Baqsimi Shortage: What Providers and Prescribers Need to Know in 2026

Baqsimi (glucagon nasal powder 3 mg) has become the standard of care for rescue glucagon in many practices — and for good reason. Its needle-free delivery dramatically lowers the administration barrier for caregivers and patients. However, as of 2026, providers across specialties continue to report patient-level access challenges that require clinical navigation.

This guide covers the current availability landscape, evidence-based alternative options, and practical strategies for ensuring your patients with diabetes have glucagon on hand at all times.

Current Baqsimi Availability Status (2026)

Baqsimi is not listed on the FDA Drug Shortage Database or the ASHP Drug Shortage Resource Center as of 2026. Amphastar Pharmaceuticals (current NDA holder following acquisition from Eli Lilly) continues to manufacture and distribute the product nationally.

Despite the absence of a formal shortage designation, providers should be aware that localized stock-outs are common and can affect patient access acutely. Structural factors driving these gaps include:

No generic equivalent: Baqsimi is the only nasal glucagon on the US market, with a single supply chain from Amphastar.

High acquisition cost (~$300-$400/device): Limits pharmacy stocking depth, particularly at independent pharmacies.

Demand growth: Expanded FDA approval in 2025 to include patients ages 1 and older increases the eligible prescribing population.

Formulary variability: Tier placement and prior authorization requirements differ significantly across payer contracts.

Regulatory and Label Updates Relevant to Prescribers

The 2025 FDA label update (reference ID 5551153) is clinically significant for prescribers:

Age range expanded from 4 years and older to 1 year and older.

Dosing remains fixed at 3 mg (one intranasal device) regardless of age or weight for patients 1 year and older.

The 2025 label confirms that common cold with nasal congestion does not significantly impact pharmacokinetics or pharmacodynamics.

NDA now held by Amphastar Pharmaceuticals — provider inquiries: 1-800-423-4136.

Clinical Alternatives When Baqsimi Is Inaccessible

A 2023 systematic literature review and indirect treatment comparison published in Diabetes Therapy evaluated all three modern ready-to-use glucagon products: Baqsimi (nasal), Gvoke (subcutaneous), and Zegalogue (dasiglucagon subcutaneous). Key clinical findings:

All three achieved treatment success (blood glucose increase ≥20 mg/dL within 30 minutes) in over 98% of patients.

Baqsimi produced a statistically lower mean maximum blood glucose rise: 168 mg/dL vs. 220 mg/dL for Gvoke and 190 mg/dL for Zegalogue — potentially relevant for posttreatment euglycemia restoration.

No statistically significant differences in serious adverse events across all three.

Clinical alternative summary for prescribers:

Gvoke (glucagon, Xeris Pharmaceuticals): Ready-to-use subcutaneous autoinjector (HypoPen) or prefilled syringe (PFS). Approved ages 2+. Weight-based dosing for pediatric patients under 12. Mechanism identical to Baqsimi's glucagon.

Zegalogue (dasiglucagon, Zealand Pharma): Glucagon analog with 7 amino acid substitutions. Approved ages 6+. Autoinjector or prefilled syringe. Stable up to 3 years refrigerated; 1 year at room temperature.

Traditional glucagon kits (GlucaGen, Novo Nordisk): Requires reconstitution. Widely stocked. Appropriate when ready-to-use options are unavailable; caregiver training on reconstitution is essential.

Formulary Navigation Strategies for 2026

Baqsimi's formulary tier varies significantly by insurer. Strategies to maximize coverage:

Check the patient's insurance formulary before prescribing — some plans may prefer Gvoke or Zegalogue at a lower tier, which can be an acceptable therapeutic substitution.

Submit medical necessity prior authorization for Baqsimi when needleless administration is clinically indicated (e.g., severe needle phobia in caregivers, young children, patients with dexterity limitations).

For commercially insured patients, the Baqsimi Got Your BAQ savings card reduces cost to as little as $25 (up to 2 devices, 12 fills/year, $1,800 annual cap) — communicate this proactively at the point of prescribing.

For uninsured or underinsured patients, refer to the Lilly Cares Patient Assistance Program (1-800-545-6962) — qualifying low-income patients may receive Baqsimi at no cost.

Patient Counseling Points for Prescribers

Every patient prescribed Baqsimi should leave your office understanding:

Baqsimi is for emergency use only — not a substitute for daily diabetes management.

Caregivers must know where the device is stored and how to use it. Provide the Instructions for Use (or direct them to baqsimi.com).

Always call emergency services (911) after administering Baqsimi.

Do not test or prime the device — it contains only one dose and cannot be reused.

If pharmacy stock is unavailable, they can ask for a special order (1-2 business day lead time at most pharmacies) or use medfinder to locate nearby stock.

Using medfinder in Your Practice Workflow

medfinder is a service that helps patients locate medications in stock at pharmacies near them. By integrating medfinder into your discharge or prescription workflow, you can reduce callbacks from patients unable to fill Baqsimi — and help ensure continuity of emergency glucagon coverage. Visit medfinder.com/providers to learn more about how medfinder supports care teams.

Key Contraindications and Drug Interactions to Review at Prescribing

Contraindications to prescribe against:

Pheochromocytoma (may stimulate catecholamine release from tumor)

Insulinoma (may cause rebound hypoglycemia via insulin release)

Known hypersensitivity to glucagon or excipients (betadex, dodecylphosphocholine)

Notable drug interactions to counsel on:

Warfarin: Baqsimi may potentiate anticoagulant effect — monitor INR after use.

Beta-blockers: May blunt glucagon's tachycardic effect; may also mask hypoglycemia symptoms.

Indomethacin: May blunt the glucose-raising effect of glucagon or cause hypoglycemia.

Summary: A Framework for Baqsimi Access in 2026

Prescribing Baqsimi is only half the job. Helping patients actually get it filled — and have a backup plan when they can't — is equally important. See our dedicated provider guide on how to help your patients find Baqsimi in stock for practice-level workflow tools and resources.