“I was faced with paying $4,000 every 90 days for Rexulti”
Even with health insurance, Ronald Weaver was lost on how to afford his prescription medication:
I was faced with paying $4,000 every 90 days for Rexulti, a medication my psychiatrist prescribed to help my depression. There is no generic yet…”
Weaver is not alone: Many (too many) Americans fall into the category of “underinsured” — meaning their out-of-pocket drug costs remain unaffordable despite insurance coverage. In fact, nearly one in five adults say they have not filled a prescription because of the cost. If only more people knew what Weaver discovered through PharmacyChecker.
Ronald discovered PharmacyChecker.com, a free and trusted resource that compares prices across U.S. discount coupons, patient assistance programs, and international online pharmacies accredited through its International Pharmacy Verification Program (IPVP). These pharmacies must meet stringent safety and licensing requirements.
So I found [PharmacyChecker] and it listed several pharmacies in Canada that charge $400 for the same medication for a 90 day supply…”
Accredited International Online Pharmacies Carry Affordable Rexulti
With his doctor’s approval, Ronald began filling his prescription at an accredited international online pharmacy. His doctor sent the prescription, and the pharmacy ships his medication every 90 days. “It takes about 7 days to receive it by USPS,” he explained.
Because Ronald’s insurance doesn’t cover Rexulti, one cash option is to pay out-of-pocket at his local pharmacy. According to PharmacyChecker.com’s price comparison tool, brand Rexulti costs about $49.61 per tablet, on average, at a U.S. retail pharmacy and a modest discount is achieved in conjunction with a discount coupon – $48.60 per tablet.
Let’s say Weaver’s prescription is to take 2 mg once daily. That’s $1,458 per month, or $4,374 every 90 days!
By contrast, an international online pharmacy accredited through the PharmacyChecker IPVP shows that the same prescription would be $127.80 when sourced from a Canadian dispensing pharmacy — a 91% savings.
Labeling shows that Rexulti sold in the U.S. and Canada is manufactured by the same manufacturer (more on that below), which is a common occurrence when it comes to globally-marketed brand name products.
It may be worth it for Ronald to explore the Rexulti Savings card, offered through Otsuka. It is designed for eligible patients with commercial insurance, potentially reducing co-pays.
Where Is Rexulti Marketed and Manufactured?
Brexpiprazole (brand name: Rexulti) was approved by the U.S. Food and Drug Administration (FDA) in July 2015 as an atypical antipsychotic indicated for use as an adjunctive therapy to antidepressants for the treatment of major depressive disorder (MDD) and the treatment of schizophrenia. In May 2023, the indication was expanded to treat agitation associated with dementia due to Alzheimer's disease.
Rexulti marketed in Canada was approved in April 2017 and is imported by Otsuka Canada Pharmaceutical Inc. from Otsuka Pharmaceuticals in Japan. We found labeling of Rexulti sold in the United States indicating it is also manufactured in Japan by Otsuka Pharmaceuticals and marketed by Lundbeck.
Rexulti marketed in Australia was approved to treat schizophrenia in 2017. In Australia, Rexulti is co-marketed by Lundbeck Australia and Otsuka Australia Pharmaceutical.
If you’re viewing drug product information on a PharmacyChecker-accredited international online pharmacy website that sources from Canada, Australia, or the United States, you’re often getting essentially the same brand-name product just with a dramatically different price tag. All are manufactured by Otsuka.
The PC IPVP accredits dispensing pharmacies located in the United States, Canada, Australia, New Zealand, India, the United Kingdom, Mauritius, etc. As of this writing, accredited pharmacies appear to only source Rexulti from Canada and Australia.
Image Source: The National Library of Medicine
Is There a Generic for Rexulti?
Ronald’s right. There is no FDA-approved generic version of Rexulti in the United States. In fact, Rexulti remains under patent protection in much of the world, which means no approved generics are available yet in the U.S., Australia, or Canada. Brand-name drugs like Rexulti are priced at a premium because the manufacturer, Otsuka Pharmaceutical, holds exclusive rights to market the drug, allowing it to set prices without generic competition. If you see a “generic Rexulti” advertised online, PharmacyChecker advises to be extremely cautious: You may be dealing with a rogue online pharmacy.
Do Rexulti’s therapeutic alternatives yield bad side effects?
Ronald went on to explain that finding an affordable option for Rexulti was a “real life saver” for him because his insurance would not cover Rexulti. Some insurers may deny coverage for Rexulti if they determine there’s a cheaper therapeutic alternative, but Weaver says, for him, the alternative “has bad side effects that Rexulti does not have.”
What drug is Ronald talking about? Many patients have reported differences in side effects or efficacy when switched from Rexulti to aripiprazole (generic Abilify), a common atypical antipsychotic also approved as an adjunctive treatment for depression. Distressing side effects include increased agitation or restlessness, compulsive behaviors, and reduced mood stabilization.
In 2016, the U.S. FDA issued a safety announcement warning that “compulsive or uncontrollable urges to gamble, binge eat, shop, and have sex have been reported with the use of the antipsychotic drug aripiprazole.” Although these impulse-control issues were reported as a rare occurrence, all of those urges stopped once the patient stopped taking the drug.
Reddit users have sought out community support regarding their unwanted side effects:
Experience on Abilify (Aripiprazole) byu/YamOrnery6686 inmentalillness
Every patient responds differently to prescription medication. There are accounts of people lamenting their use of Rexulti, for example. It’s vital to speak with your doctor about alternatives, side effects, and whether an appeal with your insurer is possible.
PharmacyChecker’s Takeaway
Ronald Weaver decided that the best way to access the medicine he needed was through an international online pharmacy.
I’m so happy that I found [PharmacyChecker]. I can’t believe it’s a free service. It’s very valuable.”
PharmacyChecker encourages all patients to speak with their healthcare providers before sourcing medication internationally — for people like Ronald, who fall into the “underinsured” gap, international price comparisons can be life-changing.
