Pristiq (Desvenlafaxine) Medicare Coverage

Pristiq
Chemical name: Desvenlafaxine

Brand name: Pristiq

Typical dosage: 50mg

Typical type: Tablet1

Pristiq is a medication used to treat depression. Pristiq is available as a brand name drug or as a generic and comes as an extended release tablet.

Pristiq is a medication that contains the active ingredient Desvenlafaxine. Pristiq is used to treat major depressive disorder.

Pristiq increases levels of serotonin and norepinephrine in the brain to improve symptoms of depression. It is typically taken once daily.

Common side effects of Pristiq include dizziness, upset stomach, throwing up, constipation, dry mouth, insomnia, loss of appetite, fatigue and sweating.

Does Medicare cover Pristiq or Desvenlafaxine?

While some Medicare plans may not cover Pristiq, 99% of Medicare Advantage plans and Medicare Part D plans cover Desvenlafaxine.1

  • Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.2

  • Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Desvenlafaxine.

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Average costs for Desvenlafaxine with Medicare drug coverage1

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.
After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.
$15 – $201 $6 – $168

Additional information

Pristiq can increase the chances of having suicidal thoughts in some people who take it. Stop taking Pristiq and call your doctor if you experience worsening depression, grouchiness, panic attacks, nervousness, restlessness or extreme changes in mood.

Pristiq can cause some serious side effects. Get medical help immediately if you throw up blood, cough up blood, find blood in your urine or stool or experience any other abnormal bleeding. Watch for signs of high blood pressure while taking Pristiq, including headache or dizziness, changes in eyesight or passing out.

Tell your doctor if you experience any other abnormal side effects while taking Pristiq including breathing problems, chest pain or pressure, seizures, fatigue or hallucinations.

 

 

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

 

Written by Hayden Gharibyar, Pharm.D.