Xyrem and Cost: What You Need to Know

Xyrem (sodium oxybate) is a prescription drug that’s used to treat narcolepsy. Xyrem’s cost may depend on factors such as your dosage, whether you have health insurance, and the pharmacy you use.

Xyrem is used in adults and certain children with narcolepsy to treat:

• excessive daytime sleepiness
• cataplexy

The active ingredient in Xyrem is sodium oxybate. (An active ingredient is what makes a drug work.) Xyrem comes as a liquid solution you swallow.

For more details on Xyrem, see this in-depth article.

The price you pay for Xyrem can vary. Your cost 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 Xyrem, talk with your doctor, pharmacist, or insurance provider.

Patients, too, are unhappy with the care they receive during those brief interactions with their doctors. Healthcare communications company West Corporation reported that 25% of patients don’t feel that their provider cares about them as an individual and nearly 20% aren’t convinced their doctor is focused on improving their health – even though 93% of doctors strongly agree that patient satisfaction is important.

Note: If you have insurance, you may need to get prior authorization before your insurance provider will cover Xyrem. This means your insurer and your doctor will discuss Xyrem in regard to your treatment. Then the insurance company will determine whether the drug is covered. If Xyrem 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 Xyrem requires prior authorization.

Below are answers to some frequently asked questions about Xyrem and cost.

How does the cost of Xyrem compare with other similar drugs, such as Xywav?

The cost of Xyrem compared with other drugs, such as Xywav, depends on several factors. These include:

• whether you have insurance or are paying out of pocket
• if you qualify for any savings programs
• the specialty pharmacy you use
• your health insurance plan (if you have one)

To find out if there’s a cost difference between Xyrem and Xywav, talk with your doctor, pharmacist, or insurance provider. They can determine what your cost will be for each of these drugs.

Is there a patient assistance program available for Xyrem?

Yes. The manufacturer of Xyrem (Jazz Pharmaceuticals) has a program called the Xyrem Patient Assistance Program. If you cannot afford the cost of Xyrem and meet certain eligibility requirements, the program helps pay for the medication.

You can learn more about the program on their website or by calling 1-866-997-3688.

If you have questions about whether you qualify for any savings programs, you can also talk with your doctor.

Xyrem only comes as a brand-name drug. It’s not currently available in a generic version. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

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 drugmaker 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 Xyrem long term, you may be able to lower your costs in certain situations. Xyrem is only available through a certified specialty pharmacy. Check with your insurance provider or the specialty pharmacy if you can get Xyrem 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 Xyrem if approved by your insurance company. If you’re eligible for getting a 90-day supply of this drug, talk with your doctor, certified specialty pharmacy, or insurance provider.

Use a mail-order certified specialty pharmacy to get your medication. Using a mail-order specialty pharmacy might help lower your cost for Xyrem. 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 through a certified specialty pharmacy. If you don’t have health insurance, talk with your doctor or the certified specialty pharmacy.

If you need help covering the cost of Xyrem or understanding your insurance, check out these resources:

• JazzCares Program
• NeedyMeds
• Medicine Assistance Tool

On these sites, you can find insurance information, details on drug assistance programs, and links to savings cards and other services.

The manufacturer of Xyrem has several savings programs available. To learn more, call 1-866-997-3688.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist.

If you still have questions about the cost of Xyrem, 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 Xyrem.

Examples of questions you may want to ask your doctor or insurance provider include:

• Is the cost of Xyrem covered by Medicare?
• Does my cost of Xyrem depend on my dosage?
• Would my cost of Xyrem be lower if I use a particular specialty pharmacy?
• Are there other lower-cost options to available to treat my condition?

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Disclaimer: Austra Health 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.

Last medically reviewed on April 7, 2023

How we reviewed this article:

Austra Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Xyrem (sodium oxybate) oral solution, CIII. (2022).
  pp.jazzpharma.com/pi/xyrem.en.USPI.pdf

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