The Cost Challenge: Reyvow in 2026

Reyvow (lasmiditan) carries a retail cash price of approximately $850–$1,100 for 8 tablets. With no generic available and permanent discontinuation approaching (U.S. distribution ends May 31, 2026), cost remains a significant barrier for patients who still benefit from this medication.

As a prescriber, you're in a unique position to help patients navigate savings programs, insurance hurdles, and patient assistance options. This guide consolidates the financial tools available for Reyvow in 2026 so you can efficiently direct patients to the right resources.

For clinical context on the discontinuation, see our provider guide to the Reyvow discontinuation.

Manufacturer Savings Programs

Reyvow Savings Card (Eli Lilly)

The Reyvow Savings Card remains active for commercially insured patients during the remaining distribution period.

Key details:

• Eligible patients: Commercially insured (private insurance, employer plans)
• Savings: Eligible patients may pay as little as $0 per prescription fill
• Annual cap: Up to $3,400 in savings per calendar year
• Not eligible: Medicare, Medicaid, TRICARE, VA, or other government-funded insurance programs
• Enrollment: Patients can enroll at Reyvow.com or by calling Lilly's support line

Clinical workflow tip: Have your office staff proactively mention the savings card when prescribing Reyvow. Many patients don't know it exists. Consider keeping enrollment information in your EHR quick-text templates for Reyvow prescriptions.

Duration note: Confirm with Eli Lilly that the savings card program remains active, as it may wind down before or concurrent with the distribution end date of May 31, 2026.

Lilly Cares Foundation Patient Assistance Program

For uninsured or underinsured patients who cannot afford Reyvow, the Lilly Cares Foundation provides the medication at no cost to qualifying individuals.

Eligibility criteria:

• Must be a U.S. resident
• Must be uninsured, underinsured, or functionally unable to afford the medication
• Income requirements apply (contact Lilly Cares for current thresholds)
• Medicare Part D patients in the coverage gap may qualify

How to apply:

1. Download the application at lillycares.com
2. Complete the patient and prescriber sections
3. Submit with proof of income and insurance status
4. Processing typically takes 2–4 weeks

Provider role: The prescriber section requires your signature, NPI, and a valid prescription. Designate a staff member to handle PAP applications — the process is straightforward but requires follow-through.

Important consideration: Given the discontinuation timeline, patients applying now should act quickly. PAP supply may be limited as Lilly winds down production.

Insurance Optimization Strategies

Prior Authorization Best Practices

Most commercial insurers require prior authorization (PA) for Reyvow, typically with step therapy requiring documentation of trials with 2+ generic triptans.

Tips for efficient PA approval:

• Document triptan trials clearly — Include specific drugs, doses, duration, and reason for discontinuation (inadequate response, adverse effects, contraindication)
• Highlight cardiovascular contraindications — If the patient cannot use triptans due to cardiovascular risk factors, this is the strongest clinical justification for Reyvow
• Use diagnosis codes precisely — G43.x codes for migraine; specify with/without aura
• Include the discontinuation context — Note that this is a time-limited request given Reyvow's upcoming discontinuation. Some utilization review committees may expedite approval given the circumstances

Appeals Process

If PA is denied:

1. Peer-to-peer review: Request to speak with the insurer's medical director. Emphasize the clinical rationale, particularly cardiovascular contraindications to triptans.
2. Letter of medical necessity: Document the patient's full treatment history, including failed alternatives.
3. External review: If internal appeals are exhausted, patients have the right to an external review by an independent reviewer.

Formulary Exceptions

Some plans may grant formulary exceptions for Reyvow if the prescriber demonstrates that formulary alternatives are clinically inappropriate. Document why CGRP-based alternatives (Ubrelvy, Nurtec ODT, Zavzpret) are not suitable if applicable — for example, if the patient has tried and failed these medications.

Third-Party Discount Programs

For patients paying cash or facing high copays, several third-party platforms offer discount pricing:

Coupon and Discount Card Platforms

• GoodRx — Compare prices across local pharmacies; may offer 10–30% off cash price
• SingleCare — Free prescription discount card accepted at most major chains
• RxSaver — Price comparison tool from RetailMeNot
• Optum Perks — Discount card with pharmacy network pricing
• BuzzRx — Free savings card with local pharmacy pricing

Realistic expectations: For a brand-name medication like Reyvow with no generic competition, discount card savings are typically modest (10–30% off cash price). The manufacturer savings card will almost always provide better value for commercially insured patients.

For a comprehensive list of savings options, direct patients to our patient guide to Reyvow coupons and savings programs.

Helping Government-Insured Patients

Patients with Medicare, Medicaid, TRICARE, or VA coverage are not eligible for the Reyvow Savings Card. Options for these patients include:

• Lilly Cares PAP — Medicare Part D patients in the coverage gap may qualify
• State pharmaceutical assistance programs (SPAPs) — Some states offer supplemental drug coverage for Medicare beneficiaries
• NeedyMeds (needymeds.org) — Database of assistance programs searchable by drug name
• RxAssist (rxassist.org) — Comprehensive database of patient assistance programs
• Medicare Extra Help/Low-Income Subsidy (LIS) — Helps low-income Medicare beneficiaries with Part D costs

Transition Planning: The Cost-Conscious Approach

Given Reyvow's discontinuation, every conversation about cost should also include transition planning. Consider these factors:

If the Patient Is Doing Well on Reyvow

• Help them maximize remaining supply through savings programs
• Begin discussing alternative medications now — don't wait until supply runs out
• Consider trial prescriptions of alternatives while Reyvow is still available as backup

If Cost Is the Primary Barrier

• Ubrelvy and Nurtec ODT have their own savings programs and may ultimately be more sustainable options
• Generic triptans (sumatriptan, rizatriptan) cost as little as $5–$15 per prescription for patients without cardiovascular contraindications
• Transitioning earlier avoids the stress of finding Reyvow in stock during the final months

For a clinical overview of alternative medications, see our provider guide to finding Reyvow in stock and the alternatives to Reyvow guide.

Creating a Financial Support Workflow in Your Practice

To consistently help patients access affordable Reyvow (and other specialty medications), consider implementing a standardized workflow:

1. At prescribing: Staff mentions manufacturer savings card and provides enrollment information
2. At PA submission: Include complete documentation per the tips above
3. If PA denied: Immediate peer-to-peer request; concurrent PAP application for eligible patients
4. At follow-up: Verify patient was able to fill; troubleshoot any remaining cost barriers
5. Transition planning: Begin alternative medication discussions at least 2–3 months before anticipated supply depletion

Designating a team member as a "medication access coordinator" — even informally — can dramatically improve patient outcomes and reduce prescriber burden.

Provider Resources

• MedFinder for Providers — medfinder.com/providers — Tools to help providers locate medications for their patients
• Lilly Cares PAP — lillycares.com
• NeedyMeds — needymeds.org
• RxAssist — rxassist.org

The Bottom Line

Reyvow's high cost and lack of a generic make financial support essential for most patients. The manufacturer savings card ($0 copay for eligible patients) and Lilly Cares PAP (free medication for qualifying uninsured patients) are the two most impactful programs. For government-insured patients, state pharmaceutical assistance programs and organizations like NeedyMeds can help fill the gap.

With discontinuation approaching, pair every financial assistance conversation with a transition plan. Your patients will thank you for thinking ahead.