How much should I expect to pay for FINTEPLA® (fenfluramine) oral solution?
Prescription drug prices can be confusing. Two people may pay different prices for the same drug, depending on their insurance situation.
The list price* of FINTEPLA is $1,610.14 per 30 mL bottle1, but the amount you pay will depend on your personal dosing as well as your prescription drug insurance coverage. The information below will provide you a better understanding of what to expect based on your insurance situation.
For the most accurate affordability information, please contact ONWARD™ at 1-833-463-7547 which can help navigate the insurance process and determine eligibility for financial assistance.
Click here for full Prescribing Information.
Which Option Below Best Describes Your Insurance Situation?
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I Have Medicare Coverage
If you have Medicare coverage, your out-of-pocket experience will vary2 depending on your coverage situation and other medications as well as whether or not you qualify for Extra Help.†
To learn more about your specific situation, please contact Zogenix Central at 1-888-964-3649.
I Have Medicaid Coverage
For most people on Medicaid, prescription drugs like FINTEPLA have an average out-of-pocket cost of between $4.95-9.85 per month.3
To find out if you qualify for Medicaid, or for more information about copayments in your state, please visit Medicaid's website. To learn more about your specific situation, please contact Zogenix Central at 1-888-964-3649.
I Don’t Have Insurance or FINTEPLA Is Not Covered By My Insurance Plan
If you do not have insurance or FINTEPLA is not covered by your insurance plan, please contact our team at Zogenix Central – our Patient Support Program may be able to help families and patients who are uninsured get access to FINTEPLA. Contact Zogenix Central at 1-888-964-3649.
I Have Insurance Through an Employer or Private Individual Policy and Am Not Covered by Medicare
What you pay for FINTEPLA will depend on your insurance plan. Each plan has different preferred drug lists and out-of-pocket amounts, and most include an annual deductible. If you haven’t met your deductible, you’ll see higher prices† until the deductible is met; then your out-of-pocket cost will likely drop. To best understand your situation, please contact Zogenix Central at 1-888-964-3649.
About 99% of commercially insured patients pay between $0-$25 out-of-pocket a month.
The Zogenix Copay Support Program is designed to help families and patients who have commercial health insurance to afford the costs of treatment with FINTEPLA. Learn more by contacting Zogenix Central at 1-888-964-3649.
References:
1 AnalySource. Accessed on January 1, 2024. Patients may have to pay a higher price than list due to additional pharmacy charges. Based on FINTEPLA 30mL.
2 Centers for Medicare & Medicaid Services (CMS). Announcement of Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies. https://www.cms.gov/files/document/2024-announcement-pdf.pdf. Accessed January 2024.
33. Centers for Medicare & Medicaid Services (CMS). Medicaid and CHIP Overview. Maximum Allowable Copayments Determined by Eligible Population’s Household Income. Updated August 2023. All out-of-pocket charges are based on the specific state’s defined payment amount for that service. Certain groups, including children, terminally ill individuals, and individuals residing in an institution, are exempt from cost sharing. Refer to your state agency for details about Medicaid out-of-pocket costs. https://marketplace.cms.gov/technical-assistance-resources/medicaid-chip-overview.pdf. Accessed January 2024.
*List price is also referred to as wholesale acquisition cost or WAC. WAC is the price at which UCB sells its products to wholesalers.
† Drug coverage under Medicare Part D is divided into four phases: 1) deductible, 2) initial coverage, 3) coverage gap, and 4) catastrophic. Each of these phases has different cost-sharing amounts.