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

The retail price of Gimoti (metoclopramide nasal spray) is approximately $2,500 per bottle — a number that leads many patients to refuse the prescription or abandon it after the first fill. But most patients who are properly enrolled in Evoke Pharma's savings program pay only $0 or $20. As the prescribing provider, you play a critical role in ensuring your patients access this pricing. Here's how.

Understanding the Gimoti Savings Program Structure

Evoke Pharma offers a patient savings program administered through ASPN Pharmacies. The program has two main tiers:

$0 copay: For patients with qualifying commercial insurance that covers Gimoti after prior authorization approval.

$20 copay: For eligible patients with commercial insurance that does not cover Gimoti, or patients whose prior authorization was denied. This is a manufacturer-subsidized price.

Not eligible: Patients enrolled in Medicare, Medicaid, TRICARE, or other state/federally funded programs are not eligible for the manufacturer copay program. However, many government payer plans do cover Gimoti — encourage these patients to verify their plan benefits.

The Provider's Role in Enabling PA Approval (and $0 Copay)

The difference between a patient paying $0 vs. $20 often comes down to whether the PA was approved. Approval rates improve significantly with complete, well-documented PA requests. Here's what to include:

Confirmed gastroparesis diagnosis: Include 4-hour gastric emptying study results showing delayed emptying. Note the percentage of solid meal retained at 4 hours.

Diabetes confirmation: Gimoti is indicated specifically for diabetic gastroparesis. Document the type and duration of diabetes.

Failed oral metoclopramide trial: Document the exact dose used, duration of trial, and reason for discontinuation (inadequate symptom control or specific side effects). Insurance plans exclude samples and discount card trials — only prescription fills count.

Clinical rationale for nasal route: Explain why nasal delivery is medically necessary for this patient (severe nausea/vomiting preventing oral absorption, dysphagia, erratic response to oral form).

TD risk counseling attestation: Confirm in documentation that you have counseled the patient about the boxed warning for tardive dyskinesia.

What to Do When PA Is Denied

A PA denial is not the end. ASPN Pharmacies manages a robust appeals process:

Level of Medical Necessity (LMN) appeal: ASPN will request an LMN letter from your office. Provide a detailed clinical narrative explaining why Gimoti is medically necessary for this specific patient. Appeal determinations take approximately 30 days.

During the appeal: Your patient can access Gimoti for $20 through the savings program while the appeal is in progress. This ensures treatment is not interrupted.

If appeal is unsuccessful: The $20 option remains available. For patients in financial hardship, contact ASPN at 1-844-244-6684 for additional assistance options.

Commercial Insurance Coverage: What Plans Require

Most commercial insurance plans that cover Gimoti apply these standard prior authorization criteria (per Cigna's coverage policy IP0085 and similar plans):

Patient is ≥18 years old.

Diagnosis of acute and recurrent diabetic gastroparesis (not general nausea/vomiting or non-diabetic gastroparesis).

Prior prescription trial of oral metoclopramide with inadequate response or intolerance (coupon/sample trials excluded).

Approval duration typically limited to 8 weeks, with potential renewal if clinically justified.

Medicare and Medicaid Coverage for Gimoti

Many Medicare fee-for-service and managed care plans cover Gimoti, although copays vary by plan. The 2026 Medicare Part D annual out-of-pocket cap is $2,100, which limits total drug costs for patients enrolled in Part D. ASPN will verify Medicare coverage and pursue PA on behalf of your patients.

For Medicaid patients, coverage is state-specific. Some state Medicaid programs cover Gimoti; others do not or require PA with strict step therapy requirements. Encourage Medicaid patients to contact ASPN to check their specific state plan coverage.

How to Have the Cost Conversation With Your Patients

When prescribing Gimoti, frame the cost conversation proactively:

"The drug is expensive — but most patients with commercial insurance pay only $0 or $20 through ASPN's savings program."

"Don't be alarmed if you look up the price online — those reflect the cash price, not what you'll actually pay."

"If PA takes some time, you can start Gimoti for $20 while we get the insurance sorted."

Office Workflow: Ensuring Your Patients Get the Savings

Route all Gimoti prescriptions directly to ASPN Pharmacies (phone: 1-844-244-6684, fax: 1-888-661-9657).

Document the prior oral metoclopramide trial clearly in your notes — including prescription dates, doses, and reason for stopping.

Respond promptly to ASPN's PA requests — delays in your office hold up insurance approval.

Inform patients that ASPN will text them within 24 hours — they should watch for the message from an unfamiliar number.

If PA is denied, promptly prepare an LMN letter to support the appeal.

Supporting Your Patients Across Their Full Medication List

Patients with diabetic gastroparesis typically manage multiple medications beyond Gimoti — diabetes medications, antihypertensives, supplements, and more. When any of these become hard to find at their local pharmacy, it can disrupt the entire treatment regimen. medfinder for providers helps your patients find pharmacies that stock their prescriptions, reducing the friction that leads to medication abandonment.

See also: How to Help Your Patients Find Gimoti In Stock: A Provider's Guide for the complete prescription routing and access guide.