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Medically reviewed by, Russell Braun RPH

Did the high price of Trulance cause you to do a google search for a coupon? As with most coupon offers, the Trulance coupon comes with some strings attached. Most websites will tell you to save 80% with their special offer.

Not so fast!

Doesn’t it seem like the Trulance coupon offer is to good to be true? Rest assured, your instincts are good. Below I explain what you need to know and what you should try first if your planning to start Trulance.

What is Trulance?

Trulance (plecanatide) is an oral tablet that is used to treat adults with ongoing constipation. There are two main types of constipation Trulance is approved by the Food and Drug Administration (FDA) to treat and they are:

• Chronic Idiopathic Constipation (CIC)
• Irritable Bowel Syndrome with Constipation (IBS-C)

Trulance is available only with a doctors prescription.

How does Trulance work?

Trulance works on a substance called a guanylate cyclase-C (GC-C) in the small intestine. This causes more fluid to be secreted into the intestines therefore relieving constipation.

It is important to understand how the drug works when you compare it to other drugs for constipation. Lower priced options typically do not work in this same way.

Learn more about how to deal with constipation without drugs in this great resource written by Dr. Wes Jones.

What is the Trulance coupon?

Most brand name drugs will have a copay coupon available. The coupon will take the copay from whatever the insurance sets it at, and reduce it down to a specific amount set by the manufacturer. An example would be the copay is $150 for brand drugs but the Trulance coupon pays $125 of that cost leaving the patient with a small copay of $25.

On the surface the Trulance coupon sounds great, pay just a few dollars per month. However, beware of a few very important details that could cost big bucks in the long run.

1. The higher your income, the higher the amount you will have to pay for each copay. Consequently, not everyone will get the lowest copay of $25.
2. Trulance coupon has a maximum amount it will pay per year. The maximum amount is not provided, therefore asking before using is critical.
3. Copay coupon savings DO NOT apply toward deductibles.
4. All patients who are covered by government insurance are ineligible. Therefore, Medicare, Medicaid, Tricare and any other government insurance are ineligible.
5. Uninsured patients are also not eligible, you can only use the Trulance coupon WITH insurance
6. Trulance coupon can’t be combined with other discounts or coupons.
7. Only participating pharmacies will accept Trulance coupon.

How the Trulance coupon program works

It is important to understand why Synergy Pharmaceuticals, the manufacturer of Trulance offers a copay coupon. Here is a quick breakdown on why copay coupons also called savings cards even exist.

High list price

For reasons that are laid out in my book Prescription for Maximum Savings the manufacturer charges a high list price. As a result, the Trulance cost is approximately $505 for a 30 day supply according to GoodRx.

PBM Rebates bring the price down for the insurance company

The Pharmacy benefits manager (PBM) who is a middleman cuts a deal with Synergy to obtain the drug at the high list price, but get a big rebate. The rebates are paid in ways that are hard to understand and the whole process is not transparent. The patient never sees any savings from the rebate! Consequently, the high list price doesn’t impact the insurance company because they get a large rebate off that list price.

Insurance companies use rebate savings to keep premiums lower

The PBM keeps some of the rebate and then passes the remainder to the insurance company. Remember, for a Trulance coupon to work you must have insurance! The insurance does not pass the rebate back to you, instead they keep it. This allows them to lower the premium they charge per month for their insurance coverage. Therefore, the insurance company can get more patients on their plan, which makes them more money.

Copay is based off of the list price

Copays are set by the insurance company and are the price the patient must pay out of pocket for each fill of the medication. Often there will be different copay tiers available such as generics, preferred brands and non preferred brands. Brand drug copays keep getting higher and higher. As a result sometimes they are hundreds of dollars per month.

Manufacturers know most patients can’t afford such high copays

Many patients can’t afford to take medications because of the high monthly copay out of pocket cost. Without some type of support the expensive drug would never be picked up at the pharmacy. That is a problem for the manufacturer who wants to sell their product. Also, keep in mind they do get to write off the amount paid out in copay coupons as charitable donations and save on taxes.

Copay coupon helps patients get started on the drug

Trulance coupon allows patients to start taking the medication because it lowers the cost. After several months it becomes harder for patients to stop taking the medication. For that reason, it is important to remember the maximum amount a coupon is worth per year. Make sure to confirm what Trulance coupon maximum savings is before signing up.

Watch out for accumulators!

Many insurance companies have added a feature called a copay accumulator, because high deducible health plans are becoming more common. This is a fancy term for counting how much of the deductible (or copay) was paid by the patient versus the copay coupon. When accumulators are used any amount paid by the copay coupon will NOT count toward the deductible. See the example below:

• Patient deductible is $1500 per year.
• Trulance 30 day supply cost is $505.
• Maximum amount paid by Trulance coupon is $1200 per year*. (*This is for example purposes, confirm the amount before using Trulance coupon)

As you can see from the table, over the 6 months the patient monthly cost goes from $25 dollars to the full $505! This is a major problem with copay coupons because many patient are not aware of this. When the maximum limit is hit and assistance runs out, patients are stuck with the full deductible left to pay.

Steps to take before using Trulance coupon

#1 Is there a generic for Trulance?

Today Trulance is brand name drug only. The generic, plecanatide can’t be manufactured and sold until the patents expire for Trulance. Lawyers working for Synergy have been finding new ways to protect the patent. Consequently, Trulance will not be generically available until 2034.

#2 Are there therapeutic alternatives to Trulance?

A therapeutic alternative is a drug that had different chemical contents, but has the same effects as other drugs for treating a condition. Trulance has no generic alternative, but does have some therapeutic alternatives. Some of these therapeutic alternatives have generics which also means they will be substantially cheaper. Before trying a Trulance coupon make sure to try one or more of the alternatives listed in the table below. 

