When Your Patients Can't Find Tivicay: A Practical Guide

You've prescribed Tivicay (Dolutegravir) because it's the right medication for your patient. But they call back saying the pharmacy doesn't have it, can't order it, or wants to substitute something else. Sound familiar?

This guide provides a structured approach for helping patients navigate Tivicay access challenges in 2026 — from pharmacy strategies to alternative regimens.

Current Availability

Tivicay 50 mg film-coated tablets are actively manufactured by ViiV Healthcare and are not listed on any formal shortage database. However, real-world availability has become inconsistent due to:

• Specialty pharmacy channeling (many retail pharmacies don't stock it)
• No generic competition (patent through June 2030)
• Formulary shifts toward combination INSTI products
• Discontinued 10 mg and 25 mg strengths (January 2024)

For a full market analysis, see our provider shortage briefing.

Why Patients Can't Find Tivicay

Understanding the patient's experience helps you respond effectively. Common barriers include:

• Pharmacy doesn't stock it: Many chain pharmacies have deprioritized standalone HIV medications in favor of high-volume combination products
• Insurance directs to specialty pharmacy: The patient may need to fill through a specific specialty pharmacy they're not aware of
• Prior authorization delays: Some plans require PA for standalone Dolutegravir when combination products are preferred
• Cost shock: Patients without adequate coverage see the ~$2,900 cash price and assume they can't afford it

What Providers Can Do: 5 Steps

Step 1: Identify the Right Pharmacy

Use Medfinder for Providers to check real-time availability at pharmacies near your patient. This tool shows which pharmacies have Tivicay in stock, saving your staff time on phone calls.

Step 2: Route to Specialty Pharmacy

If the patient's insurance requires a specialty pharmacy, identify it early and send the prescription directly. Most HIV specialty pharmacies stock Tivicay reliably. Work with your practice's pharmacy liaison to maintain an updated list of preferred specialty pharmacies.

Step 3: Address Insurance Barriers Proactively

If the plan requires prior authorization for standalone Tivicay:

• Submit the PA with clinical justification (resistance profile, failed alternatives, combination product contraindication)
• Use the plan's expedited review process when the patient is at risk of treatment interruption
• Contact ViiV Healthcare's reimbursement support team through ViiVConnect for payer-specific guidance

Step 4: Enroll in Financial Support

Connect eligible patients with cost-reduction programs:

• ViiVConnect Savings Card (myviivcard.com): Commercially insured patients may pay $0 copay
• ViiV Patient Assistance Program: Free medication for qualifying uninsured/underinsured patients
• ADAP/Ryan White: State and federal programs for low-income patients

Step 5: Have a Backup Plan

If Tivicay remains unavailable despite these steps, be prepared with an alternative regimen. Pre-identify which alternatives are appropriate for each patient so you can pivot quickly without a treatment gap.

Alternative Regimens to Consider

When standalone Tivicay isn't accessible, consider these evidence-based alternatives:

• Dovato (Dolutegravir/Lamivudine): Contains the same active INSTI. Appropriate for treatment-naive patients or those switching from suppressive regimens without resistance history. Simpler for patients — one pill, complete regimen.
• Biktarvy (Bictegravir/Emtricitabine/TAF): Different INSTI with excellent efficacy data. Most prescribed first-line regimen in the U.S. May have broader retail availability.
• Triumeq (Abacavir/Dolutegravir/Lamivudine): Contains Dolutegravir in a three-drug combination. Requires HLA-B*5701 testing before initiation.
• Cabenuva (Cabotegravir/Rilpivirine): Long-acting injectable for virologically suppressed patients. Eliminates daily adherence barriers but requires clinic visits for administration.
• Generic Raltegravir: Available and more affordable. Consider for patients with cost barriers or specific clinical scenarios where twice-daily INSTI is acceptable.

Workflow Tips for Your Practice

Streamline Tivicay access management with these practice-level strategies:

• Pharmacy partnership: Establish a relationship with 1–2 specialty pharmacies that consistently stock HIV antiretrovirals. Route Tivicay prescriptions there by default.
• Refill tracking: Flag Tivicay patients for early refill reminders (7+ days before running out) to allow time for sourcing.
• Template PA letters: Keep pre-written prior authorization letters for standalone Dolutegravir that document clinical necessity.
• Patient education handouts: Share links to patient-facing resources like How to Find Tivicay in Stock and How to Save Money on Tivicay.
• Medfinder bookmark: Add medfinder.com/providers to your practice's quick-access tools for real-time pharmacy availability checks.

Final Thoughts

Tivicay availability challenges are manageable with the right systems in place. By proactively routing prescriptions to specialty pharmacies, addressing insurance barriers early, connecting patients with financial support, and maintaining alternative regimen plans, you can minimize treatment disruptions and keep your patients virologically suppressed.

For more on the current market landscape, read our Tivicay shortage provider briefing.