Medication adherence after percutaneous coronary intervention (PCI) is critical — and cost is one of the most common reasons patients stop taking their antiplatelet therapy early. As a prescriber, you're in a unique position to help patients navigate the financial side of their Effient (Prasugrel) prescription.

This guide covers the savings options available in 2026, how to steer patients toward the most affordable options, and how to have productive cost conversations that improve adherence.

What Your Patients Are Paying

The cost of Prasugrel varies dramatically depending on whether patients fill brand or generic, have insurance, or use a discount card:

The key takeaway: generic Prasugrel without a discount card can cost nearly as much as the brand. Many patients don't realize that a free discount card can save them hundreds of dollars — and it's something your office can help them find before they leave.

Generic Prasugrel: First-Line Recommendation for Cost Savings

Generic Prasugrel is bioequivalent to brand Effient and is available in both 5 mg and 10 mg tablets. For the vast majority of patients, generic is the appropriate choice from both a clinical and financial standpoint.

Key considerations:

• Prescribe generically. Write prescriptions for "Prasugrel" rather than "Effient" to ensure pharmacies dispense the generic automatically.
• Check formulary status. Most Medicare Part D and commercial plans cover generic Prasugrel as a preferred generic or Tier 2 medication.
• Alert patients about pricing variability. Retail cash prices for generic Prasugrel can be surprisingly high ($400+) without a discount card. Patients who assume "generic = cheap" may get a shock at the pharmacy counter.

Discount Cards and Coupon Programs

Free prescription discount cards can reduce the cost of generic Prasugrel to as low as $19 for a 30-day supply. These are not insurance — they're negotiated discount programs that work at most retail pharmacies.

Recommend that patients check:

• GoodRx — Widely used, compares prices across local pharmacies
• SingleCare — Accepted at most major chains
• RxSaver — Shows coupon prices by pharmacy
• Optum Perks
• BuzzRx
• America's Pharmacy

These cards work for both insured and uninsured patients. In some cases, the discount card price may actually be lower than a patient's insurance copay — particularly for high-deductible plans. Encourage patients to compare both prices at the pharmacy.

For a comprehensive patient-facing resource, direct them to our guide on how to save money on Effient.

Manufacturer Savings Programs

Eli Lilly previously offered an Effient savings card for commercially insured patients. With generic Prasugrel now widely available, manufacturer coupons for the brand are limited. However, it's worth checking Lilly.com for any current programs, particularly for patients who require brand-name Effient for clinical reasons.

For patients who are uninsured or underinsured:

• Daiichi Sankyo Patient Assistance Program — May cover brand Effient for qualifying patients
• Lilly Cares — Eli Lilly's patient assistance foundation for eligible patients

Patient Assistance Programs (PAPs)

For patients who cannot afford their medication even with discount cards, patient assistance programs provide free or deeply discounted medication. These are typically available to patients who are:

• Uninsured or underinsured
• Below certain income thresholds (often 200–400% of the federal poverty level)
• Unable to afford their copay even with insurance

Resources to recommend:

• NeedyMeds (needymeds.org) — Database of PAPs and discount programs
• RxAssist (rxassist.org) — Comprehensive directory of patient assistance programs
• RxHope (rxhope.com) — Helps patients connect with manufacturer programs

Your office staff can help patients start the application process, which typically requires income documentation and a prescriber signature.

Mail-Order and 90-Day Supplies

For patients on maintenance Prasugrel, mail-order pharmacies often offer significant savings:

• Insurance mail-order benefits — Many plans offer 90-day supplies for the cost of 2 copays instead of 3
• Cost Plus Drugs (costplusdrugs.com) — Mark Cuban's transparent-pricing pharmacy; worth checking for Prasugrel pricing
• Amazon Pharmacy — Offers competitive pricing on generics, especially for Prime members

Mail order also solves a common problem: availability. Some local pharmacies don't regularly stock Prasugrel due to low demand. Mail-order pharmacies typically maintain consistent supply.

Having the Cost Conversation

Research consistently shows that patients are more adherent when cost is addressed proactively. Here are practical approaches:

At the Point of Prescribing

• Mention generic availability upfront. "I'm prescribing Prasugrel — the generic version of Effient. It's the same medication at a fraction of the cost."
• Flag the discount card opportunity. "Even if you have insurance, check a site like GoodRx before you fill it. Sometimes the coupon price is lower than your copay."
• Normalize the conversation. Many patients are embarrassed to bring up cost. Opening the door makes it easier for them to tell you if they're struggling.

At Follow-Up Visits

• Ask directly about adherence. "Have you been able to fill your Prasugrel regularly? Any issues with cost or availability?"
• Watch for red flags — Missed appointments, skipped refills, or switching to Clopidogrel without discussion may indicate cost barriers.
• Reassess medication choice. If cost is a persistent barrier and the patient is a candidate, Clopidogrel (generic) is significantly cheaper and may be clinically appropriate in some cases. See our alternatives guide for comparison.

Availability Challenges

Some patients report difficulty finding Prasugrel at their local pharmacy. While Effient is not currently on national shortage lists, regional availability can vary — particularly at pharmacies that don't frequently dispense it.

If patients report availability issues:

• Suggest they use MedFinder for Providers or direct patients to MedFinder to locate pharmacies with stock
• Consider sending prescriptions to larger chain pharmacies or mail-order pharmacies
• For more on the supply landscape, see our provider shortage update

Final Thoughts

Premature discontinuation of dual antiplatelet therapy after PCI carries significant clinical risk. By proactively addressing cost — prescribing generically, recommending discount cards, and connecting patients with assistance programs — you can remove one of the biggest barriers to adherence.

The tools are available. It's a matter of building cost conversations into your workflow and ensuring patients leave your office knowing their options.

For provider-specific tools and resources, visit MedFinder for Providers.