Actemra Shortage Update: What Patients Need to Know in 2026

Actemra (tocilizumab) has had one of the most dramatic shortage histories of any biologic medication in recent years. From a catastrophic supply collapse in 2021 to the entry of biosimilar competitors, the supply landscape has shifted significantly. Here's where things stand for patients in 2026 — and what you should know to protect your treatment access.

The History: How Actemra's Shortage Began

Before 2021, Actemra was a predictable specialty medication with a stable supply chain. That changed dramatically when the FDA granted an Emergency Use Authorization (EUA) for IV tocilizumab to treat hospitalized COVID-19 patients in June 2021. The COVID-19 Delta variant surge that summer caused demand for IV Actemra to spike more than 400% above pre-pandemic levels in just two weeks, according to Genentech. By August 16, 2021, all standard-sized IV vials were completely out of stock nationwide.

The shortage was "highly unusual," as pharmacy experts noted at the time — shortages typically affect low-cost generics, not expensive brand-name biologics. But tocilizumab's manufacturing complexity (it's made using living cell systems) meant Genentech couldn't rapidly increase output, and a global race for the drug ensued.

The Recovery: 2022 Through 2024

By 2022, Genentech had significantly increased manufacturing capacity and announced stable supply of all Actemra IV and SC configurations. Allocations were removed and normal ordering resumed. Then, biosimilar competition arrived:

• September 2023: FDA approves Tofidence (tocilizumab-bavi) — IV formulation, first biosimilar
• March 2024: FDA approves Tyenne (tocilizumab-aazg) — first biosimilar with both IV and SC formulations; launched April 2024
• May 2024: Tofidence commercially launched

2025–2026: A Third Biosimilar Arrives, But New Stocking Issues Emerge

January 2025 brought the FDA approval of Avtozma (tocilizumab-anoh), made by Celltrion, in both IV and SC formulations. The IV version commercially launched October 2025; the SC version became available in 2026. With three biosimilars now on the market alongside brand Actemra, the tocilizumab supply pool is larger than at any point in the drug's history.

However, the American College of Rheumatology issued a notice to members in 2025–2026 about regional supply constraints affecting Tyenne (tocilizumab-aazg) specifically, due to increased demand. This illustrates a recurring challenge: even with more products on the market, demand fluctuations can still cause localized shortages of specific formulations.

Current Status in 2026: What Does This Mean for You?

As of 2026, here is the situation:

• Brand Actemra supply is generally stable. Genentech restored normal ordering after the 2021–2022 crisis.
• Biosimilars expand options. Three FDA-approved biosimilars now on the market mean patients have more tocilizumab products to choose from.
• Specific formulations can still be regionally scarce. Individual pharmacies, infusion centers, and hospitals may be out of specific SKUs.
• Insurance step therapy is a growing challenge. Many insurers now require trying biosimilars first, adding delays even when brand Actemra is technically available.

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What Patients Should Do Right Now

Even with a more stable supply picture, smart patients plan ahead:

1. Refill early — don't wait until your last dose to reach out to your specialty pharmacy or infusion center.
2. Ask your doctor to have a biosimilar pre-authorized as a backup — this means you have a fallback if brand Actemra is temporarily unavailable.
3. Report local shortages to the FDA — you can do so at FDA.gov/drug-shortages or call 1-800-FDA-1088.
4. Use medfinder to check which pharmacies near you have your specific Actemra formulation in stock.

For more on why this medication has been hard to find, see our deep-dive into why Actemra is so hard to find. Or visit medfinder to check current pharmacy availability near you.