For patients with moderate-to-severe TD symptoms due to use of DRBAs that persist after withdrawal of the offending agent or for those without alternative treatment options for the underlying condition, valbenazine and deutetrabenazine demonstrated short-term, modest objective improvement but inconsistent subjective patient-reported improvement. At current pricing, their cost-effectiveness and potential budget impact far exceed common thresholds, and because the clinical trials were short-term, many questions remain about long-term benefits and harms. Thus, despite being approved by the FDA, there is little rationale to prescribe these drugs for the treatment of tardive dyskinesia.