How Much Is Rexulti Without Insurance?
Key takeaways:
Rexulti (brexpiprazole) is an FDA-approved antipsychotic medication. It’s used to treat depression, schizophrenia, and dementia-related agitation from Alzheimer’s disease. It may also be used off-label for borderline personality disorder.
Without insurance, 30 tablets of Rexulti 1 mg cost about $1822.15. If you qualify for a Rexulti manufacturer savings card, you may pay as little as $0 for your prescription.
Many health plans, including Medicare and Medicaid, cover Rexulti. But prior authorization and step therapy may be required.
Access savings on related medications
Table of contents
Rexulti (brexpiprazole) is an atypical antipsychotic medication. It is FDA approved as an add-on treatment for major depressive disorder (MDD) in adults and to treat schizophrenia in adults and teens ages 13 and older. It can also help manage dementia-related agitation from Alzheimer’s disease. Rexulti may be prescribed off-label to help manage symptoms of borderline personality disorder.
Rexulti tablets are typically taken once a day. It works by helping to balance certain brain chemicals. These include dopamine and serotonin, which affect mood, thinking, and behavior.
In January 2025, the FDA approved a generic version of brexpiprazole made by Alembic Pharmaceuticals. But because it’s newly approved, it may take time before it’s available in pharmacies. Generic brexpiprazole is approved to treat depression and schizophrenia in adults only. Brand-name Rexulti is approved to treat MDD in adults and schizophrenia in adults and teens.
How much does Rexulti cost?
The list price for Rexulti is about $1,500 for a 1-month supply. This is the price set by the manufacturer before discounts, insurance coverage, or savings programs. It’s not what most people end up paying out of pocket.
Without insurance, the average cash price for 30 tablets of Rexulti 1 mg is $1822.15. Retail prices often exceed the list price because of pharmacy and wholesaler markups, among other reasons. Rexulti comes in six strengths: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg tablets.
The table below shows the average retail price for different quantities and doses of Rexulti.
Rexulti quantity | Dose | Average retail price |
30 tablets | 0.25 mg | |
30 tablets | 0.5 mg | |
30 tablets | 1 mg | |
30 tablets | 2 mg | |
30 tablets | 3 mg | |
30 tablets | 4 mg | |
60 tablets | 1 mg | |
90 tablets | 1 mg |
What factors affect the cost of Rexulti?
The price of Rexulti can vary based on several factors, including:
Location: Where you live can affect how much you pay for prescription medications. For example, GoodRx research shows that some cities, like Atlanta and Denver, often have lower medication prices compared with places like New Orleans or Milwaukee.
Brand name vs. generic: Rexulti is available as a brand-name medication. The FDA has approved a generic version (brexpiprazole), but it may not be widely available. When it becomes available, the generic may cost less than the brand-name version. Both offer the same safety and effectiveness.
Insurance coverage: Even if your insurance plan covers Rexulti, you might still have out-of-pocket expenses. These include copays, deductibles, or coinsurance.
Pharmacy choice: Prices can differ between pharmacies, even within the same area. So it’s worth comparing a few before filling your prescription.
Discounts: Your cost for Rexulti may be reduced if you qualify for the Rexulti savings card, download a GoodRx coupon, or find other savings programs.
Does insurance cover Rexulti?
Most health insurance plans, including Medicare, Medicaid, and commercial options, cover Rexulti.
More than 8 in 10 people enrolled in Affordable Care Act (ACA) marketplace plans have coverage for Rexulti. Less than half of enrollees will need prior authorization. But nearly two-thirds will require step therapy (trying lower-cost alternatives first) before you receive coverage for Rexulti.
Commercial plans cover Rexulti for more than 93% of enrollees, and less than 1 in 5 need prior authorization. But nearly 1 in 3 members must complete step therapy for coverage.
Need to save on your medication? From GoodRx coupons to patient assistance programs, here are several options that can help lower the cost of your prescription.
Have a health savings account? You can use this tax-advantaged account to pay for qualified medical expenses, including prescription medications like Rexulti.
Curious about antipsychotic side effects? From weight gain to decreased libido, here are the most common side effects you should know about.
Medicare generally covers Rexulti for all enrollees. But prior authorization and step therapy are required for about 1 in 5 members.
Medicaid provides coverage of Rexulti for nearly all enrollees. But 3 in 4 will need prior authorization, and close to 2 in 3 must complete step therapy before the medication is covered.
To determine how your insurance covers Rexulti, refer to the formulary for your health plan or contact your insurer directly.
How different insurance plans cover Rexulti
The table below shows how likely it is that Rexulti will be covered by different types of insurance plans. It also shows whether prior authorization or step therapy might be required.
