A provider briefing on Auvelity XR availability in 2026. Current supply status, prior authorization landscape, prescribing considerations, and tools to help patients access their medication.
If you prescribe Auvelity XR (dextromethorphan/bupropion extended-release), you're likely fielding questions from patients who can't find it at their pharmacy. This provider briefing covers the current supply landscape, payer dynamics, and practical tools to help your patients maintain access to their medication.
August 2022: The FDA approved Auvelity (dextromethorphan HBr/bupropion HCl) for the treatment of major depressive disorder in adults, making it the first oral NMDA receptor antagonist approved for MDD.
Late 2022 – 2023: Axsome Therapeutics launched Auvelity commercially. Initial uptake was gradual as payer coverage policies were established and prescriber awareness grew. Early adopters were primarily psychiatrists treating patients with inadequate response to SSRIs and SNRIs.
2024: Prescribing volume increased substantially as clinical data and real-world experience reinforced efficacy signals from the GEMINI and ASCEND trials. Payer coverage expanded but remained inconsistent, with most plans requiring prior authorization and step therapy.
2025: Axsome introduced the extended-release formulation (Auvelity XR), improving dosing convenience. Growing prescriber adoption led to increased demand, particularly in metropolitan areas with high psychiatry density.
Early 2026: Auvelity XR is not on the FDA drug shortage list. However, localized availability gaps persist due to pharmacy stocking patterns and wholesaler allocation dynamics.
Axsome Therapeutics reports adequate manufacturing capacity for current demand. The supply chain from manufacturer to wholesaler is intact. The bottleneck occurs at the pharmacy level, where stocking decisions create a patchwork of availability.
Prior authorization remains a significant barrier to patient access. The current payer landscape includes:
Coverage approval rates are highest when documentation clearly supports:
Understanding the manufacturer → wholesaler → pharmacy pipeline helps explain why patients encounter availability gaps:
The standard 45 mg/105 mg strength is the most readily available. Pharmacies that stock Auvelity XR typically carry this formulation, as it covers both the titration and maintenance phases.
Availability tends to be better in urban and suburban areas with higher concentrations of psychiatry practices and specialty pharmacies. Rural areas may have more limited access, making medication finder services and mail-order options particularly valuable for these patients.
The wholesale acquisition cost (WAC) for Auvelity XR places the retail cash price at approximately $900-$1,300 per month for most patients paying out of pocket.
The Auvelity Savings Card from Axsome reduces the copay to as little as $10 per fill for eligible commercially insured patients. This program has been critical for patient retention. Enrollment is available at auvelity.com/savings.
Medicare Part D patients are not eligible for the manufacturer copay card (per federal anti-kickback statute). Their out-of-pocket costs depend entirely on plan tier placement and coverage phase. Medicaid coverage varies by state, with some programs offering more favorable access than others.
The Axsome Patient Assistance Program provides Auvelity XR at no cost for qualifying uninsured or underinsured patients. Providers can help patients apply through the Axsome support portal or direct patients to resources like NeedyMeds and RxAssist.
Several developments may impact Auvelity XR access in the coming months:
As prescribers, you are uniquely positioned to advocate for your patients' access to Auvelity XR. Understanding the supply chain dynamics, payer landscape, and available support programs enables you to proactively address access barriers before they lead to treatment interruptions.
Key actions for your practice:
Related resources for providers:
Share this patient-facing update with your patients: Auvelity XR Shortage Update for Patients
You focus on staying healthy. We'll handle the rest.
Try Medfinder Concierge FreeMedfinder's mission is to ensure every patient gets access to the medications they need. We believe this begins with trustworthy information. Our core values guide everything we do, including the standards that shape the accuracy, transparency, and quality of our content. We’re committed to delivering information that’s evidence-based, regularly updated, and easy to understand. For more details on our editorial process, see here.
%2C%20Color%3DOriginal.png)
