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

When you prescribe Valtoco (diazepam nasal spray, CIV) to a patient with epilepsy and seizure clusters, cost barriers can prevent them from actually filling their prescription. With retail prices exceeding $2,000 per kit and frequent insurance prior authorization requirements, proactive cost management is a clinical and practical necessity. This guide outlines every savings option available for Valtoco patients and what you can do as a prescriber to ensure your patients have access.

The Cost Challenge: Why Valtoco Patients May Struggle

Valtoco is a brand-name-only medication. There is no generic diazepam nasal spray on the market as of 2026. Retail prices vary:

Valtoco 5 mg 5-dose kit: approximately $2,414 retail

Valtoco 10 mg 5-dose kit: approximately $2,572 retail

For patients with high-deductible plans, insurance denials, Medicare without adequate Part D coverage, or no insurance at all, these prices represent a significant barrier to access for a medication that must be on hand before an emergency occurs.

Program 1: Valtoco Copay Assistance Card (For Commercially Insured Patients)

The Valtoco Copay Assistance Program is the first tool for commercially insured patients. Key clinical facts:

Benefit: Eligible commercially insured patients can pay as little as $20 per Valtoco prescription

Eligibility: Commercial insurance only; does not apply to Medicare, Medicaid, or other federal program patients

Enrollment: No enrollment required per Neurelis; patients register at valtoco.com/savings-and-support or via myNEURELIS (1-866-696-3873 / 1-855-426-1301)

Action for providers: Mention the copay card at the time of prescribing. A brief note in your discharge summary or after-visit summary pointing patients to myNEURELIS can significantly improve adherence.

Program 2: myNEURELIS Patient Assistance Program (For Uninsured/Underinsured)

For patients without insurance or those denied coverage, the myNEURELIS Patient Assistance Program (PAP) provides Valtoco at no cost to eligible patients. Clinical details:

Benefit: Valtoco provided at no cost for eligible patients

Eligibility: Uninsured patients or those denied coverage; income is verified via Experian against Federal Poverty Level guidelines

Application: Complete the myNEURELIS referral form (requires original prescriber signature—stamps not accepted). E-prescriptions must be sent to PharmaCord Pharmacy (NABP 1836191)

Contact: 1-866-696-3873, Monday–Friday, 8 AM–8 PM ET

Action for providers: Complete the PAP application form at the time of the prescribing visit for eligible patients rather than expecting patients to navigate it on their own.

Prior Authorization: Strategies for Successful Approval

Most commercial payers require PA for Valtoco. Proactive PA submission dramatically reduces fill delays. Key strategies:

Submit at prescribing, not after pharmacy rejection. Waiting for a rejection adds days of delay for a rescue medication.

Document clinical specifics. Include: ICD-10 code for epilepsy with seizure clusters, patient age and weight, description of how seizure clusters differ from usual pattern, and rationale for nasal spray route.

Address step therapy proactively. If the payer requires prior trial of alternatives (e.g., Diastat), document why those alternatives are not appropriate: patient age (pediatric patients under 6 cannot use Nayzilam), patient/caregiver comfort with nasal vs. rectal administration, and self-administration feasibility.

Use myNEURELIS PA support. The myNEURELIS case managers can help with PA submissions, gather needed documentation, and support appeals when necessary.

Medicare and Medicaid Coverage Considerations

Medicare Part D coverage of Valtoco varies by plan and formulary. Some Medicare Advantage plans cover Valtoco; others do not or place it on a high tier. Manufacturer copay cards

cannot be used for Medicare or Medicaid patients (federal anti-kickback considerations). For Medicare patients denied coverage or facing high cost-sharing, the PAP may be an option depending on income eligibility. Refer to myNEURELIS for Medicare-specific guidance.

Prescription Discount Cards as a Bridge

For patients who aren't eligible for manufacturer programs and are paying cash, GoodRx and SingleCare can reduce Valtoco costs by approximately 15–30% from retail. GoodRx coupons bring the 10 mg 5-dose kit to approximately $1,760 (vs. ~$2,147 retail). This is a significant but imperfect option for cash-pay patients.

When Cost Barriers Cannot Be Resolved: Consider Alternatives

If all avenues are exhausted and cost remains a barrier, consider:

Generic diazepam rectal gel (generic Diastat): Same active ingredient; significantly lower cost; available at most pharmacies. The rectal administration route is less preferred but effective.

Nayzilam (midazolam nasal spray): For patients ages 12 and older. UCBCares offers patient support at 1-844-599-2273.

The Bottom Line for Prescribers

The most impactful steps you can take at the time of prescribing: (1) submit the PA proactively, (2) enroll or refer the patient to myNEURELIS, and (3) e-prescribe to a specialty pharmacy that reliably stocks Valtoco. For patients who need additional help locating their medication after filling, recommend medfinder to take the pharmacy-hunting burden off their plate.

See also: How to Help Your Patients Find Valtoco in Stock: A Provider's Guide.