Austedo is the brand name for deutetrabenazine, an oral VMAT2 inhibitor (vesicular monoamine transporter 2 inhibitor) manufactured by Teva Pharmaceuticals. FDA approved Austedo in 2017 for chorea associated with Huntington's disease and for tardive dyskinesia (TD), an involuntary movement disorder often caused by long-term use of antipsychotic or certain other medications. Austedo XR is a once-daily extended-release formulation approved in 2022 as a convenience alternative to the twice-daily Austedo tablet. Both formulations contain the same active molecule.
Austedo's 2026 retail list price sits at approximately $6,526 per month for the most common dosage, according to GoodRx and pharmacy pricing surveys. That positions it among the costliest oral specialty neurological drugs on the US market. The Inflation Reduction Act of 2022 selected Austedo for the second round of Medicare price negotiations, and CMS announced the negotiated Maximum Fair Price of $4,093 per month effective January 1, 2027. Patients prescribed Austedo in 2026 are still subject to the current list price unless they qualify for the Teva Cares Foundation patient assistance program, the Teva copay card (commercially insured only), or Medicare Extra Help. Reviewing the federal poverty level guidelines can help determine whether you qualify for the income-based Teva Cares program.
Medicare Part D total spending on Austedo exceeded $1.68 billion in 2024, underscoring the drug's outsized cost burden on federal insurance programs. Starting January 1, 2027, all Medicare Part D plans will be required to cover both Austedo and Austedo XR on their formularies at the negotiated Maximum Fair Price. Patients who currently lack formulary coverage in 2026 should know that mandatory formulary inclusion is a 2027 change tied specifically to the Round 2 IRA Maximum Fair Price. Patients managing related conditions should also compare Medicaid income limits for their state, since Medicaid can cover Austedo for eligible low-income patients with prior authorization.
What Austedo Costs by Point of Pay (2026)
The price you pay depends almost entirely on WHERE you pay. The same austedo can cost many times more at a hospital than at your local pharmacy:
2026 Austedo Price by Point of Pay| Where you pay | Typical cost | Notes |
|---|
| Pharmacy counter (retail cash, no insurance) | $4,925 - $7,741/month | GoodRx coupon brings the standard formulation to roughly $4,925 for 60 tablets. Without a coupon, retail averages $6,526/month in 2026. |
| Medicare Part D (2026, specialty tier 5) | Variable until $2,100 annual OOP cap is reached; then $0 | Most Part D plans place Austedo on tier 5 at 25-33% coinsurance. At $6,526/month list price, patients typically hit the $2,100 OOP cap within one to two fills. |
| Commercial insurance (specialty tier) | $100 - $500/month after prior authorization | Prior authorization is standard. The Teva copay card can reduce cost to $0 for eligible commercially insured patients. |
| Teva copay card (commercially insured patients) | $0 per prescription (eligible commercially insured patients) | Not available to Medicare, Medicaid, TRICARE, or VA beneficiaries. Maximum annual savings limits apply. See austedo.com for current terms. |
| Medicaid | $1 - $4/prescription, with prior authorization | Covered for tardive dyskinesia and Huntington's chorea in most states. Coverage and PA requirements vary by state Medicaid program. |
Retail cash prices reflect 2026 GoodRx and pharmacy survey data for the standard twice-daily Austedo formulation. Part D ranges depend on your plan's formulary tier placement and how far into your benefit year you are. The IRA Round 2 Maximum Fair Price of $4,093 per month takes effect January 1, 2027.
Source: CMS Part D 2026 benefit parameters, GoodRx 2026 pharmacy survey, Teva Austedo patient programs, CMS IRA Round 2 negotiated prices
Why Hospitals Charge So Much
Austedo is an outpatient oral specialty drug taken at home; it is rarely dispensed in an inpatient hospital setting. When a patient with a tardive dyskinesia or Huntington's disease diagnosis is admitted to a hospital and their Austedo supply is not brought from home, the hospital pharmacy may dispense the drug at facility acquisition cost plus a substantial markup. Inpatient hospital pharmacies routinely layer facility fees, pharmacy handling charges, and overhead allocation onto specialty drug acquisition costs, which can push the per-tablet charge well above the retail list price.
Three structural factors drive high facility charges for oral specialty drugs like Austedo. First, hospitals bill using a chargemaster rate that bears little resemblance to the drug's acquisition cost. Second, specialty drugs dispensed during inpatient stays are bundled into the DRG payment and are not separately billable to Medicare Part D, so the cost falls on the inpatient DRG rate. Third, uninsured or self-pay patients are most exposed because they lack a contracted rate between the payer and the hospital. Patients who receive Austedo in any facility setting should request an itemized bill and compare the per-tablet charge to the retail list price. Charges of $200 to $400 per tablet (versus a retail per-tablet cost of roughly $109 at list) are common dispute targets and can be negotiated with the hospital financial assistance office.
