How to Help Your Patients Find Anucort-HC in Stock: A Provider's Guide

For gastroenterologists, colorectal surgeons, and primary care providers who prescribe Anucort-HC, there's a growing operational challenge: patients who can't find it at their pharmacy. The result is a flood of callbacks, refill request confusion, and sometimes unnecessary delays in anti-inflammatory treatment that can worsen outcomes for patients with hemorrhoids, proctitis, or ulcerative colitis. This guide provides actionable strategies to get ahead of the problem.

Understanding Why Patients Can't Fill Anucort-HC

Anucort-HC (hydrocortisone acetate 25 mg rectal suppository) is distributed by Cosette Pharmaceuticals as a brand-name specialty product. Unlike high-volume oral medications, rectal suppositories are lower-turnover items at retail pharmacies, and many chains keep only a small quantity on hand or don't stock Anucort-HC specifically (preferring to stock generics or competing brands when they bother ordering any at all).

Patients presenting a brand-specific Anucort-HC prescription often hit a wall at a pharmacy that carries only the generic or a different brand. Without explicit guidance from your office, they don't know whether a substitution is appropriate — leading to callbacks and treatment gaps.

Strategy 1: Write Prescriptions Generically to Maximize Pharmacy Flexibility

The single most effective way to reduce access barriers is to write the prescription as "hydrocortisone acetate 25 mg rectal suppository" rather than specifying Anucort-HC by brand name. This gives the pharmacist the flexibility to dispense whatever equivalent formulation they have in stock — whether it's the generic, Anusol-HC, Proctosol-HC, or another brand — without needing to call your office for authorization.

If you are using an e-prescribing platform, ensure the DAW (Dispense As Written) field is set to 0 ("no product selection indicated" or "generic allowed"). This is especially important if the patient is on a cost-sensitive plan.

Strategy 2: Provide Patients an Approved Substitutes List at the Visit

Give patients a brief written note (or have it printed in their discharge paperwork) listing brands your office considers therapeutically equivalent to Anucort-HC:

Generic hydrocortisone acetate 25 mg rectal suppository

Anusol-HC (hydrocortisone acetate 25 mg suppository)

Proctosol-HC (hydrocortisone acetate 25 mg suppository)

Hemmorex-HC (hydrocortisone acetate 25 mg suppository)

Proctozone HC (hydrocortisone acetate 25 mg suppository)

Empowering patients to request these at the pharmacy counter — rather than calling your office — reduces callbacks significantly.

Strategy 3: Direct Patients to medfinder for Pharmacy Location

Rather than having your front desk staff research pharmacy stock, direct patients to medfinder. The service contacts pharmacies near the patient to check which ones can fill their prescription, then texts the results to the patient. This takes the phone-call burden off both the patient and your staff.

medfinder covers all medications — not just shortage drugs — so it's a useful patient resource for any hard-to-find prescription.

Strategy 4: Proactively Address Prior Authorization at the Time of Prescribing

Several insurers (including some Cigna plans) have step therapy requirements for hydrocortisone acetate suppositories. This means the patient may need to demonstrate failure with a generic or OTC product before their plan will cover the brand-name Anucort-HC. If you are prescribing Anucort-HC by brand name for a patient with one of these plans, initiate the prior authorization at the time of prescribing rather than waiting for the pharmacy to reject it.

Alternatively, if there is no clinical reason to require the brand specifically, writing generically avoids the prior authorization process entirely, getting the patient their medication faster.

Strategy 5: Consider Escalating to Mesalamine for IBD Patients

For patients with ulcerative proctitis, this may be an opportunity to transition to first-line therapy. AGA guidelines recommend mesalamine suppositories (1 g once daily) as preferred first-line treatment for ulcerative proctitis, with significantly superior remission rates compared to rectal corticosteroids. If your patient is currently on Anucort-HC for ulcerative proctitis, consider whether transitioning to mesalamine is clinically appropriate and would avoid future access issues.

Building an In-Office Protocol for Anucort-HC Access Issues

Consider building a brief standing protocol for your staff to follow when a patient calls reporting they cannot fill their Anucort-HC prescription:

Advise patient to try independent or hospital-affiliated pharmacies, or to use medfinder

If unavailable after search: contact prescriber to authorize generic or branded equivalent

If condition is IBD-related: flag for prescriber to consider mesalamine as alternative

Document the access delay in the chart and follow up within 3-5 business days to confirm patient received medication

For a clinical overview of availability and alternative recommendations, see our guide on what providers need to know about the Anucort-HC shortage in 2026.