How to Help Your Patients Save Money on Dhivy: A Provider's Guide to Savings Programs

Dhivy (carbidopa/levodopa, Avion Pharmaceuticals) is a clinically valuable tool for Parkinson's disease management — but as a brand-name-only product without a generic equivalent, its cost can be a significant barrier for patients. The average retail cash price for 90 tablets of Dhivy 25 mg/100 mg is approximately $405, compared to as little as $9 per month for generic carbidopa/levodopa IR with a discount coupon.

This guide is designed to help you help your patients navigate the cost of Dhivy — whether that means leveraging the manufacturer's savings program, documenting prior authorization appeals effectively, or identifying the right patient assistance resources for your most financially vulnerable patients.

Understanding the Dhivy Cost Landscape

Before addressing savings strategies, it helps to understand the cost landscape your patients face:

• Retail cash price (90 tablets): ~$405
• With GoodRx coupon (90 tablets): ~$130 (67% reduction)
• With private insurance: Copay varies; some plans cover Dhivy at Tier 2–3, some may require PA
• With Medicare Part D: Coverage varies by plan; 2026 out-of-pocket cap is $2,100; many plans cover carbidopa/levodopa products at Tier 1–2
• Generic carbidopa/levodopa IR comparison: As low as $9/month with GoodRx — flagging this for patients on tight budgets who may not require Dhivy's precision dosing is appropriate

1. Avion Pharmaceuticals Patient Savings and Support Program

Avion Pharmaceuticals offers a savings and support program for Dhivy patients, accessible at dhivy.com/savings-and-support or by calling 1-888-612-8466. The program offers:

• Copay assistance cards for commercially insured patients — can reduce out-of-pocket copays significantly
• Patient assistance program (PAP) for uninsured or underinsured patients who meet income eligibility
• Starter samples for practices — your office can sign up to receive Dhivy practice samples at dhivyhcp.com

Note: Manufacturer copay cards typically cannot be used for Medicare patients (due to anti-kickback regulations) but are available for commercially insured patients under 65.

2. Third-Party Discount Programs: GoodRx and Alternatives

For uninsured patients or those whose insurance coverage is less than GoodRx pricing, discount programs are an excellent option. GoodRx can reduce Dhivy to approximately $130 for 90 tablets — a 67% reduction from retail. Direct patients to goodrx.com to compare pharmacy prices and download a coupon.

Other programs worth mentioning:

• SingleCare (singlecare.com): Comparable discount program, accepted at most major pharmacy chains
• BuzzRx (buzzrx.com): Alternative discount card accepted at 60,000+ pharmacies nationwide

3. Optimizing Insurance Coverage: Prior Authorization Strategy

Some insurance plans require prior authorization (PA) for Dhivy. A well-documented PA request dramatically improves approval rates. Key elements to include in your PA letter:

1. Diagnosis and clinical context: Document the Parkinson's disease diagnosis date, UPDRS score if available, and current symptom burden.
2. Clinical rationale for Dhivy specifically: Document why Dhivy's precise quarter-dosing is medically necessary for this patient — for example, motor fluctuations requiring 25 mg levodopa incremental adjustments, or dysphagia requiring smaller tablet fragments.
3. Inadequacy of alternatives: Document that generic carbidopa/levodopa tablets cannot reliably be quartered to 6.25/25 mg doses, and that this precision is necessary for the patient's motor management.
4. Prior treatment history: If the patient was previously on generic carbidopa/levodopa and had inadequate dose control, document this trial and failure.

Avion Pharmaceuticals can provide prior authorization support resources — contact their medical affairs team at 1-888-612-8466.

4. Medicare-Specific Considerations

Most of your Parkinson's disease patients will be Medicare-eligible. Key 2026 Medicare considerations for Dhivy:

• $2,100 out-of-pocket cap: As of 2026, Medicare Part D has a $2,100 annual out-of-pocket maximum. Once a patient reaches this cap, the plan pays 100% for the rest of the year.
• Formulary variation: Dhivy's coverage and tier placement vary by plan. Patients whose current plan doesn't cover Dhivy can switch plans during the annual enrollment period (Oct 15 – Dec 7) or, if experiencing a qualifying life event, during a special enrollment period.
• Extra Help (LIS): Patients with limited income and resources may qualify for Medicare's Extra Help program (also called Low-Income Subsidy / LIS), which can dramatically reduce Part D copays. Refer eligible patients to their local SHIP (State Health Insurance Assistance Program) counselor.
• Medicare Prescription Payment Plan: As of 2025, Medicare enrollees can spread their Part D out-of-pocket costs over the year rather than paying large amounts early. This can help patients maintain adherence while managing cash flow.

5. Patient Assistance Programs for Uninsured/Underinsured Patients

For patients who cannot afford Dhivy even with discount programs, refer them to these resources:

• NeedyMeds (needymeds.org): Comprehensive database of manufacturer PAPs, state pharmaceutical assistance programs, and disease-specific foundations
• RxAssist (rxassist.org): Searchable PAP database to identify programs for Dhivy and co-medications
• PAN Foundation (panfoundation.org): Offers financial assistance for patients with Parkinson's disease. Fund availability varies; apply early.
• Parkinson's Foundation Helpline (1-800-4PD-INFO): Can provide medication access resources and referrals to financial assistance programs

6. When to Consider Switching to Generic Carbidopa/Levodopa

Not every patient requires Dhivy's unique four-segment precision. For patients who:

• Are taking only whole or half tablets (no quarter-dosing needed)
• Have stable, well-controlled disease without motor fluctuations
• Face financial hardship and cannot access savings programs

...switching to generic carbidopa/levodopa 25/100 mg IR tablets is a clinically reasonable and far less expensive option ($9/month with GoodRx vs. $130/month for Dhivy). Document the clinical discussion in the chart, and monitor these patients for any change in symptom control after the switch.

Provider Summary: Dhivy Savings Workflow

• Check formulary coverage at point of prescribing
• For commercially insured patients: direct to dhivy.com/savings-and-support for copay card
• For Medicare patients: check Part D formulary; consider if plan switch is warranted; refer to Extra Help if income-eligible
• For uninsured patients: direct to GoodRx first (~$130/90 tabs); then NeedyMeds/RxAssist/PAN Foundation for PAP
• For PA appeals: document clinical rationale for Dhivy's precision dosing feature
• For cost-prohibitive cases: assess whether generic IR tablets could meet clinical needs

For help directing patients to pharmacies that stock Dhivy, visit medfinder.com/providers. For a complete workflow on access management, see our companion article on how to help your patients find Dhivy in stock.