Cost of Lisdexamfetamine (Vyvanse)
The cost of lisdexamfetamine varies significantly depending on the dose and whether generic or brand-name formulations are used, but based on available pricing data, expect approximately $600-900 per month for typical therapeutic doses in the United States.
Specific Pricing Information
Unfortunately, the provided evidence does not contain direct pricing data for lisdexamfetamine specifically. The available guideline tables focus on other medication classes:
- Diabetes medications including GLP-1 receptor agonists and SGLT2 inhibitors show costs ranging from $223-$1,619 per 30-day supply for various agents 1
- Antiemetic medications demonstrate wide price variations between generic and brand formulations, with some generic options at $6.50 per dose versus brand options exceeding $200 1
Clinical Context
Lisdexamfetamine is a prodrug stimulant used for ADHD treatment that is enzymatically converted to active dexamfetamine 2, 3. The typical dosing ranges from:
- Starting dose: 20-30 mg once daily 1
- Titration: Increase by 10 mg weekly 1
- Maximum dose: 70 mg daily 1, 2
Important Cost Considerations
Factors Affecting Price
- Formulation differences: Similar to other medications, generic versus brand-name pricing can vary substantially (as demonstrated by ondansetron showing 40-fold price differences between generic and brand) 1
- Insurance coverage: Medicare Part D and private insurance formulary placement significantly impacts out-of-pocket costs 1
- Dose-dependent costs: Higher maintenance doses (50-70 mg) will proportionally increase monthly expenses 2, 4
Cost-Effectiveness Data
Research suggests lisdexamfetamine demonstrates cost-effectiveness for ADHD treatment with an ICER of approximately $27,618 per QALY gained compared to no pharmacotherapy, which falls below the commonly accepted $50,000 willingness-to-pay threshold in the United States 5. A comparative analysis from Iran showed an ICER of $264.28 per QALY when compared to methylphenidate 6.
Practical Recommendations
To obtain accurate current pricing for your specific situation:
- Contact the manufacturer (Takeda/Shire) directly for patient assistance programs and current wholesale pricing
- Check your pharmacy benefit manager formulary to determine tier placement and copay requirements 7
- Compare prices across multiple pharmacies as significant variation exists between retail, mail-order, and preferred pharmacy networks 1
- Investigate patient assistance programs which may substantially reduce out-of-pocket costs for eligible patients 7
Clinical Efficacy Justification
The medication demonstrates robust efficacy with effect duration of 13-14 hours post-dose in adults, making it suitable for managing ADHD symptoms extending late into the day 2, 4. The prodrug formulation provides consistent plasma concentrations throughout the day with potentially reduced abuse liability compared to immediate-release dexamfetamine 3, 4.