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Key takeaways
Insurance plans may stop covering Vyvanse as a cost-saving measure.
Generic Vyvanse (lisdexamfetamine dimesylate) may still be covered by your insurance provider even if name-brand Vyvanse isn’t.
If you need to pay out of pocket for Vyvanse, a SingleCare discount card can provide significant cost savings.
Vyvanse (lisdexamfetamine dimesylate) is a central nervous system stimulant or amphetamine that’s approved by the Food and Drug Administration (FDA) to treat attention-deficit hyperactivity disorder (ADHD) and moderate to severe binge eating disorder. Although some health insurance plans cover Vyvanse, insurance companies may change their formularies (the list of drugs they’ll cover) for various reasons. If your health insurance stops covering Vyvanse, this guide will help you decide what to do next.
Possible reasons why your insurance stopped covering Vyvanse
There’s a small chance your Vyvanse coverage ended due to a clinical or administrative error. Insurance companies may deny coverage for a drug if they think you no longer need it.
But in many cases, it’s all about cost. “Sometimes it’s just a formulary change—not based on your clinical need but on internal pricing decisions,” says Ritu Goel, MD, a board-certified child, adolescent, and adult integrative psychiatrist at Mind Claire in Los Angeles. “Insurance plans may also drop the brand-name version when a generic becomes available to cut expenses.”
Sure enough, the generic version of Vyvanse was approved by the FDA in August 2023. As more pharmaceutical companies begin manufacturing the drug, it becomes cheaper and easier to source.
Sometimes insurance companies think both the name-brand and generic versions of a prescription drug are too expensive compared to alternatives, and they’ll remove both from the formulary. Make sure you review your insurance policy’s formulary every year during the open enrollment period to verify coverage for all your medications. Consider switching to another health plan if your current one stops covering your medications.
How much is Vyvanse without insurance?
The average out-of-pocket cost of Vyvanse without insurance is $550 for 30, 30 mg capsules. In comparison, generic lisdexamfetamine dimesylate costs about $443 for the same dosage without insurance or coupons.
What to do if your insurance won’t cover Vyvanse
If your insurance stopped covering Vyvanse, you should immediately make two phone calls: one to the insurance company and one to your healthcare provider. Here’s what to ask.
1. Find out why your insurance stopped covering Vyvanse
First, ask the insurance company why it denied coverage for Vyvanse. Do they think you no longer need the drug? Are they only covering the generic version? Make sure you know what’s going on so you can take appropriate action.
2. Talk to your healthcare provider about appealing the decision
Sometimes insurance companies will cover a medication that’s not in their formulary on a case-by-case basis. To be considered for Vyvanse coverage, your healthcare provider must send a letter on your behalf explaining why Vyvanse is the best treatment option for you. This appeal may be approved or denied.
3. Don’t stop taking Vyvanse without your doctor’s approval
It can sometimes take an extended time to hear back from the insurance company, so it’s important to have a plan in place while you wait. Your healthcare provider may recommend staying on Vyvanse until a decision is made, or they may recommend switching to an alternative medication.
Either way, it’s important to follow their guidance in order to avoid Vyvanse withdrawal symptoms. Like many other stimulants, Vyvanse may cause uncomfortable side effects when it’s stopped cold turkey. Although side effects aren’t severe, Dr. Goel says stopping Vyvanse abruptly can leave people feeling more tired, hungrier, and less focused for a few days.
Anoop Singh, MD, a board-certified psychiatrist and regional director at Mindpath Health, agrees that Vyvanse is unlikely to cause severe withdrawal symptoms when it’s been taken as prescribed. “Some patients may be at a higher risk due to individual health factors. In most such cases, symptoms are mild and self-resolving; however, it may be safest for those on a higher dose or with certain medical risk factors to gradually reduce their medication dose over a few days.”
Dr. Singh says severe Vyvanse withdrawal symptoms are more likely to occur when people have taken far too much of the drug for an extended period of time. “Individuals experiencing acute amphetamine withdrawal will likely start experiencing symptoms 36 to 48 hours after stopping Vyvanse, and these could last up to two to three weeks or longer, but the severity and duration of symptoms can vary widely.”
