For families managing Lennox-Gastaut syndrome (LGS), the high price of medication is a major concern. Onfi (clobazam) is a critical adjunctive treatment for this severe form of epilepsy, but its cost can be prohibitive without financial assistance. A significant factor in determining the price is whether you purchase the brand-name drug or its generic counterpart.
Onfi vs. Clobazam: Brand vs. Generic Pricing
Understanding the Price Difference
The price disparity between brand-name Onfi and its generic, clobazam, is substantial. For example, a 100-tablet supply of 10 mg brand-name Onfi can have a cash price of around $3,149, while the same quantity of generic clobazam might only cost about $204. This massive difference is due to the brand-name drug's manufacturer setting a high list price, which often bears little resemblance to the actual amount paid by consumers with good insurance.
- Brand-Name Onfi (Tablets): Expensive cash price, but often heavily subsidized for commercially insured patients via manufacturer programs.
- Generic Clobazam (Tablets): Much lower cash price and often covered by most insurance plans at a lower tier.
- Brand-Name Onfi (Suspension): The oral liquid version also carries a high price tag.
- Generic Clobazam (Suspension): Available at a significantly lower cost compared to the brand's suspension.
Insurance, Medicare, and Patient Assistance Programs
Navigating Insurance Coverage
For most people, the cost of Onfi is not the retail cash price, but rather the copayment or coinsurance dictated by their health insurance plan. Insurers typically cover generic drugs more readily and with lower out-of-pocket costs than brand-name drugs. Always check your plan's formulary to see which version of clobazam is covered and at what cost. Factors like your plan's deductible, copay, and whether you have met your maximum out-of-pocket limit will also influence your final cost.
Medicare Coverage for Clobazam
Medicare Part D plans often cover generic clobazam, but brand-name Onfi coverage is less common. Since the cost of brand-name medications can be very high, Medicare beneficiaries will likely find that generic clobazam is the more affordable option. It's important for Medicare patients to compare different Part D plans to find one with the best coverage for their medications.
Finding Savings and Financial Aid
Fortunately, several avenues exist to help reduce the financial burden of Onfi and clobazam.
Discount Cards and Manufacturer Programs
- Discount Cards: Websites like GoodRx and SingleCare offer free coupons that can lower the cash price of generic clobazam at most major U.S. pharmacies. These can be especially useful for uninsured individuals or those with high deductibles.
- Manufacturer Patient Assistance: For commercially insured patients, the manufacturer of Onfi, Lundbeck, offers a savings program that can reduce monthly costs to as little as $10. Eligibility varies, and certain government programs like Medicare and Medicaid usually exclude participants.
- Patient Assistance Programs (PAPs): Patients without insurance or who are underinsured may qualify for Patient Assistance Programs offered by manufacturers or non-profits. These programs can provide the medication for free or at a significantly reduced cost. You can often find information on these programs via the manufacturer's website or by searching for "Onfi patient assistance program."
Factors Influencing the Total Cost of Onfi
The overall cost of treatment isn't just the sticker price of the medication. Several other variables play a role:
- Dosage and Strength: The prescribed dosage and strength (e.g., 10 mg vs. 20 mg tablets) will directly impact the total quantity needed and, therefore, the total cost.
- Formulation: Onfi and clobazam are available in both tablet and oral suspension forms, and their prices can differ.
- Pharmacy Prices: Even with discount cards, prices can vary between different pharmacies, so it is wise to shop around.
- Associated Medical Costs: Managing LGS involves more than just medication. Doctor's visits, additional tests, and management of side effects all contribute to the overall healthcare expense.
Cost Comparison: Onfi vs. Generic Clobazam
| Feature | Brand-Name Onfi | Generic Clobazam |
|---|---|---|
| Drug Name | Onfi | Clobazam (Active Ingredient) |
| Manufacturer | Lundbeck Inc. | Various Generic Manufacturers |
| Approximate Cost (100 x 10mg Tablets) | ~$3,149 cash price | ~$204 cash price |
| Approximate Cost (120mL of Oral Suspension) | ~$1,659 cash price | ~$45 cash price |
| Savings Options | Manufacturer savings card (for commercially insured) | Discount cards (GoodRx, SingleCare) |
| Medicare Coverage | Often excluded or not preferred | Often covered by most plans |
Conclusion
Understanding how much Onfi costs involves more than just looking at the retail price. While brand-name Onfi has a very high cash price, financial assistance from the manufacturer can provide significant savings for eligible commercially insured patients. However, for those without comprehensive coverage, the generic version, clobazam, represents a substantially more affordable option. Navigating insurance coverage, exploring discount cards, and enrolling in patient assistance programs are all critical steps to managing the cost of this important medication. Always consult with your healthcare provider and pharmacist to discuss the most cost-effective treatment plan for your specific situation. For more information, visit the manufacturer's website at Onfi.com.
