Cost Is the Biggest Barrier to Cholesterol Medication Adherence

You prescribed Roszet (Ezetimibe/Rosuvastatin) because your patient needed aggressive LDL lowering with a convenient single-tablet regimen. But when they get to the pharmacy and see the price tag — $150 to $350 per month without insurance — many walk away empty-handed.

Medication non-adherence due to cost is one of the most common and preventable problems in lipid management. Studies consistently show that high out-of-pocket costs lead to delayed fills, split doses, and outright abandonment of statin therapy. For patients on combination therapy like Roszet, the financial burden can be even greater.

This guide is designed for prescribers, pharmacists, and care teams who want to help patients access Roszet — or an equivalent alternative — without breaking the bank.

What Patients Are Actually Paying

Understanding the cost landscape helps you anticipate barriers before the patient leaves your office:

• Cash price (no insurance): $150 to $350 per 30 tablets depending on strength and pharmacy
• With commercial insurance: Varies widely. Many plans classify Roszet as a non-preferred brand, resulting in copays of $50-$100+ or outright non-coverage. Prior authorization and step therapy requirements are common — most insurers require patients to have tried separate generic Rosuvastatin and generic Ezetimibe first.
• Medicare Part D: Brand Roszet typically falls on a non-preferred tier. Out-of-pocket costs can be substantial, especially in the coverage gap ("donut hole").
• Generic components separately: Generic Rosuvastatin costs $10-$30/month and generic Ezetimibe costs $10-$25/month. Total: $20-$55/month for the same active ingredients in two pills instead of one.

Critical update: Brand Roszet has been discontinued by Althera Life Sciences. No generic combination product is available, with the earliest expected generic launch around 2033. This makes cost conversations even more important, since remaining brand supply is limited and increasingly difficult to source.

Manufacturer Savings Programs

Althera Life Sciences previously offered a copay savings card for commercially insured patients taking Roszet. However, since the brand has been discontinued, this program may no longer be active.

Before assuming it's unavailable:

• Check roszet.com for any remaining program information
• Contact Althera's patient services line (if still operational) to verify current status
• Check NeedyMeds (needymeds.org) for updated program listings

If the manufacturer program is no longer available, the strategies below become even more important.

Coupon and Discount Cards

For patients paying cash or facing high copays, third-party discount cards can significantly reduce the price of Roszet — if it can be found in stock. These cards are free to use and work at most pharmacies:

• GoodRx (goodrx.com) — Compare prices across pharmacies and apply discount coupons at checkout
• SingleCare (singlecare.com) — Accepted at CVS, Walgreens, Walmart, and most chains
• RxSaver (rxsaver.com) — Compare prices and download coupons
• Optum Perks (perks.optum.com) — Free discount card with pharmacy price comparison
• BuzzRx (buzzrx.com) — Discounts at over 60,000 pharmacies nationwide

Important note: These discount cards cannot be combined with insurance. They're most useful for uninsured patients or when the cash price with a coupon is lower than the insurance copay.

For patients who need ongoing cost assistance, organizations like RxAssist (rxassist.org), RxHope (rxhope.com), and NeedyMeds (needymeds.org) maintain databases of patient assistance programs for those facing financial hardship.

Generic Alternatives and Therapeutic Substitution

Given Roszet's discontinuation and high cost, the most practical path for most patients is therapeutic substitution using the individual generic components:

Option 1: Generic Rosuvastatin + Generic Ezetimibe (Two Separate Pills)

This is the most direct substitute. The patient takes two pills instead of one, but gets the exact same active ingredients:

• Generic Rosuvastatin (5 mg, 10 mg, 20 mg, or 40 mg): $10-$30/month
• Generic Ezetimibe (10 mg): $10-$25/month
• Total: $20-$55/month vs. $150-$350 for brand Roszet

The clinical efficacy is identical. The only trade-off is pill burden (two tablets vs. one), which has a modest impact on adherence for most patients.

Option 2: Vytorin (Ezetimibe/Simvastatin) or Generic Equivalent

For patients who prefer a single combination tablet, Vytorin (Ezetimibe/Simvastatin) is available as a generic. Note that Simvastatin is generally less potent than Rosuvastatin at equivalent doses, so an appropriate dose adjustment is needed.

Option 3: Atorvastatin + Ezetimibe

Atorvastatin (generic Lipitor) combined with generic Ezetimibe is another widely used pairing. Both components are available as low-cost generics. Atorvastatin is more potent than Simvastatin and comparable to Rosuvastatin at higher doses.

When to Switch vs. When to Source Brand

For most patients, switching to generic Rosuvastatin + generic Ezetimibe is straightforward and clinically equivalent. Consider sourcing remaining brand Roszet only when:

• The patient has a strong preference for single-tablet dosing and has found a pharmacy with remaining stock
• The patient has documented poor adherence with multiple pills
• Cost is not a barrier (rare)

In almost all other situations, the generic components are the better long-term solution given Roszet's permanent discontinuation.

Building Cost Conversations into Your Workflow

Many providers assume patients will raise cost concerns on their own. In reality, patients often feel embarrassed to bring up money or don't realize cheaper options exist. Proactive cost discussions improve adherence:

At the Point of Prescribing

• Ask about insurance coverage. "Do you know if your insurance covers brand-name medications, or do they mostly cover generics?"
• Discuss the two-pill option upfront. "I can prescribe this as one combination pill or as two separate generics that cost a fraction of the price. The active ingredients are the same."
• Mention discount cards. "If cost is a concern, sites like GoodRx can help you compare prices and get coupons."

At Follow-Up Visits

• Check if the prescription was filled. One in four new prescriptions is never filled. A simple "Were you able to pick up your medication?" catches the problem early.
• Ask about cost barriers. "Are you having any trouble affording your cholesterol medication?" Normalizing the question makes patients more likely to be honest.
• Review alternatives. If the patient is struggling with cost, discuss switching to generic components or a different statin/Ezetimibe combination.

Staff and System-Level Strategies

• Train front-desk and nursing staff to ask about medication affordability at intake
• Keep a cheat sheet of current discount card options and patient assistance programs in exam rooms or your EHR
• Use electronic prescribing features that show real-time cost estimates at the point of prescribing
• Consider partnering with a clinical pharmacist who can do medication therapy management and cost optimization

Final Thoughts

Roszet offered a convenient single-tablet approach to combination cholesterol therapy, but its discontinuation and high cost have made it impractical for most patients. The good news is that the same active ingredients are available as affordable generics.

As a prescriber, you're in the best position to prevent cost-driven non-adherence. A brief conversation about affordability at the point of prescribing can be the difference between a patient who fills their prescription and one who doesn't.

For help managing medication availability for your patient panel, visit Medfinder for Providers. And for more on the Roszet discontinuation and clinical alternatives, see our provider guide to the Roszet shortage.