Cost Is a Seizure Control Problem

For patients with epilepsy, medication adherence isn't just a best practice — it's the difference between seizure freedom and a breakthrough event that can result in injury, hospitalization, or worse. Yet cost remains one of the most common reasons patients skip doses, split pills, or abandon their prescriptions entirely.

Lacosamide (Vimpat) is an effective antiepileptic drug for partial-onset and primary generalized tonic-clonic seizures, but its pricing — particularly for brand-name Vimpat — can be a barrier. As a prescriber, you're in a unique position to help patients navigate cost and improve adherence.

This guide outlines what your patients are actually paying, what savings programs exist, and how to have productive cost conversations in clinical practice.

What Patients Are Actually Paying for Lacosamide

Understanding the cost landscape helps you anticipate where your patients may struggle:

The gap between retail cash pricing and coupon/insurance pricing is enormous. Patients who don't know about discount programs may assume they can't afford their medication — and they may be right if they're looking at the sticker price.

Manufacturer Savings Programs

UCB Pharma offers two key programs for Vimpat:

Vimpat Direct-to-Patient Program

Eligible patients can purchase brand-name Vimpat directly for $84.99 per 60 tablets (or $79.99 per 60 when ordering 180+ tablets). This is available regardless of insurance status and can be a good option for patients who prefer or need the brand.

UCB Copay Assistance

For commercially insured patients whose plans cover Vimpat but impose high copays, UCB offers copay assistance cards that reduce the out-of-pocket cost. Patients can enroll through their provider or at the UCB website.

UCB Cares Patient Assistance Program

For uninsured or underinsured patients who meet income requirements, the UCB Cares Patient Assistance Program provides Vimpat at no cost. Applications are available at ucb-usa.com or by calling 1-844-599-CARE. As a provider, you can initiate the application process on behalf of your patient.

Discount Coupons and Pharmacy Programs

For patients taking generic Lacosamide, free discount coupon programs can dramatically reduce costs:

• SingleCare — Often offers prices as low as $24-$30/month for generic Lacosamide at major chains
• GoodRx — Compares pricing across pharmacies and provides printable or digital coupons
• RxSaver — Similar comparison tool with pharmacy-specific pricing
• Optum Perks, BuzzRx, Inside Rx — Additional discount card programs worth checking

These coupons are free, require no enrollment, and work at most major pharmacies. They cannot be combined with insurance but are often cheaper than insured copays for patients with high-deductible plans.

Clinical tip: When prescribing generic Lacosamide, proactively mention that patients should compare their insurance copay against coupon pricing. Some patients pay less out of pocket with a coupon than with their insurance.

Generic Substitution: What Providers Should Know

Generic Lacosamide has been available since 2022 and is manufactured by multiple companies. Key considerations:

• Bioequivalence — FDA-approved generics must demonstrate bioequivalence to the brand. Generic Lacosamide meets the same standards for absorption and bioavailability as Vimpat.
• Formulary preference — Most commercial and Medicare Part D plans prefer generic Lacosamide. Brand-name Vimpat typically requires prior authorization or step therapy through generic first.
• Patient concerns — Some epilepsy patients express concern about switching between brand and generic or between different generic manufacturers. While evidence for clinically meaningful differences is limited, the concern is understandable for a condition where breakthrough seizures carry significant risk. If a patient is stable on a specific formulation, consider noting "Dispense As Written" if clinically warranted.
• Cost impact — Switching from brand Vimpat to generic Lacosamide with a coupon can save patients over $900 per month.

Having the Cost Conversation

Many patients won't bring up cost on their own — they'll just stop filling their prescription. Here are strategies for integrating cost into your clinical workflow:

Ask Directly

A simple question at each visit can surface problems early:

• "Are you having any trouble affording your medications?"
• "Have you been able to fill your Lacosamide prescription consistently?"
• "Would it help to explore some cost-saving options?"

Involve Your Care Team

Nurses, medical assistants, social workers, and pharmacy liaisons can help patients navigate savings programs, complete PAP applications, and compare pricing. Build cost navigation into your discharge and follow-up workflows.

Document Cost Barriers

If a patient reports cost as a barrier, document it. This supports prior authorization appeals, PAP applications, and clinical decision-making around medication selection.

Prescribe With Cost in Mind

When Lacosamide is appropriate and cost is a factor:

• Prescribe generic Lacosamide unless there's a clinical reason for brand
• Suggest patients compare coupon vs. insurance pricing
• Consider pill strengths that optimize cost (e.g., one 200 mg tablet vs. two 100 mg tablets may differ in price)
• Use 90-day prescriptions when possible — they're often cheaper per unit than 30-day fills

Helping Patients Find Lacosamide in Stock

Occasionally, patients report difficulty finding Lacosamide at their pharmacy. While there's no major national shortage, individual pharmacies may not stock it consistently. Medfinder for Providers can help you and your staff direct patients to pharmacies with confirmed availability.

For more on supply issues, see our provider guide: Lacosamide Shortage: What Providers Need to Know.

Final Thoughts

Medication cost is a clinical variable, not just an administrative one. For patients on Lacosamide, the difference between affordability and abandonment can be as simple as knowing about a $30 coupon or a free patient assistance program.

By proactively addressing cost — through generic prescribing, coupon awareness, manufacturer programs, and direct conversations — you can remove one of the most common barriers to seizure control.

For additional provider resources, visit medfinder.com/providers. For patient-facing cost information, see our guide: How to Save Money on Lacosamide.