Insurance type | Enrollees covered for Rexulti 2 mg capsule | Enrollees required to get prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
83.5% | 43.2% | 61.9% | |
Commercial plans (excluding ACA plans) | 93.7% | 19.4% | 29.6% |
Medicare (original Medicare and Medicare Advantage plans) | 100% | 23.1% | 21.02% |
Medicaid, including state-run and managed care plans | 99.9% | 77.5% | 60.6% |
Source: Managed Markets Insight & Technology, LLC™, as of April 14, 2025. (See methodology below.)
If your insurance does not cover Rexulti, you still have some options:
Ask a healthcare professional about switching to a different medication that may be covered by your insurance or come with lower out-of-pocket costs than Rexulti.
Contact your insurance company to request a formulary exception for Rexulti.
If the exception is denied, you can file an appeal.
During open enrollment, choose one that offers better coverage for your medication needs.
Ways to save on Rexulti
Whether you have insurance or not, here are five ways you may be able to save on Rexulti, or even get it at no cost:
1. Download a GoodRx coupon
A free GoodRx coupon could help lower the cost of your Rexulti prescription. Many pharmacies accept these coupons. And you can visit the GoodRx website or download the app to compare prices and find the best deal near you.
The tables below show average prices for different doses and quantities of Rexulti when using a GoodRx coupon at participating pharmacies.
Rexulti quantity | Dose | GoodRx price (as low as) |
|---|---|---|
30 tablets | 0.25 mg | |
30 tablets | 0.5 mg | |
30 tablets | 1 mg | |
30 tablets | 2 mg | |
30 tablets | 3 mg | |
30 tablets | 4 mg | |
60 tablets | 1 mg | |
90 tablets | 1 mg |
To get your free GoodRx coupon for Rexulti:
Go to www.goodrx.com, or download the GoodRx app on your phone.
Search for “Rexulti.”
Enter your prescribed dose and quantity, then set your location.
Click “Find the lowest prices” or press “Enter.”
You can have the coupon sent 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 at drop-off before the prescription is filled.
2. Check if you qualify for a Rexulti savings card
If you have a Rexulti prescription and have commercial insurance (such as a plan through your employer or a private plan), you may qualify for the Rexulti savings card. This card can help you pay as little as $0 for monthly Rexulti refills up to a 90-day supply. You can also use this savings card to lower your cost to $0 for a generic antidepressant. This is covered under the program if prescribed by your healthcare professional.
You may qualify for the Rexulti savings card program if all of the following apply:
You have commercial (nongovernment) health insurance.
Your prescription is for an FDA-approved use of Rexulti.
You are not covered by Medicare, Medicaid, or any other government insurance.
You live in the U.S. (including Puerto Rico).
You won’t request reimbursement from your insurance for using the savings card.
3. Check eligibility for the patient assistance program
If you’re unable to afford your medication, you may qualify for a patient assistance program that provides brand-name prescriptions at no cost. The Otsuka Patient Assistance Foundation (OPAF) supports eligible individuals who are uninsured or underinsured. If you meet the program’s income and eligibility requirements, you could receive Rexulti for free. Visit the OPAF website or speak with a healthcare professional to see if you qualify.
4. Consider using a generic or lower-cost alternative
Once a generic version of Rexulti (called brexpiprazole) is available in pharmacies, it may be a more affordable option. Generic medications contain the same active ingredient and work the same way as the brand-name version, but they often cost less. You can also talk to your healthcare professional about other lower-cost alternatives that may be covered by insurance.
5. Use your HSA or FSA to pay for Rexulti
If you have a health savings account (HSA) or flexible spending account (FSA), you can use those pretax funds to cover the cost of prescription medications like Rexulti. FSA funds usually expire at the end of the plan year, while HSA funds roll over and can be used in the future. These accounts can help reduce your out-of-pocket costs for Rexulti and other qualified medical expenses.
The bottom line
Without insurance, 30 tablets of Rexulti 1 mg can cost $1822.15 on average. What you pay will depend on factors like your insurance coverage, dose, and location.
If you have commercial insurance, you may qualify for the Rexulti savings card, which could lower your cost to as little as $0 per fill. You might also be eligible for free medication through the Otsuka Patient Assistance Foundation. Other ways to save include using a GoodRx coupon, using the generic once it’s available, or using HSA or FSA funds 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
Carlat, D. J., et al. (2024). Brexpiprazole (Rexulti) fact sheet. Medication Fact Book for Psychiatric Practice, 7th Edition. Carlat Publishing.
HealthCare.gov. (n.d.). Appealing a health plan decision. Centers for Medicare & Medicaid Services.
Medicaid.gov. (n.d.). Managed care. Centers for Medicare & Medicaid Services.
Otsuka America Pharmaceutical. (2025). Rexulti- brexpiprazole tablet [package insert].
Rexulti. (2024). Rexulti savings program. Otsuka America Pharmaceutical.
Rexulti. (2025). Savings & cost. Otsuka America Pharmaceutical.
U.S. Food and Drug Administration. (2025). Prescription and over-the-counter drug product list 45th edition.
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