Abilify®—Is It Worth It?
My doctor recently gave me a prescription for Abilify, a fast-acting antidepressant for patients with major depressive disorder. I couldn’t shake a depression that had kept me in bed for most of a month. Although I’d been taking a maintenance dose of Zoloft for years, it wasn’t potent enough to prevent this episode. I needed a drug that would supplement the Zoloft.
Abilify was developed by Bristol-Myers Squibb for patients with major clinical depression resistant to treatment with standard antidepressants. (It’s used for other psychiatric indications, too.) Abilify is intended to serve as an add-on treatment.
After 5 days of 10 mg of Abilify nightly, I felt my depression start to lift. I was regaining my motivation to move around and get things done. By day 7, I was pretty much back to normal, working on writing projects, talking with friends, and running errands. My enthusiasm for life was returning
By day 8, I was a bit too enthusiastic. My mood was slightly manic. My speech was pressured. At the same time, my body felt clumsy and my balance shaky. I took two falls in a week. Also, I was becoming surprisingly forgetful. In the middle of a conversation, I’d lose track of the topic. When going to another room to get something, I’d forget what it was by the time I got there. According to clinical studies, impaired memory is sometimes reported by Abilify users. My other symptoms weren’t listed among adverse events associated with taking the medication, but they felt like side effects.
Since my mood was lightening, the doctor suggested lowering the dose to 5 mg by splitting the pills in half. Then, if the improvement continued after several days, I could take one quarter of a pill. After that, I could stop altogether.
While the effects of Abilify were gratifying, the cost of the drug was daunting. My pharmacist told me a 30-day supply would cost $834.00. When he saw my shock, he asked whether I had insurance. I said no. He suggested that I apply to Bristol-Myers Squibb online for a discount coupon. I did that and found that the application could take up to two weeks to process—too long for me. I bought a 7-day supply of Abilify for $199 from my pharmacist and ordered the rest from a Canadian pharmacy, where the cost was only $165 for a 30-day supply. It would arrive by the time my initial supply was used up.
Abilify comes in six dosage strengths, ranging from 2 mg to 30 mg. In the U.S., a one-month supply of any of the four lower doses is the same—about $800. The two higher doses sell for about $1200. In Canada, the same branded product costs 80% less.
Why Canadian Prices Are Lower
The reason Canadian prices for Abilify are so much lower is that Canada, like many other countries, imposes price controls on retail medications. In the U.S., the sky’s the limit. Pharmaceutical lobbies in Washington have persuaded Congress that the high prices are justified by the cost of research and development. While this is true, the profits are often many times the amount needed to reach this goal. It’s true, too, that drug companies need to be compensated for their risk in developing new drugs that never come to market because FDA approval can’t be obtained. When this happens, they rely on the profits from other branded drugs to make up for their losses.
After Abilify sales had been tallied for the last 10 months in 2013, Bristol-Myers Squibb was found to net $16.4 billion. Only $3.7 billion of this was needed to recoup research costs. The company is undoubtedly currently maximizing profits before generic products are introduced in the U.S. in mid-2015.
Why Are Abilify Tablets So Tiny?
The tiny size of Abilify tablets may have been a measure of Bristol-Myers Squibb to deter users from sectioning high-dose tablets into pieces; pill-splitting is a money-saving exercise. A doctor may prescribe 5 mg of an expensive drug per day, but write a 15-mg prescription so the patient can score the tablets in thirds and cut costs. Sectioning is difficult with the tiny Abilify tablets. Using a pill crusher is an option, but even this is tricky for a patient trying to divide a 30-mg pill into sixths to achieve separate 5-mg doses.
Bristol-Myers Squibb warns consumers to “take tablets whole.” There’s no pharmacological need for this, as the density and composition of each tablet are uniform throughout. The Discmelt formulation of Abilify is the exception.
Is Abilify Worth It?
Who wouldn’t pay a lot of money to recover from a severe clinical depression? It’s like death to many of us. We’re convinced that it’s permanent. Knowing that a rescue drug is available is priceless.
If I need the Abilify again in the future, I’ll buy ten 10-mg tablets from Canada ($55.00) and take one pill a day for six days. I’ll cut two pills in half and take the half-pills for four nights. I’ll quarter one and take the quarters for four nights. (This will leave one pill just in case.) Abilify will then most certainly be worth it.
Hi Barbara- Thanks for this helpful article. I’ve been dealing with depression on and off for years, trying different meds, etc. Abilify was prescribed recently and is helpful, but as you say, ridiculously $$$ even with some insurance coverage. I’m taking quite a low dosage, cutting a tiny pill in half and now I understand why they’re so small.
You reported that you took Abilify for a limited time, reducing dosage gradually and eventually going off it all together. I’m worrying about being on it long term as I’m having some memory issues.
Am considering ordering from Canada. Is there a downside to doing this? Does simply mailing your doc’s Rx to the pharmacy do the trick?
Thanks for your help!
In response to your questions about Abilify….I started taking it for acute depression after Zoloft and Wellbutrin failed to bail me out when the going got really rough. It worked beautifully when I took it to get me on the road again, then quit after a few days, just long enough for the depression to lift. I did this two or three times. Then my doctor said I shouldn’t fool around with this starting/stopping routine and just take a very low dose on a long-term basis, at least for the immediate future. I’ve been on 2.5 mg/day for about 3 months. The Abilify is working well, and I’m pleased with it. Events that would have triggered another depression haven’t done so. I plan to continue it for a while, even though the cost is ridiculous. I know better than to come off the drug cold turkey after chronic use, so I’m in a wait-and-see mode for the present. The way I take my 2.5-mg dose is to split one 10-mg tablet in half and take half every other day. My reasons are totally economic. The drug has such a long half-life that you can do this and be OK. I checked with my doctor.
You can get U.S.-made Abilify from several Canadian pharmacies for much less than from any U.S. sources. Just go to PharmacyChecker.com. One pharmacy, Canada Drugs, sells 30 2-mg tablets for $129.50 and 28 10-mg tablets for $103.50. If you make sure the order comes from U.K., Australia, NZealand, or Israel, you won’t have to worry about bogus drugs. (I learned that the hard way.)
Best of luck!