Provider Briefing: Alitretinoin (Panretin Gel) Shortage Status

The ongoing shortage of Alitretinoin 0.1% topical gel (Panretin) continues to impact patient care for AIDS-related Kaposi sarcoma (KS) in 2026. This briefing provides an overview of the current situation, prescribing implications, and practical resources for managing your patients through this disruption.

For the patient-facing version of this update, see our Alitretinoin shortage update for patients.

Shortage Timeline

Here's how the Alitretinoin shortage has unfolded:

• 2025 (Mid-Year): Manufacturing issues at the Advanz Pharma production facility led to reduced output of Panretin Gel. Supply began tightening across US specialty pharmacy networks.
• December 2025: The FDA authorized the temporary importation and sale of EU-approved Panretin Gel tubes in the United States to address the supply gap. This was a notable regulatory intervention, reflecting the severity of the shortage for a medication with no generic alternative.
• Early 2026: Supply remains limited. Both US-labeled and EU-labeled Panretin Gel may be available at different pharmacies, but overall availability is inconsistent. No firm timeline for full supply recovery has been provided by the manufacturer.

Prescribing Implications

The shortage raises several clinical and logistical considerations for prescribers:

Prescription Verification

Pharmacies may contact your office to verify that patients are appropriate candidates for Panretin Gel, particularly given the high cost ($6,000 to $7,500 per tube) and limited supply. Be prepared for additional prior authorization requests from payers.

EU-Labeled Product

The FDA-authorized EU-labeled Panretin Gel contains the same active ingredient (Alitretinoin 0.1%) in the same formulation. Patients may receive tubes with European packaging. Reassure patients that this product is equivalent and FDA-sanctioned for use during the shortage.

Patient Communication

Patients are experiencing significant anxiety about medication access. Proactive communication about the shortage, expected timelines, and backup plans can help reduce patient distress and prevent gaps in treatment. Direct patients to practical guidance on finding Alitretinoin in stock.

Current Availability Picture

Availability varies significantly by region and pharmacy type:

• Specialty pharmacies remain the primary distribution channel and are more likely to have or be able to source stock than retail pharmacies.
• Hospital outpatient pharmacies at cancer centers and HIV clinics may have dedicated supply channels.
• Retail chain pharmacies generally do not stock Panretin Gel and are least likely to have it available during the shortage.

Providers can use Medfinder for Providers to help patients locate pharmacies with current stock. This tool checks real-time availability across multiple pharmacy networks.

Cost and Access Considerations

The financial burden of Panretin Gel is significant even under normal circumstances:

• Cash price: $6,000 to $7,500 per 60-gram tube
• Discount card pricing: Approximately $5,950 through GoodRx or SingleCare
• Insurance: Covered by most Medicare and commercial plans with prior authorization. Specialty tier copays may apply.
• Patient assistance: Eisai offers a Patient Assistance Program for eligible patients. Additionally, organizations like NeedyMeds and RxAssist maintain directories of available assistance programs.

For patients struggling with cost, consider directing them to our comprehensive guide on saving money on Alitretinoin or our provider-focused resource on helping patients save on this medication.

Tools and Resources for Providers

The following resources can assist in managing patients during the shortage:

• Medfinder for Providers: Real-time pharmacy stock lookup for Alitretinoin and other hard-to-find medications. Can be integrated into clinical workflows.
• FDA Drug Shortage Database: Official shortage status and manufacturer communications for Alitretinoin.
• Eisai Patient Assistance Program: Contact Eisai Inc. directly for patient eligibility screening and enrollment in financial assistance programs.
• RxAssist (rxassist.org): Comprehensive database of patient assistance programs, including Eisai's program for Panretin.
• NeedyMeds (needymeds.org): Additional patient assistance program directory with application guidance.

Alternative Treatment Considerations

When Panretin Gel is unavailable, the following alternatives should be considered for localized cutaneous KS based on published evidence:

1. Intralesional Vinblastine: Well-established first-line alternative for localized KS. Injected directly into lesions every 2-3 weeks. Strong evidence base with decades of clinical use.
2. Topical Imiquimod 5% (Aldara): Off-label use for cutaneous KS with positive responses documented in systematic reviews. Immune-mediated mechanism via TLR7 activation. More accessible and significantly less expensive than Panretin.
3. Topical Timolol: Off-label beta-blocker with reported efficacy in case series. May inhibit angiogenesis in KS lesions. Limited but promising evidence; very low cost.
4. Localized Radiation Therapy: Effective for lesions unresponsive to topical treatment or for more extensive localized disease. Requires referral to radiation oncology.

A comprehensive review of these options is available in our alternatives guide. For drug interaction considerations when switching therapies, see our Alitretinoin drug interactions guide.

Looking Ahead

Several factors will determine when the shortage resolves:

• Manufacturing recovery: Advanz Pharma has not provided a public timeline for full production resumption.
• Generic development: No generic ANDA applications for Alitretinoin gel are currently listed with the FDA, meaning a generic alternative is not imminent.
• Continued FDA flexibility: The temporary importation of EU-labeled product may continue as long as the shortage persists.

We recommend maintaining alternative treatment protocols and keeping patients informed about evolving supply conditions.

Final Thoughts

The Alitretinoin shortage presents a genuine challenge for providers managing patients with AIDS-related Kaposi sarcoma. Having a plan that includes alternative therapies, awareness of supply channels, and patient communication strategies will help ensure continuity of care.

Use Medfinder for Providers to help your patients find Alitretinoin in stock, and visit our provider's guide to helping patients find Alitretinoin for actionable workflow tips.