Affordable alternatives to Vyvanse
If your insurance still won’t cover Vyvanse after the appeals process, your healthcare provider may recommend a Vyvanse alternative.
“Generic lisdexamfetamine is probably the most appropriate alternative option, given that it contains the same medication but with significantly lower cost,” Dr. Singh says.
He explains that generic medications are just as safe and effective as name-brand drugs, despite being far more affordable. “Generic drug manufacturers can bring their products to market more quickly and at a significantly lower cost because the original brand-name drug has already been approved by the FDA. Since they don’t have to repeat the same research, generics are usually much cheaper.”
If you need to switch to a completely different medication, Dr. Goel says there are both stimulant and non-stimulant medications approved to treat ADHD. Stimulant alternatives include Adderall (amphetamine-dextroamphetamine), Concerta (methylphenidate extended-release), Focalin (dexmethylphenidate), and Ritalin (methylphenidate), while non-stimulants include atomoxetine and Intuniv (guanfacine ER). These medications (or their generics) may be covered by your insurance even if Vyvanse isn’t.
“Some people find Vyvanse smoother or long acting, but alternatives can be just as effective with the correct dose. It’s all about what works for you,” Dr. Goel says.
Compare Vyvanse alternatives |
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|---|---|---|---|
| Drug name | Price without insurance of brand-name drug | SingleCare price* | Savings options |
| Vyvanse (lisdexamfetamine) | $550 for 30, 30 mg capsules of name-brand Vyvanse | $65 for 30, 30 mg capsules of generic lisdexamfetamine | See latest prices |
| Adderall XR (dextroamphetamine/ amphetamine ER) | $346 for 30, 30 mg capsules of name-brand Adderall XR | $29 for 30, 30 mg capsules of generic dextroamphetamine/ amphetamine ER | See latest prices |
| Concerta (methylphenidate HCl ER) | $643 for 30, 36 mg tablets of name-brand Concerta | $36 for 30, 36 mg tablets of generic methylphenidate HCl ER | See latest prices |
| Focalin (dexmethylphenidate) | $63 for 30, 10 mg tablets of name-brand Focalin | $12 for 30, 10 mg tablets of generic dexmethylphenidate | See latest prices |
| Focalin XR (dexmethylphenidate ER) | $478 for 30, 30 mg capsules of name-brand Focalin XR | $49 for 30, 30 mg capsules of generic dexmethylphenidate ER | See latest prices |
| Ritalin (methylphenidate HCl) | $138 for 60, 20 mg tablets of name-brand Ritalin | $19 for 60, 20 mg tablets of generic methylphenidate HCl | See latest prices |
| Atomoxetine HCL | $470 for 30, 40 mg capsules | $27 for 30, 40 mg capsules | See latest prices |
| Intuniv (guanfacine ER) | $361 for 30, 2 mg tablets of name-brand Intuniv | $15 for 30, 2 mg tablets of generic guanfacine ER | See latest prices |
| Clonidine HCl ER | $171 for 30, 0.1 mg tablets | $16 for 30, 0.1 mg tablets | See latest prices |
| Quillivant XR (methylphenidate ER) | $480 per 1, 120 mL bottle of 25 mg/5 mL liquid name-brand Quillivant XR | $340 per 1, 120 mL bottle of 25 mg/5 mL liquid brand-name Quillivant XR | See latest prices |
*Cost at time of publication. Drug prices fluctuate and vary by pharmacy and location.
How to save on Vyvanse without insurance
If you still want to take Vyvanse after insurance stops covering it, there are other ways to save money at the pharmacy.
For example, using a SingleCare prescription discount card at a participating pharmacy reduces the out-of-pocket cost from about $550 per 30, 30 mg capsules of Vyvanse to as little as $65 for the same dose of generic lisdexamfetamine. Simply sign up for a free SingleCare account, print or save your discount coupon, and show it to the pharmacist whenever you pick up your medication.
- FDA approves multiple generics of ADHD and BED treatment, Food and Drug Administration (2023)