Bronchitol Shortage Update: What Patients Need to Know in 2026

If you've been prescribed Bronchitol (inhaled mannitol) for cystic fibrosis and are worried about whether it will be available in 2026, this article gives you the clearest current picture of the supply situation — in both the United States and Europe.

Is Bronchitol in Shortage in the United States in 2026?

No. As of 2026, Bronchitol is not listed on the FDA's official drug shortage database in the United States. The U.S. supply, which is managed by Chiesi USA through a network of specialty pharmacies, is generally stable.

When patients in the U.S. have difficulty accessing Bronchitol, it's typically not a supply shortage — it's a system access problem: prior authorization delays, specialty pharmacy routing issues, or cost barriers. These are important to distinguish because the solutions are different.

The European Bronchitol Shortage: What's Happening

The situation in Europe is very different. In October 2024, Pharmaxis Europe Limited — the company that developed Bronchitol and markets it in the EU — planned to change its distributor. That transition took longer than anticipated in several EU member states, causing supply disruptions and shortages.

In some member states where the distributor change was not successful, Pharmaxis made the commercial decision to discontinue Bronchitol entirely from October 2025 onward. In countries where Bronchitol is still being marketed — Germany, Ireland, Italy, and Spain — shortages are still occurring, and no new patients should be started on Bronchitol in those markets until the initiation dose assessment packs return to normal supply.

The European Medicines Agency (EMA) has classified this as an ongoing medicine shortage and issued communications to healthcare professionals in affected member states. This shortage is not related to any quality defect or safety issue with the product.

Does the EU Shortage Affect U.S. Patients?

No — the U.S. and EU supply chains for Bronchitol are completely separate. Chiesi USA distributes Bronchitol in the United States and 11 other non-EU countries under a different distribution arrangement than Pharmaxis Europe. The EU distributor transition problems do not affect U.S. supply.

Why Does Bronchitol Sometimes Feel Hard to Find in the U.S.?

Even without a true shortage, U.S. patients commonly experience access friction with Bronchitol for these reasons:

Specialty pharmacy routing: Bronchitol cannot be dispensed at regular retail pharmacies — only approved specialty pharmacies

Prior authorization: Most insurers require prior authorization, which can take days to weeks to process

Bronchitol Tolerance Test requirement: The BTT must be completed before any prescription can be written

High cost: At ~$3,826/month without insurance, cost creates an effective access barrier for many patients

What U.S. Patients Should Do If They Can't Get Bronchitol

Contact your CF care team. They can reroute your prescription to a specialty pharmacy known to carry Bronchitol.

Contact Chiesi CareConnect. They offer prescription routing, copay assistance, and patient assistance programs.

Appeal insurance denials. If your prior authorization was denied, ask your CF team to submit a medical necessity appeal.

Explore bridge therapy. Ask your doctor about using hypertonic saline temporarily while access is being resolved.

Use medfinder. medfinder calls pharmacies on your behalf to find which ones can fill your Bronchitol prescription near you.

What European Patients Should Do

If you're in the EU and currently taking Bronchitol, the EMA recommends contacting your pharmacy or doctor well before your current supply runs out. In countries where Bronchitol is being discontinued, your healthcare team will discuss alternative mucolytic treatments such as hypertonic saline or dornase alfa. You should continue your standard CF care throughout.

For a full breakdown of CF treatment alternatives, see: Alternatives to Bronchitol If You Can't Fill Your Prescription.

Also see: Why Is Bronchitol So Hard to Find? [Explained for 2026].