Prescription

Unfortunately, most of the therapeutic alternatives to Trulance that are prescription only don’t have generics either. Make sure to ask your doctor about the best over the counter options that do have generics, in table 2 below.

Table 1

Over the counter

These over the counter options are available in both over the counter and prescription only strengths. The good news, they are all available as generics! Again, talk to your doctor about the dose and frequency which to take these medications based on symptoms.

Table 2

# 3 Utilize drug discount programs to research alternatives

Drug discount programs are available today in a variety of formats. It is imporant to understand the differences in a drug discount card or app in contrast to the Trulance coupon. These discount programs negotiate prices with one or all of the following:

• Pharmacies
• Pharmacy benefit managers (PBM’s)
• Drug manufacturers

Most work with pharmacies who want to show up in the search function on the discount programs website or mobile application. Therefore, patients can see a discounted price the pharmacy negotiates with the discount program. Keep in mind these can not be used with insurance, but instead when the negotiated price is better than the price with insurance. Most people would not think the discount price could be better than insurance, but many times it is. A few of the major discount programs available today include:

• GoodRx
• BlinkHealth
• Singlecard
• Trialcard

Trulance has a high list price and because of that drug discount programs are not going to make the price tag manageable for most people. The best practice is to use drug discount programs to see how much the alternatives to Trulance (listed in table 2 above) cost and talk to your doctor about those options.

#4 How much does Trulance cost?

The price for Trulance is typically $505 according to GoodRx. That price is the full cash price, without any insurance or drug discount program discount. GoodRx claims their price is $438, a 13% discount on Trulance, again that is without insurance.

As you can see even with the discounted price, that cost each month can add up quickly.

#5 Is Trulance covered by insurance?

What can be done if a therapeutic alternative is not an option? Check with your insurance to see if Trulance is on formulary. If Trulance is on formulary it will have a more favorable out of pocket cost for the patient.

Check with your pharmacist to calculate your out of pocket cost using your insurance. Costs can vary widely depending on your insurance plan.

Also, the type of insurance plan you have will make a big difference.

• High deductible health plans (HDHP) will have a large deductible that will come from your pocket or the Trulance coupon.
• Preferred provider organizations (PPO) will have a set copay amount, Trulance coupon can also be used for that copay.

Read HDHP vs. PPO to understand more on the differences between these types of insurance.

#6 Is Trulance covered by Medicare?

Trulance ranges from being covered as a preferred drug all the way to being not covered by Medicare. The only way to know for sure in your situation is to go to Medicare.gov and use the plan compare tool. Follow the prompts and provide your basic information about prescriptions and pharmacy preference. Next, you will see many details about coverage, focus in on two things:

1. Drug deductible
2. Pharmacies & prescription drugs

Clicking on the link under pharmacies & prescription drugs will show you exactly how much Trulance will cost you monthly and yearly.

Remember, Trulance coupon can NOT be used for Medicare!

Medicare also offers the Extra Help subsidy, for lower income people. Everyone on Medicare should check to see if they are eligible, because investigating costs you nothing. Consequently, if you are eligible the savings could be huge.

#7 Are there samples available?

Before trying any new medication the best practice is to try samples. Brand name drugs like Trulance will have samples that the manufacturer provides to doctors. Sampling the medication allows a trial where it can be determined if the medication is going to be well tolerated or not. For the best outcome I recommend bullet journaling medication effects.

Trulance like other medications for constipation can take a few days to a week to determine if it is working. Ask for enough Trulance samples to last at least two weeks. This provides enough time to determine effectiveness, side effects and allows time to get a prescription filled.

Want to know what other patients say about Trulance? Read reviews and things you should know about Trulance.

#8 Patient Assistance Programs (PAPs)

In addition to offering the Trulance coupon, a patient assistance program is available through Bausch Health. The program is designed to help patients get Trulance at no cost.

To be eligible for this assistance patients must meet the following criteria:

• Be a resident of the United States
• Treatment provided by a US licensed healthcare provider
• Have no drug coverage via insurance
• Medicare Part D determined on case by case basis
• Income limit based on Federal Poverty Level (FPL)

Anyone who is close to the FPL cutoff level should still apply. The applications are approved on a case by case basis and anyone slightly over that mark could still get assistance.

The Bausch Health Patient Assistance Program for Trulance Access Services can be downloaded here. A doctor must complete the paperwork sign and return to Bausch. The optimal time to complete the process is after part of the sample period so that when a prescription is required the assistance is available.

State Prescription Assistance Programs (SPAPs)

Some states have there own state pharmaceutical assistance programs that are run by the state. They normally focus on low-income patients and also offer some type of Medicare Part D coverage as the Trulance coupon program does not apply to Medicare.

A state by state listing of SPAPs can be searched on Medicare.gov.

#9 How do I get a Trulance coupon savings card?

After trying the steps mentioned above, the Trulance coupon may be the best option because it does lower copay or deductible costs. Once it is confirmed that Trulance worked and was well tolerated, a coupon can be obtained here.

Synergy’s program for Trulance is called savings-to-go that offers an option to get text messages to let you know when the prescription is ready to be picked up at the pharmacy.

Synergy claims that patients can get Trulance for as low as $25 dollars per month using the Trulance coupon.

Please remember the Trulance coupon has a maximum payout and is only good for 12 uses.

Finally, you may be able eligible to get a new savings coupon the next year that is good for another 12 fills or the maximum payout amount.

Click here to get Dr. Jason Reed’s exclusive list of medication questions you MUST ask your doctor, for FREE!

Share your story

Have you tried Trulance? Also, let us know if it worked for you? Please chime in below with your comments and thoughts.

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