine XR shortage and our guide to helping patients find Amphetamine XR in stock. To explore our provider tools, visit medfinder.com/providers.