Caplyta (lumateperone) is a prescription drug used to treat certain mental health conditions. Caplyta’s cost may depend on factors such as your dosage, whether you have health insurance, and the pharmacy you use.
Caplyta is used in adults to treat:
- schizophrenia
- depression associated with bipolar I or II disorder, for which it may be used alone or with another medication (lithium or valproate)
The active ingredient in Caplyta is lumateperone. (An active ingredient is what makes a drug work.) Caplyta comes as an oral capsule.
For more details on Caplyta, see this in-depth article.
The price you pay for Caplyta can vary. It may depend on your treatment plan, your insurance coverage (if you have it), and the pharmacy you use. To find out how much you’ll pay for Caplyta, talk with your doctor, pharmacist, or insurance provider.
Note: If you have insurance, you may need to get prior authorization before your insurance provider will cover Caplyta. This means your insurer and your doctor will discuss Caplyta in regard to your treatment. Then the insurance company will determine whether the drug is covered. If Caplyta requires prior authorization and you don’t receive it before you start treatment, you could pay the full cost of the drug.
Be sure to ask your insurance company whether Caplyta requires prior authorization.
Caplyta only comes as a brand-name drug. It’s not currently available in a generic version. A generic contains an exact copy of the active drug in a brand-name medication but tends to cost less.
Why is there such a cost difference between brand-name drugs and generics?Years of research and testing are needed to ensure that brand-name drugs are safe and effective. This testing can make the drugs expensive. The manufacturer of a brand-name drug can sell the drug for up to 20 years. After that, other drugmakers can create generic versions. This competition in the market can lead to lower costs for generics. And because generics have the same active ingredients as brand-name drugs, they don’t need to be studied again. This can also lead to lower generic costs.
If you take Caplyta long term, you may be able to lower your costs in the following ways:
Look into getting a 90-day supply of your medication. You may be able to get a 90-day supply of Caplyta if approved by your insurance company. This could reduce your number of trips to the pharmacy and help lower the cost of Caplyta. If you’re interested in getting a 90-day supply of this drug, talk with your doctor, pharmacist, or insurance provider.
Use a mail-order pharmacy to get your medication. Using a mail-order pharmacy might help lower your cost for Caplyta. Plus, you could get your medication without leaving home. Some Medicare plans may help cover the cost of mail-order drugs. You may also be able to get a 90-day supply of the drug through mail order. If you don’t have health insurance, talk with your doctor or pharmacist. They may be able to suggest online pharmacy options that could work for you.
If you need help covering the cost of Caplyta or understanding your insurance, check out these resources:
On these sites, you can find insurance information, details on drug assistance programs, and links to savings cards and other services.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist.
Below are answers to some frequently asked questions about Caplyta and cost.
What is the cost of Caplyta with insurance?
The cost of Caplyta with insurance depends on various factors. These include:
- your specific plan benefits
- if you apply and qualify for the Caplyta savings program
The cost may also depend on your dosage and other factors, such as your copay (your share of the cost of a medication).
To learn about the cost of Caplyta with insurance, talk with your insurance provider or your doctor. They can let you know what you can expect to pay for Caplyta.
Even if you have insurance, you can visit Optum Perks* to get price estimates for Caplyta when you use coupons from the site. It’s important to note that Optum Perks coupons cannot be used with any insurance copays or benefits.
* Optum Perks is a sister site of Healthline.
How does the cost of Caplyta compare with that of similar drugs, such as Vraylar?
The cost of Caplyta compared with similar medications such as Vraylar can depend on several factors. These include:
- whether there are any savings programs available for the drug you’re prescribed
- whether you have insurance or are paying out of pocket
- your dosage
- how long your treatment lasts
If you have questions about the cost of Caplyta compared with similar medications, talk with your doctor, pharmacist, or insurance provider. They can share more details on treatment costs based on your specific situation.
If you still have questions about the cost of Caplyta, talk with your doctor or pharmacist. They may be able to give you a better idea of what you’ll pay for this drug. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you’d pay for Caplyta.
Examples of questions you may want to ask your doctor or insurance provider include:
- Does my cost for Caplyta depend on my dosage of the drug?
- Am I eligible for Caplyta savings if I have Medicare?
- How does the cost of Caplyta compare with Abilify (aripiprazole)?
To learn more about Caplyta, see these articles:
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.