Auvi-Q Shortage: What Providers and Prescribers Need to Know in 2026

Provider Briefing: Epinephrine Auto-Injector Availability in 2026

The epinephrine auto-injector market continues to face supply chain challenges that directly impact your patients with anaphylaxis risk. As a prescriber, staying current on which products are available — and how to access them — is critical to ensuring your patients maintain uninterrupted access to this life-saving medication.

This briefing covers the current state of Auvi-Q availability, the broader epinephrine shortage landscape, prescribing considerations, and tools to help your patients access their medication.

Timeline: The Epinephrine Auto-Injector Shortage

The supply disruptions affecting epinephrine auto-injectors are not new, but they continue to evolve:

• 2012: Auvi-Q originally approved by the FDA
• 2015: Kaléo voluntarily recalls Auvi-Q due to potential dosing concerns; product temporarily off the market
• 2017: Auvi-Q relaunched with a new direct-to-patient distribution model through ASPN Pharmacies
• 2018: Pfizer manufacturing issues lead to widespread EpiPen shortages; ASHP lists epinephrine auto-injectors on drug shortage database
• 2018–2024: Recurring shortages of EpiPen and generic versions, particularly during back-to-school season (July–September)
• June 2025: ASHP confirms ongoing shortage of several epinephrine auto-injectors; Auvi-Q is not affected
• 2026 (current): Auvi-Q remains available with confirmed supply from Kaléo. EpiPen and generic shortage status varies by region

Prescribing Implications

The shortage landscape has several practical implications for prescribers:

Product Availability Varies Significantly

EpiPen and its authorized generic hold approximately 90% of the epinephrine auto-injector market. When these products face shortages, the impact is widespread. Auvi-Q, manufactured independently by Kaléo, has maintained consistent supply because it uses a separate manufacturing process and distribution network.

Auvi-Q Requires Specific Prescribing Pathways

Unlike EpiPen, Auvi-Q is not widely stocked at retail pharmacies. Prescriptions should be routed through one of two channels:

1. ASPN Pharmacies — Send prescriptions via EMR, phone, or fax for direct-to-patient home delivery. The ASPN Prescriber Portal allows real-time prescription tracking.
2. Walgreens — In-store pickup is available at Walgreens locations. Prescriptions can be sent directly.

Writing a prescription for "epinephrine auto-injector" generically will likely result in the pharmacy dispensing EpiPen or its generic — not Auvi-Q. If Auvi-Q is the preferred product, specify it by brand name.

The 0.1 mg Dose Is Unique to Auvi-Q

Auvi-Q is the only epinephrine auto-injector with a 0.1 mg dose for infants and toddlers weighing 16.5–33 lbs (7.5–15 kg). For this patient population, there is no auto-injector alternative. EpiPen Jr's 0.15 mg dose starts at 33 lbs.

Current Availability Picture

Here's the current availability status for epinephrine auto-injectors:

• Auvi-Q (Kaléo): Available — not in shortage. Distributed through ASPN Pharmacies and Walgreens.
• EpiPen / EpiPen Jr (Viatris): Intermittent shortages reported; availability varies by pharmacy and region.
• Generic Epinephrine Auto-Injector (Viatris): Intermittent shortages; subject to the same manufacturing constraints as brand EpiPen.
• Adrenaclick / Generic Adrenaclick: Generally available but not universally stocked.
• Symjepi: Available; prefilled syringe (not auto-injector). Requires patient education on manual injection technique.

For real-time availability data, Medfinder for Providers can help you and your staff determine which pharmacies have specific products in stock.

Cost and Access Considerations

Cost remains a significant barrier to medication adherence for patients prescribed epinephrine auto-injectors:

Auvi-Q Pricing

• Cash price: $360 through ASPN Pharmacies; up to $820+ at retail
• Copay Support Program: Commercially insured patients may pay $0–$150 out-of-pocket
• Patient Assistance Program (PAP): Free Auvi-Q for uninsured patients with financial hardship
• Contact: 1-877-30-AUVIQ (1-877-302-8847) or auvi-q.com/get-auvi-q

Comparative Pricing (2-Pack)

• Brand EpiPen: $650–$700
• Generic EpiPen: $300–$400 with coupons
• Generic Adrenaclick: $150–$300
• Auvi-Q (through ASPN): $360 cash; often $0 with copay program

Insurance formulary placement varies. Some plans require step therapy (generic EpiPen before Auvi-Q) or prior authorization. When submitting prior authorization, documenting the patient's preference for voice-guided instructions, the unique form factor, or the need for the 0.1 mg pediatric dose can support approval.

Tools and Resources for Your Practice

ASPN Prescriber Portal

Register at the ASPN Prescriber Portal to electronically prescribe Auvi-Q, track prescription status, and manage refills. Prescriptions can also be called in or faxed.

Medfinder for Providers

Medfinder provides real-time pharmacy availability data that your staff can use to direct patients to pharmacies with epinephrine auto-injectors in stock.

Patient Education Resources

Auvi-Q comes with a reusable trainer device (no needle, no medication) for practice. Kaléo also provides training videos at auvi-q.com. Consider having trainer devices available in your office for patient education.

School and Community Access

Auvi-Q is available through authorized distributors for schools, first responders, daycares, and community organizations. Contact Kaléo for institutional purchasing information.

Looking Ahead

The epinephrine auto-injector shortage is likely to persist as a structural issue in the market. Factors driving continued supply disruption include:

• Concentrated manufacturing (few facilities produce the majority of devices)
• Seasonal demand spikes during back-to-school periods
• Limited generic competition specifically for auto-injector devices
• Regulatory and manufacturing complexity of combination products (drug + device)

Familiarizing your practice with multiple epinephrine products — including their prescribing pathways, injection techniques, and patient assistance programs — will help ensure your patients maintain access regardless of which products face shortages.

Final Thoughts

Auvi-Q offers a reliable, in-stock alternative for patients who need epinephrine auto-injectors. Its unique distribution model requires a slightly different prescribing workflow, but the ASPN Pharmacies system and Walgreens partnership provide dependable access.

For your patients who are struggling with availability or cost, direct them to Medfinder for Providers and consider enrolling them in Kaléo's copay support or patient assistance programs. For more patient-facing information, share our guide on finding Auvi-Q in stock or the patient shortage update.