Patient Assistance Programs
Teva Pharmaceuticals operates two distinct programs for Austedo cost reduction. Commercially insured patients can use the Teva copay card (a manufacturer coupon that applies at the pharmacy counter) to reduce their out-of-pocket cost to $0 per fill, subject to annual limits. Uninsured patients with incomes at or below 300 percent of the Federal Poverty Level can apply for free Austedo through the Teva Cares Foundation Patient Assistance Program, which has income-verified eligibility reviewed within 10 business days. Understanding which program applies to you is critical: the copay card is for commercially insured patients only and is blocked by federal anti-kickback law for any government insurance beneficiary.
Patient assistance programs for Austedo| Manufacturer program | Cost / Benefit | How to apply |
|---|
| Teva Copay Card (Austedo / Austedo XR) | $0 per prescription for eligible commercially insured patients; maximum annual savings limits apply | austedo.com/tardive-dyskinesia/financial-support |
| Teva Cares Foundation Patient Assistance Program | Free Austedo for uninsured or underinsured patients with household income at or below 300% of FPL | tevacaresportal.org |
| NeedyMeds Drug Discount Card | Variable discount accepted at most US pharmacies; may reduce cash price by 10 to 25 percent | needymeds.org |
Manufacturer copay cards and savings programs are not available to Medicare, Medicaid, TRICARE, or VA beneficiaries under the federal anti-kickback statute (42 U.S.C. Section 1320a-7b). If you have any government insurance, the Teva copay card is legally barred. Apply for the Teva Cares Foundation income-based PAP instead. Patients with Medicare Part D who qualify for Extra Help (Low-Income Subsidy) pay reduced copays as low as $0 to $12.65 per fill for Austedo.
Source: Teva Pharmaceuticals austedo.com/tardive-dyskinesia/financial-support, Teva Cares Foundation tevacares.org, NeedyMeds.org
Medicare Part D
Austedo is a Medicare Part D drug. For 2026, your total annual out-of-pocket spending across all Medicare Part D drugs is capped at $2,100 under the Inflation Reduction Act of 2022. Because Austedo's list price is approximately $6,526 per month, most Medicare patients on standard specialty-tier cost-sharing (25 to 33 percent coinsurance) will reach the $2,100 annual cap after one or two monthly fills. Once you hit the $2,100 out-of-pocket threshold, Medicare pays $0 cost-sharing for covered Part D drugs for the remainder of the calendar year, including Austedo.
Medicare Part D plans typically place Austedo on specialty formulary tier 5, the highest cost-sharing tier. Prior authorization is standard across virtually all Part D plans for Austedo. If your plan denies prior authorization, you have the right to file a coverage exception or appeal within 60 days. Starting January 1, 2027, all Part D plans will be required to cover both Austedo and Austedo XR as a result of the IRA Round 2 price negotiation, which means patients who currently face formulary exclusion will gain mandatory coverage. The 2027 negotiated Maximum Fair Price of $4,093 per month is a significant step toward affordability for the approximately 72 percent of Part D enrollees who were already covered in 2024. Patients can also enroll in the Medicare Prescription Payment Plan to spread 2026 Part D costs evenly across the year rather than facing a large first-of-year bill.
Patients enrolled in Medicare Extra Help (Low-Income Subsidy) pay significantly reduced Austedo copays. In 2026, full-subsidy Extra Help enrollees pay no more than $12.65 per fill for brand-name drugs like Austedo. Eligibility for Extra Help is based on income and assets; Medicare.gov has a screening tool to check eligibility. Extra Help can be especially valuable for Austedo because the drug's specialty tier cost-sharing would otherwise be substantial before the $2,100 OOP cap is reached.
Common Austedo Billing Errors
If you receive an Austedo bill that exceeds expected cost-sharing under your plan, check for these common billing problems before paying:
- Prior authorization not submitted or expired: virtually every insurance plan requires an active PA for Austedo. An expired or missing PA means your claim is processed as cash-pay. Confirm PA status with your prescriber before each refill.
- Formulary tier mismatch: Austedo and Austedo XR have different NDC codes. If your plan covers one formulation but not the other, your pharmacist may inadvertently fill the non-covered version. Confirm which NDC your plan covers.
- Charged full specialty tier coinsurance after exceeding the $2,100 Part D annual out-of-pocket cap: once you reach $2,100, your cost-sharing for covered Part D drugs drops to $0 for the rest of the year. Pharmacies occasionally fail to apply this automatically.
- Teva copay card not applied at point of sale even though you are commercially insured and eligible: ask the pharmacist to run the claim with the copay card BIN and PCN before paying any amount.
- Inpatient facility charge for Austedo included in an itemized hospital bill at many times the retail per-tablet price: request the NDC-level line item, compare to the retail per-tablet list price of approximately $109 (for 6mg tablets, list price), and file a dispute if the facility charge is disproportionate.
Frequently Asked Questions
How much does Austedo cost without insurance in 2026?
