Cost Is One of the Biggest Barriers to Evekeo Adherence

You've determined that Evekeo (amphetamine sulfate) is the right medication for your patient. The 1:1 racemic amphetamine ratio works well for them, they tolerate it better than other stimulants, and their symptoms are well-controlled. Then they come back at the next visit and tell you they stopped taking it — because they couldn't afford the refill.

This scenario plays out constantly with brand-name stimulants. Evekeo's cash price of $350 to $600 per month puts it out of reach for many patients, and insurance coverage is inconsistent at best. As prescribers, we can make a significant difference by proactively addressing cost and connecting patients with available savings programs.

This guide covers the practical tools and strategies you can use to help your patients afford Evekeo.

What Your Patients Are Paying

Understanding the current cost landscape helps you anticipate barriers:

• Brand-name Evekeo: $350–$600 for a 30-day supply at retail
• Evekeo ODT: Often at the higher end of this range due to the orally disintegrating formulation
• Generic amphetamine sulfate tablets: $30–$80 per month (though specific 1:1 racemic formulations may not be available generically in all strengths)
• Insurance coverage: Evekeo is frequently classified as non-preferred or excluded from formularies. Prior authorization is the norm. Many plans require step therapy — typically trying generic mixed amphetamine salts (Adderall) or Methylphenidate before approving Evekeo.

Even patients with commercial insurance may face co-pays of $100 or more per month for non-preferred brand medications. For uninsured patients, the brand-name price is simply prohibitive without assistance.

Manufacturer Savings Programs

Azurity Pharmaceuticals (Evekeo's manufacturer) has offered co-pay savings programs for eligible patients:

• Co-pay savings card: Available for commercially insured patients, these cards can reduce out-of-pocket costs to as low as $30–$50 per prescription.
• Eligibility: Patients must have commercial insurance (not Medicare, Medicaid, or other government-funded programs). There may be annual or per-fill caps on savings.
• How to access: Visit evekeo.com or azurityrx.com for current program details. Cards can typically be downloaded directly or requested through the manufacturer's patient services line.

Consider keeping savings card information in your EHR or printing cards to hand out at the point of prescribing. When patients leave your office with a savings card already in hand, they're far more likely to use it.

Patient Assistance Program

For uninsured or underinsured patients who meet income criteria, Azurity Pharmaceuticals may offer a separate patient assistance program (PAP) that provides Evekeo at no cost or reduced cost. Application typically requires:

• Proof of income (often below 200–300% of the federal poverty level)
• Verification of insurance status
• Prescriber signature

Your office can streamline this by designating a staff member to handle PAP applications or using a service like NeedyMeds or RxAssist to identify available programs.

Coupon and Discount Cards

Third-party coupon and discount programs can provide meaningful savings, especially for patients paying cash:

• GoodRx — One of the most widely recognized prescription discount platforms. Patients can search for Evekeo pricing at nearby pharmacies and present a digital coupon at checkout.
• SingleCare — Similar to GoodRx, often with competitive or lower pricing depending on the pharmacy.
• RxSaver — Another option for comparing prices across pharmacies.
• BuzzRx, Optum Perks, Inside Rx — Additional discount card providers worth checking.

Important considerations for your patients:

• Discount cards cannot be combined with insurance — the patient uses one or the other at the pharmacy counter.
• Prices vary significantly by pharmacy. A difference of $50–$100+ is common between pharmacies for the same medication.
• These cards work for both brand-name Evekeo and generic amphetamine sulfate.

You can recommend that patients compare prices on multiple platforms before filling. Even a five-minute search can save them hundreds of dollars.

Generic Alternatives and Therapeutic Substitution

When cost is a significant barrier, it's worth revisiting whether a therapeutic alternative might work:

Generic Amphetamine Sulfate

Generic amphetamine sulfate tablets are available at $30–$80 per month — a fraction of brand-name Evekeo. However, the specific 1:1 racemic ratio may not be available generically in all formulations and strengths. If your patient does well on a generic amphetamine sulfate product, this can be a cost-effective solution.

Therapeutic Alternatives

If generic amphetamine sulfate isn't available or doesn't work, consider:

• Generic mixed amphetamine salts (Adderall generic) — Widely available at $20–$60 per month. Uses a 3:1 d- to l-amphetamine ratio rather than Evekeo's 1:1, so clinical response may differ.
• Dextroamphetamine (generic Dexedrine) — Pure d-amphetamine, generally affordable.
• Generic Lisdexamfetamine (Vyvanse generic) — Now available as a generic, typically $30–$80 per month. Extended-release prodrug formulation.
• Methylphenidate (generic Ritalin/Concerta) — A different stimulant class entirely. May be appropriate if the patient hasn't tried it and cost is the primary driver.

For a comprehensive comparison, see our guide on alternatives to Evekeo.

Document the clinical rationale if you're keeping a patient on brand-name Evekeo despite cheaper alternatives — this strengthens prior authorization appeals and helps justify the decision to insurance reviewers.

Building Cost Conversations Into Your Workflow

Cost conversations shouldn't be an afterthought. Here are practical ways to integrate them into your prescribing workflow:

1. Ask About Cost at Every Prescribing Decision

A simple question — "Can you tell me what you're paying for your medication each month?" — opens the door. Many patients won't volunteer cost concerns unless asked directly. They may simply stop filling prescriptions instead.

2. Check Insurance Formulary Before Prescribing

If your EHR has formulary integration, check coverage before writing the prescription. This saves the patient a frustrating pharmacy visit where they discover a $400 co-pay. If Evekeo isn't covered, consider submitting a prior authorization preemptively or discussing alternatives with the patient.

3. Provide Savings Resources at the Point of Prescribing

Have your staff prepare a one-page handout or digital resource with:

• Manufacturer savings card link
• GoodRx/SingleCare instructions
• Patient assistance program contact information
• Link to Medfinder's Evekeo savings guide for patients

4. Designate a Cost-Navigation Resource

If your practice has a social worker, care coordinator, or financial navigator, loop them in when prescribing expensive medications. They can handle manufacturer program applications, appeal insurance denials, and identify community resources.

5. Follow Up on Adherence

At follow-up visits, explicitly ask whether the patient has been able to fill their prescription consistently. Non-adherence due to cost is extremely common with stimulant medications and may present as "the medication isn't working anymore" when in reality the patient has been rationing doses or skipping refills.

Additional Resources for Providers

Stay up to date on Evekeo availability and prescribing considerations:

• Medfinder for Providers — Tools to help your patients find Evekeo in stock at nearby pharmacies
• Evekeo shortage update for providers — Current availability status and supply chain information
• How to help patients find Evekeo in stock — Practical guide for navigating the stimulant shortage

Final Thoughts

Medication adherence and medication affordability are inseparable. When a patient tells you Evekeo works for them, your job extends beyond the prescription — it includes helping them actually access and afford it month after month.

The tools exist: manufacturer savings cards, coupon platforms, generic alternatives, and patient assistance programs. The key is integrating these into your workflow so that cost conversations happen proactively, not after a patient has already abandoned their medication.

For more provider resources, visit Medfinder for Providers.