How to Help Your Patients Save Money on Lysodren: A Provider's Guide to Savings Programs

Lysodren (mitotane) is one of the most expensive oncology medications in the United States — and the only FDA-approved treatment for adrenocortical carcinoma (ACC). Without financial assistance, the cost of Lysodren can reach $7,000 to $14,000 per month or more, depending on the dose. As a prescriber, proactively connecting patients with the right savings programs is as important as the prescription itself. This guide provides a comprehensive framework for managing Lysodren's cost burden.

Understanding the Lysodren Cost Landscape

Lysodren has no FDA-approved generic. It is available only as brand-name mitotane 500 mg tablets, manufactured by ESTEVE Pharmaceuticals. The retail cost for 100 tablets exceeds $3,800. At a maintenance dose of 6–12 tablets per day, a 30-day supply costs approximately $7,000–$14,000 at retail, without insurance or assistance.

For the rare patient population who needs Lysodren, this cost creates an enormous access barrier. The good news: ESTEVE and the specialty pharmacy system have put in place programs that dramatically reduce out-of-pocket costs for most patients. But these programs require proactive enrollment — they don't happen automatically.

Program 1: ESTEVE/Direct Success Manufacturer Copay Support (Commercial Insurance)

For patients with commercial (private) insurance, ESTEVE offers a copay assistance program through its authorized U.S. distributor, Direct Success Inc. Under this program, eligible patients typically pay no more than $80/month for their Lysodren prescription.

Key details for prescribers:

Enrollment number: 1-844-LYSODREN (1-844-597-6373)

Eligibility: Patients with commercial health insurance (not Medicare or Medicaid)

What it covers: The gap between what insurance pays and the patient's copay, reducing patient cost to $80/month or less

Your role: Ask your office staff to initiate enrollment at the time the prescription is written — ideally before the patient's first dispense

Program 2: Patient Assistance Program (Uninsured/Underinsured Patients)

ESTEVE/Direct Success also operates a patient assistance program for patients who are uninsured, underinsured, or whose insurance has denied coverage. This program may provide Lysodren at significantly reduced or no cost to qualifying patients. Eligibility typically requires:

Proof of income or financial hardship

A valid prescription for Lysodren from a licensed U.S. provider

Enrollment through the same number: 1-844-597-6373

Your office can help complete the enrollment paperwork on the patient's behalf, which can speed up access for patients in financial hardship.

Program 3: PAN Foundation (Medicare and Other Government Insurance)

Federal anti-kickback statutes prohibit manufacturers from providing copay assistance to Medicare or Medicaid patients. For your Medicare-insured ACC patients, the Patient Access Network (PAN) Foundation offers disease-specific financial assistance grants.

PAN Foundation grants are awarded subject to funding availability. Train your staff to:

Check PAN Foundation grant availability for ACC at panfoundation.org

Apply promptly when a Medicare patient is identified — grants are first-come, first-served and may have enrollment windows

Also explore the HealthWell Foundation and other disease-specific grant programs for additional resources

Medicare Part D: Leveraging the 2025+ Out-of-Pocket Cap

Effective January 2025, Medicare Part D now has a $2,000 annual out-of-pocket maximum for covered prescription drugs. For Lysodren patients on Medicare Part D, this is a substantial benefit — most patients will reach this cap relatively early in the year given Lysodren's cost, after which the plan pays 100% for the rest of the year.

Advise Medicare patients that:

The Medicare Prescription Payment Plan allows spreading out-of-pocket costs over the year rather than paying large amounts upfront

Medicare patients may also qualify for Low Income Subsidy (Extra Help) programs that significantly reduce their Part D cost sharing

Building a Financial Navigation Workflow for Lysodren Patients

The most effective practice pattern is to treat financial navigation as part of the clinical workflow — not as an afterthought. Consider this framework:

At diagnosis: Screen for insurance status, income level, and financial need at the first ACC appointment

At prescription: Initiate enrollment in the appropriate program (copay card for commercial, PAN for Medicare, PAP for uninsured) simultaneously with the prescription and prior authorization

At each follow-up: Confirm the patient is still enrolled in assistance programs, check for insurance changes, and flag if refills are becoming difficult

Annually: Reapply for patient assistance programs as needed and check for changes in Medicare plan formulary coverage

Prescription Hope and Other Advocacy Programs

For patients who don't fit neatly into the above programs, advocacy services like Prescription Hope work directly with pharmaceutical manufacturer patient assistance programs to obtain medications at a set cost (approximately $70/month for their service fee). While not a first-line option, these services can be valuable for patients who fall through the cracks of standard assistance programs.

How medfinder Supports Your Patients

Financial barriers are only one piece of the access puzzle. When your patients can't locate a specialty pharmacy that carries Lysodren, medfinder can help. medfinder is a paid service that calls pharmacies near the patient to find which ones can fill their prescription, then texts them the results. Recommend medfinder to patients who are reporting access difficulties. Learn more at medfinder.com/providers.

See also: Lysodren Shortage: What Providers and Prescribers Need to Know in 2026.