VIVITROL should be part of a comprehensive management program that includes psychosocial support.
of people with insurance are covered for VIVITROL,
including those on most government and
commercial plans.1
*Based on commercial and Medicaid pharmacy lives and Medicare low-income subsidy lives. Coverage may include plans with restricted access such as: prior authorization, step edits, or mandatory buy and bill.
Source: Fingertip Formulary 10/5/2020.
Pharmacy options, approval requirements, and the cost for VIVITROL prescriptions vary by health plan. Health plans can cover VIVITROL as either a medical or pharmacy benefit.
How healthcare providers obtain VIVITROL usually depends on how it is covered by the patient’s health plan. Get information on insurer requirements and forms plus pharmacy options for fulfillment of VIVITROL from the Insurance and Pharmacy Navigator.
Retail pharmacy: Some health plans allow any network pharmacy to fill VIVITROL.
Specialty pharmacy: These pharmacies will obtain and ship a patient-specific prescription to your office. If a patient’s insurance covers VIVITROL under the medical benefit portion of the health plan, the plan may allow a network pharmacy to ship VIVITROL directly to the provider’s office and bill the patient’s health plan directly on behalf of the provider. The Vivitrol2gether® team can work with offices to send prescriptions to pharmacies based on their patients' health care plan requirements. Link to Vivitrol2gether® enrollment form on previous page.
Buy and bill: Another option if VIVITROL is covered through the medical benefit is for the healthcare provider to buy units of VIVITROL from a specialty distributor and bill the patient’s insurance directly when it is administered.
Buy-and-bill providers and the VIVITROL® Co-pay Savings Program:
The following steps provide an understanding of the ordering process for VIVITROL.
Learn how the VIVITROL® Co-pay Savings Program may assist eligible* patients with out-of-pocket expenses for their VIVITROL prescriptions.
*Terms and Conditions
Eligibility for Alkermes-Sponsored Co-pay Savings. This offer is only available to patients 18 years or older, with a prescription consistent with the Prescribing Information and the patient is not enrolled in, or covered by, any local, state, federal or other government program that pays for any portion of medication costs, including but not limited to Medicare, including Medicare Part D or Medicare Advantage plans; Medicaid, including Medicaid Managed Care and Alternative Benefit Plans under the Affordable Care Act; Medigap; VA; DOD; TRICARE; or a residential correctional program.
Additional Terms of Use: This offer is not conditioned on any past, present, or future purchase, including refills. Alkermes reserves the right to rescind, revoke, or amend this offer, program eligibility, and requirements at any time without notice. This offer is limited to one per patient, may not be used with any other offer, is not transferable and may not be sold, purchased or traded, or offered for sale, purchase or trade. Void where prohibited by law. Program Administrator or its designee will have the right upon reasonable prior written notice, during normal business hours, and subject to applicable law, to audit compliance with this program.
See Important Safety Information.
See Prescribing Information. Review Medication Guide with your patients.
Reference: 1. Data on file. Alkermes, Inc. Waltham, MA.
Reference: 1. Data on file. Alkermes, Inc. Waltham, MA.