Cost Is the Biggest Barrier to Medication Adherence

When you prescribe Eprontia (Topiramate oral solution, 25 mg/mL), you're choosing it for a reason — your patient needs a liquid formulation of Topiramate, whether due to age, swallowing difficulty, or precise dosing requirements. But cost can quickly become the reason they don't fill the prescription.

Eprontia is a brand-name medication with no generic oral solution equivalent. At retail prices of $252–$334 for 120 mL, many patients face significant out-of-pocket costs, especially those with high-deductible plans or no insurance. Studies consistently show that cost-related non-adherence leads to worse clinical outcomes — more breakthrough seizures, more ER visits, and higher long-term healthcare costs.

This guide gives you practical tools to help your patients access Eprontia at a price they can manage.

What Your Patients Are Paying

Here's a snapshot of Eprontia pricing in 2026:

• Retail cash price: $252–$334 for 120 mL (without insurance)
• With discount coupons (GoodRx, SingleCare, etc.): $85–$116 for 120 mL
• Generic Topiramate tablets (for comparison): As low as $1.80 for a 30-day supply with coupon
• Generic Topiramate oral solution: Approximately $260 for 120 mL (limited availability)

The price gap between Eprontia and generic tablets is enormous. For patients who can switch to tablets, the savings are dramatic. For those who truly need the liquid, the savings programs below can help bridge the gap.

Insurance Coverage Landscape

Coverage for Eprontia varies widely:

• Many commercial plans require prior authorization
• Some plans mandate step therapy — requiring a trial of generic Topiramate tablets before approving brand-name Eprontia
• Medicare Part D may cover with restrictions and formulary placement varies
• Medicaid coverage varies by state

When a prior authorization is needed, your documentation should clearly explain why the liquid formulation is medically necessary (e.g., pediatric patient unable to swallow tablets, precise dose titration needed, dysphagia).

Manufacturer Savings Programs

Azurity Pharmaceuticals, the maker of Eprontia, offers several programs:

Co-Pay Savings Program

Available through eVoucherRx and Voucher on Demand, this program reduces out-of-pocket costs for commercially insured patients. Key details:

• For patients with commercial insurance only (not valid for government insurance including Medicare, Medicaid, TRICARE)
• Can significantly reduce co-pay at the pharmacy
• Applied at the point of sale — patients don't need to submit receipts

Your office can help patients enroll or direct them to the Azurity website for information.

Bridge Program

If insurance approval takes more than 48 hours, Azurity's Bridge Program can provide temporary medication access so patients aren't left without treatment while waiting for authorization. This is particularly valuable for epilepsy patients who cannot safely miss doses.

Patient Assistance Programs

For uninsured or underinsured patients, additional options include:

• Azurity patient assistance — Contact the manufacturer directly for eligibility
• NeedyMeds (needymeds.org) — Comprehensive database of assistance programs
• RxAssist (rxassist.org) — Patient assistance program directory
• RxHope (rxhope.com) — Connects patients with manufacturer programs

Coupon and Discount Cards

For patients paying cash or facing high co-pays, prescription discount cards can cut the price substantially:

• GoodRx — Often brings Eprontia down to $85–$116 for 120 mL
• SingleCare — Competitive pricing at major pharmacy chains
• RxSaver — Compares prices across local pharmacies
• Optum Perks — Free discount card accepted at most pharmacies
• BuzzRx — Another option for comparing pharmacy-specific pricing

These cards are free to use and can be combined with some pharmacy loyalty programs. They generally cannot be combined with insurance or the manufacturer co-pay program. Patients should compare prices across pharmacies, as pricing varies significantly by location.

For a patient-facing breakdown, you can direct patients to our guide on saving money on Eprontia.

Generic Alternatives and Therapeutic Substitution

The most impactful cost conversation may be about whether the patient truly needs Eprontia specifically. Consider these alternatives:

Generic Topiramate Tablets

At $1.80–$15 for a 30-day supply, generic Topiramate tablets are dramatically cheaper. If your patient can swallow tablets (or crush them per pharmacist guidance), this is the most cost-effective option by far.

Qudexy XR (Extended-Release Capsules)

Qudexy XR capsules can be opened and sprinkled on soft food, making them an alternative for patients with swallowing difficulty. Once-daily dosing may also improve adherence. Cost is higher than generic tablets but may be more accessible than Eprontia with some insurance plans.

Trokendi XR (Extended-Release Capsules)

Another once-daily Topiramate option, though capsules must be swallowed whole. May have different insurance coverage than Eprontia.

Compounded Topiramate Solution

A compounding pharmacy can prepare a liquid Topiramate solution. This may be less expensive than brand-name Eprontia but requires a compounding-specific prescription and quality can vary. Not all insurance plans cover compounded medications.

When Eprontia Is the Right Choice

Some patients genuinely need Eprontia's specific formulation:

• Very young children (age 2–5) who cannot swallow any capsule or tablet form
• Patients with dysphagia or feeding tubes requiring a commercial liquid
• Patients requiring very precise dose adjustments that are difficult with tablets
• Patients with compliance issues where a flavored, ready-to-use liquid improves adherence

Document the medical necessity clearly — this strengthens prior authorization requests and supports the clinical rationale for the higher-cost formulation.

Building Cost Conversations into Your Workflow

Proactive cost discussions improve adherence and patient trust. Here's how to integrate them:

At the Point of Prescribing

• Ask about cost concerns — "Before I send this to the pharmacy, let's talk about cost. Do you have insurance that covers medications?"
• Discuss alternatives upfront — "Eprontia is the liquid form and costs more. If you can take tablets, generic Topiramate is much cheaper. Which would work better for you?"
• Mention discount programs proactively — Don't wait for the patient to tell you they can't afford it

At the Practice Level

• Keep a reference list of current Eprontia savings programs (manufacturer, discount cards, PAPs)
• Train front-desk and nursing staff to help patients navigate savings programs and prior authorizations
• Use Medfinder for Providers to help patients locate pharmacies that stock Eprontia and find competitive pricing
• Set up prior authorization templates that document liquid formulation necessity efficiently

At Follow-Up Visits

• Ask about adherence — "Have you been able to fill your Eprontia without any issues?"
• Screen for cost-related skipping — Patients often stretch their medication by taking it less frequently rather than admitting they can't afford refills
• Reassess formulation needs — A child who couldn't swallow pills at age 3 may be able to at age 6. Reassess whether a switch to tablets is feasible.

Quick Reference: Eprontia Cost Resources

• Azurity Co-Pay Program: eVoucherRx / Voucher on Demand (commercial insurance)
• Azurity Bridge Program: Temporary supply during PA delays
• GoodRx / SingleCare: Discount cards reducing price to ~$85–$116
• NeedyMeds / RxAssist / RxHope: Patient assistance program directories
• Generic Topiramate tablets: ~$1.80–$15 per month
• Medfinder for Providers: medfinder.com/providers

Final Thoughts

The patients who need Eprontia most — young children, patients with swallowing disorders — are often the ones least able to advocate for themselves on cost issues. As a provider, you're in a unique position to connect them with savings programs before cost becomes an adherence barrier.

A two-minute conversation about cost at the point of prescribing can prevent a missed refill, a breakthrough seizure, and an avoidable ER visit. The programs exist — the challenge is making sure patients and their families know about them.

For more provider resources, visit Medfinder for Providers. For additional clinical guidance on Eprontia availability and stocking, see our provider's guide to finding Eprontia in stock.