Fintepla's Annual Cost
Fintepla (cenobamate), used for focal seizures, costs about $108,000 per year at list price for a typical 400 mg daily dose, based on U.S. pricing data from 2023.[1] With insurance or patient assistance, out-of-pocket costs drop to $0-$5,000 annually for many, though coverage varies.
How It Stacks Up Against Other Focal Seizure Drugs
Fintepla ranks among the priciest options. Here's a comparison of annual list prices for common alternatives (400 mg cenobamate equivalent dosing where applicable; prices exclude discounts):
| Drug | Brand | Annual List Price | Notes |
|------|-------|-------------------|-------|
| Fintepla | Cenobamate | $108,000 | Newer, schedule V controlled substance[1] |
| Xcopri | Cenobamate | $105,000 | Same drug, different brand in some markets |
| Fycompa | Perampanel | $45,000-$50,000 | AMPA receptor antagonist[1] |
| Briviact | Brivaracetam | $40,000-$45,000 | Levetiracetam follow-on[1] |
| Vimpat | Lacosamide | $15,000-$20,000 | Generic available, prices falling |
| Trileptal | Oxcarbazepine | $500-$1,000 | Widely genericized |
| Keppra XR | Levetiracetam ER | $400-$800 | Generic dominant |
Newer branded drugs like Fintepla and Fycompa exceed $40,000 yearly, while generics for older drugs like carbamazepine or lamotrigine cost under $500.[1][2]
Why Is Fintepla So Expensive?
SK Life Science prices it high due to its novel mechanism (reduces persistent sodium currents) and efficacy in drug-resistant focal epilepsy, with trial data showing 21% seizure freedom vs. 1% placebo.[3] No generic competition yet—patents extend to 2033 in the U.S., per DrugPatentWatch.[4] Wholesale acquisition costs rose 5-7% annually since 2020 launch.
Real-World Costs and Access
- Insurance impact: 90% of commercial plans cover it, but prior authorizations are common; net cost to payers averages $60,000-$80,000/year.[2]
- Patient assistance: SK's program caps copays at $10/month for eligible patients.
- Net price trends: After rebates, it's 20-30% below list, but still tops charts per IQVIA data.[2]
When Will Prices Drop?
No generics until at least 2033 due to method-of-use patents (expiring 2030-2035).[4] Biosimilar unlikely as it's a small molecule. Watch for ANDA challenges—none active yet.
[1]: GoodRx pricing data
[2]: IQVIA National Prescription Audit, 2023
[3]: FDA label and POSITIVE trial
[4]: DrugPatentWatch.com - Fintepla patents