Key takeaways:
Motegrity (prucalopride) is the only FDA-approved selective serotonin-4 receptor agonist for treating chronic idiopathic constipation in adults.
Without insurance, 30 tablets of 2 mg brand-name Motegrity cost an average of $618.29. The first generic version of Motegrity was approved in early 2025, which may help reduce the price of the medication over time.
Insurance coverage for Motegrity varies widely among health plans. But you may be able to save on Motegrity by using a GoodRx coupon.
Save on related medications
If over-the-counter laxatives aren’t working for chronic constipation, your healthcare professional might recommend a prescription laxative like Motegrity (prucalopride). Motegrity is a prescription-only medication for chronic idiopathic constipation (CIC), which is ongoing constipation with no known cause. Motegrity is the only FDA-approved selective serotonin-4 receptor agonist for treating CIC in adults.
Motegrity is available as a tablet and is typically taken once daily by mouth. The usual starting dosage for adults is 2 mg daily, although a 1 mg dose may be recommended for those with kidney issues.
Insurance coverage for Motegrity varies widely, so out-of-pocket costs for the medication depend on the specific plan. The first generic version of Motegrity was approved in January 2025, which may help reduce prices over time. But there are still ways to save on brand-name Motegrity now, including using a GoodRx coupon.
How much does Motegrity cost?
Without insurance, 30 tablets of 2 mg brand-name Motegrity cost an average of $618.29. The average cost for the same quantity and dose of generic Motegrity is $393.65.
Your actual out-of-pocket costs will depend on several factors, including:
Where you live
Your pharmacy
Your dosage
Whether or not you have insurance coverage
Available savings cards or discounts
Does insurance cover Motegrity?
Less than 28% of people enrolled in Affordable Care Act (ACA) marketplace plans or Medicare have coverage for brand-name Motegrity. Among those who have ACA coverage, some are required to get prior authorization, which means their prescriber must seek approval before their plan will cover the medication. Other insurance carriers may require enrollees to try different, lower-cost treatments first — which is called step therapy — before approving Motegrity. Medicare enrollees are rarely required to get prior authorization or do step therapy.
Medicaid plans cover Motegrity for the vast majority of enrollees, but nearly all enrollees are required to get prior authorization. Commercial insurance plans cover Motegrity for more than half of enrollees, but more than 1 in 3 will be required to get prior authorization or do step therapy.
To get a better idea of what’s covered and understand your out-of-pocket costs, review your plan’s formulary. You can also contact your insurance provider to determine if any extra steps are required for coverage.
How different insurance plans cover Motegrity
The following tables show the likelihood of having coverage — and prior authorization and step therapy requirements — for brand-name Motegrity based on the type of insurance plan.
Insurance type | Enrollees covered for Motegrity 2 mg | Enrollees required to get prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
27.3% | 19.1% | 12.8% | |
Commercial plans (excluding ACA plans) | 58.5% | 39.2% | 34.5% |
Medicare, including original Medicare and Medicare Advantage plans | 27.6% | 1.3% | 3.1% |
Medicaid, including state-run and managed care plans | 99.8% | 95.9% | 45.3% |
Source: Managed Markets Insight & Technology, LLC™, as of April 14, 2025. (See methodology below.)
If your insurance doesn’t cover Motegrity, try the following steps:
Ask your prescriber about switching to a different medication that may be covered by your insurance or come with lower out-of-pocket costs than Motegrity.
Contact your insurance company to request a formulary exception for Motegrity.
If your formulary exception request is denied, file an appeal.
During the next open enrollment period, compare insurance plans to see which ones provide the best coverage for your medication needs.
Use your health savings account (HSA) funds to pay for Motegrity. Here’s how your HSA can help cover the cost of Motegrity (prucalopride) and other medications.
Got a flexible spending account (FSA)? Find out how to use your FSA to pay for prescription medications like Motegrity.
Looking for other ways to save on medication costs? These tips can help lower your out-of-pocket costs for prescription medications.
Ways to save on Motegrity
Whether or not you have insurance coverage, there are ways to reduce your out-of-pocket costs for Motegrity. Here are four options to consider.
1. Use a free GoodRx coupon
A free GoodRx coupon could lower the cost of brand-name Motegrity at many pharmacies. With a GoodRx coupon, you may be able to pay as little as $553.45 for 30 tablets of 2 mg brand-name Motegrity. Or you might pay around $36.79 for the same quantity and dose of generic Motegrity. To compare prices and find the best deal in your area, you can visit the GoodRx website or download the app.
To get your GoodRx coupon for Motegrity:
Go to www.goodrx.com, or download the GoodRx app on your phone.
Search for “Motegrity.”
Enter your prescribed dose and quantity, then set your location.
Click “Find the lowest prices” or press “Enter.”
Have the coupon sent to you by text or email, or print it out.
To apply the discount, show the coupon at the pharmacy when you fill your prescription. Ideally, this is done when you drop off the prescription.
2. Request a 90-day supply
Consider asking your healthcare professional about prescribing you a 90-day supply of Motegrity. Many pharmacies offer discounts for larger supplies, and some insurance plans may have lower copays for a 90-day supply than for monthly refills. While savings aren’t always guaranteed, it’s a good idea to compare prices and see if this could lower your costs.
3. Ask about the generic version or lower-cost alternatives
The generic version of Motegrity, called prucalopride, is available in pharmacies and is typically more affordable than the brand-name medication. Generic medications are made to work the same way as brand-name medications, but they often cost less. You can also talk to your healthcare professional about other lower-cost alternatives that may be covered by insurance.
4. Use your HSA or FSA funds
If you have a tax-advantaged health account, such as a health savings account (HSA) or flexible spending account (FSA), you can use the funds in your account to pay for Motegrity. If you have an HSA, you can pay directly with your HSA card or submit a request for reimbursement at any time. FSAs are time-sensitive accounts, so you’ll need to purchase your medications and request reimbursement prior to your funds expiring.
The bottom line
Without insurance, 30 tablets of 2 mg brand-name Motegrity cost an average of $618.29. What you’ll actually pay depends on several factors, including your pharmacy and insurance coverage. You can save money by downloading a GoodRx coupon or trying the generic version of the medication. You can also use a tax-advantaged health account to help cover out-of-pocket costs.
Why trust our experts?
Methodology
We obtained national prescription coverage data for each medication from Managed Markets Insight & Technology (MMIT). The data reflects health insurance coverage as of April 2025.
We calculated the percentage of enrollees in plans that cover each medication by dividing the number of enrollees covered for the medication within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel.
We determined the percentage of enrollees in plans with a prior authorization requirement by calculating the proportion of enrollees in plans that required prior authorization for the medication within each channel.
Finally, we measured the percentage of enrollees in plans with a step therapy requirement by calculating the proportion of enrollees in plans that imposed step therapy requirements for the medication in each channel.
These estimates, derived from national MMIT coverage data, provide insight into health insurance coverage for each medication. They take into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total number of enrollees covered by various insurance channels, including ACA plans, commercial (excluding ACA) plans, Medicare, and Medicaid (both state-run and managed care plans).
References
ANI Pharmaceuticals. (2025). ANI Pharmaceuticals announces the FDA approval and launch of prucalopride tablets with 180-day CGT exclusivity. GlobeNewswire.
HealthCare.gov. (n.d.). Appealing a health plan decision.
Medicaid. (n.d.). Managed care.
Takeda Pharmaceuticals America. (2025). Motegrity - prucalopride tablet, film coated [package insert].