Cost Is the #1 Barrier to Lacosamide Adherence — Here's How to Help

You know the scenario: you prescribe Lacosamide (Vimpat) because it's the right drug for your patient's focal seizures, only to learn at follow-up that they never filled the prescription. The reason? Cost.

Medication non-adherence in epilepsy is directly correlated with breakthrough seizures, emergency department visits, and increased mortality. And when a 30-day supply of brand-name Vimpat exceeds $1,000, even insured patients with high-deductible plans may balk at the pharmacy counter.

The good news: with generic availability since 2022 and multiple savings programs, Lacosamide is now accessible at a fraction of its original cost. This guide equips you with practical tools to address cost barriers proactively.

What Your Patients Are Actually Paying

Understanding the price landscape helps you anticipate where patients will struggle:

• Brand-name Vimpat: $1,000-$1,100/month (60 tablets)
• Generic Lacosamide (retail, no coupon): $300-$500/month
• Generic Lacosamide (with discount coupon): $22-$45/month
• With commercial insurance: Typically $10-$50 copay for generic
• UCB Direct-to-Patient: $84.99/month (brand)

The critical gap is between "retail generic" ($300-500) and "coupon generic" ($22-45). Patients who don't know about free coupon programs pay 10x more than they need to.

Manufacturer Savings Programs

UCB Copay Assistance (Commercially Insured Patients)

For patients with commercial insurance whose copay for Vimpat is prohibitively high, UCB offers copay assistance that can reduce out-of-pocket costs to as low as $0-$25/month.

• Not available for Medicare, Medicaid, or government-insured patients
• Enrollment through ucb-usa.com or the Vimpat website

UCB Direct-to-Patient Program

When generic is unavailable or when patients prefer brand:

• 60 tablets for $84.99
• 180+ tablets at $79.99 per 60
• Ships directly to patient's home

This is especially useful during periods when specific generic manufacturers have supply disruptions.

UCB Cares Patient Assistance Program

For uninsured or underinsured patients meeting income criteria (generally below 400% FPL):

• Provides free Vimpat
• Application requires provider signature
• Contact: 1-844-599-CARE (2273) or ucb-usa.com
• Medication shipped to provider's office or patient's home

Keep enrollment forms in your office — the application process is simpler than most PAPs, and turnaround is typically 2-4 weeks.

Coupon and Discount Card Programs

For patients paying cash or facing high copays on generic Lacosamide, free coupon programs are the single most impactful intervention:

• GoodRx: Prices as low as $22-$30/month at Costco, CVS, Walmart
• SingleCare: $25-$40/month at 35,000+ pharmacies
• Optum Perks: $25-$45/month
• RxSaver: Aggregates multiple discount programs

Practical tip: print a GoodRx coupon for generic Lacosamide and hand it to the patient along with the prescription. This single step can mean the difference between a filled and unfilled prescription.

Generic Strategy and Therapeutic Substitution

Always Prescribe Generic Unless Clinically Necessary

Generic Lacosamide has been available since 2022 and is bioequivalent to Vimpat. Unless a patient has documented breakthrough seizures with generic substitution (which is rare), there is no clinical reason to specify DAW (Dispense As Written).

Consider Therapeutic Alternatives for Cost-Sensitive Patients

If cost remains prohibitive even with coupons, consider these therapeutic alternatives:

• Levetiracetam (Keppra): $5-$15/month generic. Different mechanism (SV2A binding) but effective for focal and generalized seizures. Watch for irritability/mood changes.
• Carbamazepine (Tegretol): $5-$15/month generic. Sodium channel blocker. More drug interactions and requires monitoring, but extremely affordable.
• Oxcarbazepine (Trileptal): $10-$30/month generic. Sodium channel blocker with fewer interactions than Carbamazepine. Watch for hyponatremia.

For a detailed comparison, see our patient guide on alternatives to Lacosamide.

Building Cost Conversations Into Your Workflow

Cost shouldn't be an afterthought. Here are workflow integrations that help:

1. Ask About Insurance and Cost at Every Prescribing Decision

A simple question — "Do you have any concerns about affording this medication?" — opens the door. Many patients are embarrassed to bring up cost on their own.

2. Check Formulary Status Before Prescribing

If your EHR integrates with pharmacy benefit information, check whether generic Lacosamide is on the patient's formulary and what tier it falls under. This prevents the pharmacy surprise.

3. Provide a Coupon With the Prescription

Keep printed GoodRx or SingleCare coupons for your most commonly prescribed medications. Handing a coupon to the patient takes 10 seconds and can save them hundreds of dollars.

4. Document Cost Discussions

When you discuss cost or switch medications due to affordability, document it. This protects you clinically and helps other providers on the care team understand the rationale.

5. Use Medfinder for Stock and Price Checks

When patients report difficulty finding Lacosamide, direct them to Medfinder for Providers to check pharmacy availability in their area. This is faster than having your staff call around.

Final Thoughts

Lacosamide is an excellent medication for focal seizures, but its value is zero if the patient can't afford to fill it. With generic pricing as low as $22/month via discount coupons and UCB's patient assistance providing free medication to qualifying patients, the tools exist to make Lacosamide accessible to virtually everyone.

The key is proactive communication: ask about cost, provide coupon resources, and know the assistance programs. Your patients' seizure control depends on it.

For more provider resources, visit Medfinder for Providers. For the patient perspective on shortage and availability, see our provider shortage briefing.