The cash retail price for Austedo in 2026 is approximately $4,925 to $7,741 per month for a 30-day supply, depending on strength and pharmacy. The standard twice-daily formulation (60 tablets, 6mg) averages about $6,526 per month at retail without insurance, or roughly $4,925 with a GoodRx coupon. Austedo XR (once-daily extended release) carries a higher list price near $9,480 per month. If you are uninsured and your household income is at or below 300 percent of the Federal Poverty Level, the Teva Cares Foundation patient assistance program can supply Austedo free of charge.
Is there a generic or biosimilar for Austedo (deutetrabenazine)?
No. As of June 2026, no FDA-approved generic for deutetrabenazine is commercially available. Austedo is not a biologic, so biosimilar pathways do not apply. Teva holds multiple patents on the compound and formulation. At least one pharmaceutical company has filed for generic approval, and patent challenges under Paragraph IV are ongoing. The earliest potential generic launch based on Paragraph IV challenge outcomes could be as soon as 2027, though formulation and method patents may extend Teva's market exclusivity well beyond that. Patients should not assume a generic will be available in 2026.
How do I apply for the Teva Cares Foundation patient assistance program for Austedo?
To apply for the Teva Cares Foundation PAP for Austedo, visit tevacaresportal.org or call 1-877-237-4881. You will need a valid Austedo prescription, proof of household income (tax return or pay stubs) showing income at or below 300 percent of FPL, proof of US residency, and a signed prescriber co-signature on the application. Submit online, by fax to 1-877-438-4404, or by mail to their San Diego address. Processing takes about 10 business days. If your income is below 150 percent FPL and you have Medicare, you must first apply for Medicare Extra Help and submit the denial letter before Teva Cares will consider your application.
Can I use the Austedo copay card with Medicare?
No. Federal anti-kickback law (42 U.S.C. Section 1320a-7b) bars manufacturer copay cards from being used by Medicare, Medicaid, TRICARE, or VA beneficiaries. The Teva Austedo copay card is for commercially insured patients only. If you have Medicare, your cost-reduction options are the Teva Cares Foundation income-based PAP (for uninsured or underinsured patients at or below 300% FPL), Medicare Extra Help (Low-Income Subsidy), or the Medicare Prescription Payment Plan to spread Part D costs across the year.
Does the IRA negotiated price apply to Austedo in 2026?
Not yet in 2026. Austedo was selected for IRA Round 2 Medicare price negotiation under the Inflation Reduction Act of 2022. CMS announced the negotiated Maximum Fair Price of $4,093 per month, which is a 38 percent reduction from the current list price of approximately $6,623. That Maximum Fair Price takes effect January 1, 2027. In 2026, you pay the current list price and standard cost-sharing. Starting in 2027, all Medicare Part D plans will be required to cover Austedo and Austedo XR on their formularies at the negotiated Maximum Fair Price.
Does Medicare Part D cover Austedo in 2026?
Most Medicare Part D plans cover Austedo in 2026, though coverage varies by plan. Austedo is typically placed on specialty tier 5 with 25 to 33 percent coinsurance and requires prior authorization. The 2026 annual out-of-pocket cap for all Part D drugs combined is $2,100 under the Inflation Reduction Act. Because Austedo's specialty tier cost-sharing on a $6,526 list price is substantial, most Medicare patients will reach the $2,100 cap quickly and then pay $0 for the rest of the year. Starting January 1, 2027, all Part D plans must cover Austedo at the negotiated Maximum Fair Price due to the IRA Round 2 mandatory formulary inclusion requirement.
What if my insurance denies coverage for Austedo?
If your plan denies Austedo, you have multiple options. First, request a written denial notice and file a formal appeal within 60 days. Ask your neurologist or psychiatrist to initiate a peer-to-peer review with the plan's medical director, which overturns denials at a meaningful rate. If your plan requires a step-therapy alternative first, request a step-therapy override if you have already tried and failed an alternative VMAT2 inhibitor. If internal appeals fail, escalate to an independent external review through your state Department of Insurance (commercial plans) or MAXIMUS Federal Services (Medicare Part D). As a fallback, apply for the Teva Cares Foundation PAP if your income is at or below 300 percent of FPL.
Do I qualify for the Teva Cares Foundation patient assistance program for Austedo?
To qualify for the Teva Cares Foundation PAP for Austedo in 2026, your total household income must be at or below 300 percent of the Federal Poverty Level. For a single-person household, that is income at or below $47,880 per year. For a family of four, the threshold is $99,000 per year. You must also reside in the United States, have a valid Austedo prescription from a licensed US physician, and not have prescription drug insurance that covers Austedo. If you have Medicare and your income is below 150 percent FPL, you must first apply for Medicare Extra Help and provide proof of denial before Teva Cares will review your application. Non-income eligibility requirements include US residency, a valid prescription, and no qualifying prescription drug coverage.
