Provider Briefing: Emgality Supply in 2026

If your patients are reporting difficulty filling Emgality (Galcanezumab-gnlm) prescriptions, the issue is real and ongoing. As of early 2026, Emgality remains on the ASHP drug shortage list due to increased demand, with no specific resolution date from Eli Lilly.

This briefing covers the current supply situation, clinical implications for prescribing, available alternatives, and practical tools to help your patients maintain access to CGRP-based migraine prevention.

Shortage Timeline

Emgality supply issues have followed a pattern of intermittent disruptions rather than a complete stockout:

• Late 2022: First widespread patient reports of difficulty finding Emgality at major retail chains (CVS, Walgreens). Pharmacies cited inability to obtain stock from wholesalers.
• 2023: ASHP formally listed Galcanezumab-gnlm on its drug shortage database, citing increased demand from Lilly as the cause. Eli Lilly confirmed supply constraints but stated there was no formal manufacturing disruption.
• 2024-2025: Intermittent availability continued. Some regions and pharmacies reported consistent access, while others — particularly retail chains reliant on single wholesalers — experienced recurring gaps.
• Early 2026: The shortage listing remains active. Supply has improved compared to 2022-2023 peaks, but inconsistency persists, especially in areas with high CGRP inhibitor prescribing volume.

Prescribing Implications

The supply situation introduces several clinical considerations:

Treatment Continuity

Gaps in Emgality treatment can lead to increased migraine frequency. While missing one monthly dose doesn't cause withdrawal (Galcanezumab is not a controlled substance and has a half-life of approximately 27 days), patients may experience a return of migraine attacks within 1-2 months of discontinuation. Counsel patients to:

• Refill prescriptions 5-7 days before their next scheduled injection
• Have a backup pharmacy identified in case their primary pharmacy is out of stock
• Report supply issues to your office so you can help troubleshoot or switch therapies proactively

Prior Authorization Burden

Most commercial and Medicare plans require prior authorization for Emgality, with many also mandating step therapy (typically failure of 2+ preventive medications such as Topiramate, Propranolol, or Amitriptyline). If you're considering switching a patient to an alternative CGRP inhibitor due to availability, be aware that:

• A new prior auth may be required for the replacement agent
• Some insurers accept documentation that a patient was stable on a CGRP inhibitor as partial justification for approving a different one
• The prior auth process can take 1-3 weeks, so initiate early if you anticipate a switch

No Biosimilar on the Horizon

As of 2026, no biosimilar for Galcanezumab has been approved or is in late-stage development. Eli Lilly remains the sole manufacturer. This means supply constraints are likely to continue until either production capacity expands or demand redistributes across the broader CGRP inhibitor class.

Current Availability Picture

Availability varies significantly by pharmacy type and region:

• Specialty pharmacies: Most consistent access. Many insurance plans route biologic prescriptions through designated specialty pharmacies, which typically maintain better stock of CGRP inhibitors.
• Mail-order pharmacies: Generally reliable for patients enrolled in mail-order specialty programs.
• Retail chains (CVS, Walgreens, Rite Aid): Most variable. Stock depends on individual store ordering patterns and wholesaler allocation.
• Independent pharmacies: Often have better access due to relationships with multiple wholesalers.

Providers can direct patients to Medfinder for Providers to check real-time pharmacy availability in their area.

Cost and Access Considerations

Cost remains a significant barrier to access, independent of supply:

• Wholesale Acquisition Cost (WAC): Approximately $723 per 120 mg pen
• Patient cash price: $700-$950/month without insurance
• Emgality Savings Card: Eligible commercially insured patients pay as little as $0 for the first month, then $35/month for up to 12 months. Not available for government insurance beneficiaries.
• Lilly Cares Foundation: Patient assistance program providing Emgality free to qualifying uninsured patients
• Prescription Hope: Third-party program offering Emgality for $70/month for qualifying patients

When cost-related non-adherence is a concern, refer patients to our savings guide: How to save money on Emgality. For provider-specific cost guidance, see How to help patients save money on Emgality: A provider's guide.

Tools and Resources for Providers

Medfinder for Providers

Medfinder offers a provider-facing tool that checks pharmacy stock in real time. You can search by drug and location to identify pharmacies that currently have Emgality available — useful for point-of-care conversations with patients about where to fill their prescription.

Eli Lilly Provider Resources

Lilly offers prior authorization support, including pre-populated forms and payer-specific requirements, at emgality.lilly.com/hcp. Their provider support line can also assist with locating stock: 1-833-364-2548.

ASHP Drug Shortage Updates

Monitor the ASHP Drug Shortages Resource Center (ashp.org/drug-shortages) for the latest status updates on Galcanezumab-gnlm supply.

Alternative CGRP Inhibitors: Clinical Comparison

When switching is clinically appropriate, the following alternatives are available:

• Aimovig (Erenumab) 70-140 mg SC monthly: Targets the CGRP receptor (different mechanism than Galcanezumab). May be effective in patients who did not respond to CGRP ligand antibodies. Constipation and hypertension are more commonly reported than with Emgality.
• Ajovy (Fremanezumab) 225 mg SC monthly or 675 mg SC quarterly: Targets CGRP ligand (same mechanism as Emgality). Quarterly dosing is a differentiator. Most pharmacologically similar to Emgality.
• Vyepti (Eptinezumab) 100-300 mg IV every 3 months: Targets CGRP ligand. Administered in-office as a 30-minute IV infusion. Fastest onset of all CGRP inhibitors. Consider for patients who benefit from provider-administered treatment.
• Qulipta (Atogepant) 10-60 mg PO daily: Oral CGRP receptor antagonist. Best option for injection-averse patients. Approved for both episodic and chronic migraine prevention.

For patient-facing information on alternatives, direct patients to: Alternatives to Emgality.

Looking Ahead

The CGRP inhibitor market continues to evolve. New formulations, expanded indications, and eventual biosimilar competition may improve access over time. In the interim, proactive prescribing — including identifying backup medications, enrolling patients in savings programs, and using tools like Medfinder — is the most effective strategy for maintaining treatment continuity.

For practical workflow integration, see our companion guide: How to help your patients find Emgality in stock: A provider's guide.

Final Thoughts

The Emgality shortage is a demand-driven supply constraint that affects patient access unevenly across regions and pharmacy types. As a prescriber, you can mitigate the impact by using real-time stock-checking tools, having an alternative CGRP inhibitor identified for each patient, supporting prior authorization submissions proactively, and connecting patients with cost-assistance resources.

Patients trust their providers to help them navigate these challenges. With the right tools and planning, you can help ensure your migraine patients stay on effective preventive therapy — whether that's Emgality or a well-chosen alternative.