How to Help Your Patients Save Money on Zilxi

Zilxi (Minocycline topical foam 1.5%) is an effective treatment for the inflammatory lesions of rosacea — but its cost creates a real barrier to adherence. With a cash price of $400 to $600 per 60g canister, many patients struggle to fill their prescriptions, abandon treatment early, or never start it at all.

As a provider, you're in a unique position to help patients navigate cost barriers before they become compliance problems. This guide covers what your patients are actually paying, the savings programs available, and how to build cost conversations into your clinical workflow.

What Patients Are Actually Paying

Understanding the cost landscape helps you anticipate patient barriers:

• Cash price (uninsured): $400–$600 per 60g canister. This is what patients without insurance or with non-formulary coverage will face at the pharmacy counter.
• Commercial insurance: Coverage varies widely. Many plans place Zilxi on a specialty or non-preferred tier, requiring prior authorization and step therapy. Even with coverage, copays can range from $50 to $150+ depending on the plan.
• Medicare and Medicaid: Coverage is inconsistent. Many Medicare Part D plans do not cover Zilxi or place it on a high-cost tier. Medicaid coverage varies by state.
• With manufacturer savings card: As low as $25 per prescription for eligible commercially insured patients.

The bottom line: most patients will face sticker shock unless they have strong commercial insurance or access to a savings program.

Manufacturer Savings Programs

Zilxi Savings Card

Journey Medical Corporation offers a savings card that can reduce the patient's out-of-pocket cost to as little as $25 per prescription. Key details:

• Eligibility: Commercially insured patients (private insurance, employer plans)
• Not eligible: Patients with government insurance — Medicare, Medicaid, Tricare, VA, or any federal/state healthcare program
• How to enroll: Patients can call 888-786-5876 or visit the Zilxi website. Your office can also keep savings cards on hand to distribute during visits.
• Integration tip: Print or bookmark the savings card enrollment page. Include it in your rosacea treatment workflow so patients leave with it at the same time as their prescription.

Patient Assistance Program

For patients who are uninsured or underinsured and cannot afford Zilxi even with other discounts, Journey Medical Corporation may offer additional assistance. Direct patients to:

• Journey Medical: 1-844-375-3673
• NeedyMeds.org — A database of patient assistance programs searchable by medication
• RxAssist.org — Another comprehensive database of manufacturer and foundation assistance programs

Encourage your office staff to screen patients for PAP eligibility at the time of prescribing — don't wait for the patient to report a cost problem.

Coupon and Discount Cards

For patients who don't qualify for the manufacturer savings card (or who want to compare prices), third-party discount cards can help:

• GoodRx — Provides price comparisons across pharmacies and offers coupon codes. Prices for Zilxi vary by location and can sometimes beat insurance copays.
• SingleCare — Similar to GoodRx, allows patients to search for discounted prices at local pharmacies.
• RxSaver — Another option for comparing prices and finding discounts.

These are especially useful for patients paying cash or those whose insurance doesn't cover Zilxi at all. Remind patients that discount card prices can vary significantly between pharmacies — it's worth checking multiple locations.

For a comprehensive list of savings options, see our patient-facing savings guide.

Generic Alternatives and Therapeutic Substitution

As of 2026, there is no generic version of Zilxi. Minocycline topical foam 1.5% is only available as the brand-name product. This limits cost-saving options on the exact formulation.

However, there are therapeutic alternatives your patients may respond to if cost is the primary barrier:

• Metronidazole (MetroGel, MetroCream) — Available as a generic. Typically $20–$60 with a discount card. First-line topical for rosacea and often required as step therapy before Zilxi is covered.
• Azelaic Acid (Finacea) — Generic available. Typically $30–$80 with a discount card. Effective for mild-to-moderate inflammatory rosacea.
• Ivermectin (Soolantra) — Brand-name, but a generic may become available. Targets Demodex mites. $200–$400+ without insurance.
• Doxycycline (Oracea) — Low-dose oral option. Generic Doxycycline is very affordable ($10–$30), though it introduces systemic side effects.

When Zilxi is the right clinical choice but cost is prohibitive, document the clinical rationale thoroughly — this strengthens prior authorization appeals and supports the case for coverage.

For a detailed comparison, see alternatives to Zilxi.

Building Cost Conversations Into Your Workflow

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

1. Ask About Cost Concerns Upfront

Before writing the prescription, ask: "Has medication cost been a barrier for you in the past?" or "Do you know what your insurance covers for specialty dermatology medications?" This simple step can prevent prescription abandonment.

2. Pre-Screen Insurance Coverage

If your practice has a benefits verification team or uses electronic prior authorization tools, check Zilxi coverage before the patient leaves. Knowing the expected copay or PA requirements upfront lets you plan accordingly.

3. Provide Savings Resources at the Point of Prescribing

Don't assume patients will find savings programs on their own. Hand them the Zilxi Savings Card information, a GoodRx printout, or a link to Medfinder for Providers at the same time you write the prescription.

4. Follow Up on Fill Rates

Track whether patients actually fill their Zilxi prescriptions. If your EHR supports it, set a task to follow up within 7-10 days of prescribing. If a patient hasn't filled, a quick call or message to troubleshoot cost or availability issues can rescue an abandoned prescription.

5. Document Step Therapy and Treatment Failures

Many insurers require step therapy before covering Zilxi. Keep clear documentation of which first-line treatments the patient has tried and failed — this is critical for prior authorization approvals and appeals.

6. Use Medfinder to Help Patients Find Stock

Zilxi is a specialty product that not every pharmacy stocks. Medfinder for Providers can help you and your staff direct patients to pharmacies that have Zilxi available, reducing the chances of a frustrated patient giving up at the pharmacy counter.

Navigating Prior Authorization

Prior authorization is one of the biggest barriers to Zilxi access. Tips for a smoother process:

• Submit early. Don't wait until the patient is at the pharmacy. Start the PA process as soon as you decide to prescribe Zilxi.
• Include clinical documentation. Note the specific treatments the patient has tried and failed, their rosacea severity, and why Zilxi is the appropriate next step.
• Appeal denials. First-round PA denials are common. A well-documented appeal that includes treatment history and clinical rationale often succeeds on the second attempt.
• Use peer-to-peer review. If your appeal is denied, request a peer-to-peer review with the insurance company's medical director. This is often the most effective step in overturning a denial.

Final Thoughts

Zilxi is a clinically valuable option for patients with inflammatory rosacea, but its cost can undermine adherence if not addressed proactively. By integrating savings programs, cost conversations, and prior authorization strategies into your workflow, you can help more patients access and stay on the treatment they need.

Key resources to share with patients:

• Zilxi Savings Card: 888-786-5876
• Journey Medical PAP: 1-844-375-3673
• Medfinder: medfinder.com (patients) or medfinder.com/providers (providers)

For more provider resources, see our guides on Zilxi shortage information for providers and how to help patients find Zilxi in stock.