How to Help Your Patients Find Myobloc in Stock: A Provider's Guide

Patients prescribed Myobloc (rimabotulinumtoxinB) for cervical dystonia or chronic sialorrhea often struggle to find it at their local pharmacy. As a prescriber, you're in the best position to guide patients through the access process — and in many cases, to remove barriers entirely through in-office procurement. This guide walks through the most effective strategies.

Why Myobloc Is Hard for Patients to Find

Myobloc is a brand-only specialty injectable with no generic equivalent. It requires cold chain storage (36°F–46°F), is expensive (average retail ~$1,777 per 10,000-unit vial), and serves a small patient population — primarily adults with type A botulinum toxin resistance. As a result, most retail pharmacies simply don't stock it. Patients are often left making calls to multiple specialty pharmacies before finding a source, or they end up without their medication.

Option 1: Stock Myobloc In Your Practice

The most effective way to eliminate access barriers for your Myobloc patients is to purchase and stock it directly in your practice. This approach is standard at many neurology and movement disorder clinics, and is particularly practical if you see multiple Myobloc patients regularly.

To set up in-office stocking:

Contact Solstice Neurosciences (Supernus Pharmaceuticals) at 1-888-461-2255 or visit myobloc.com to establish an account with their specialty distributor network

Ensure your clinic has appropriate refrigeration (2°C–8°C / 36°F–46°F) that can be reliably maintained — do not freeze

Order the vial sizes that match your patient dosing needs: 2,500 units/0.5 mL, 5,000 units/mL, or 10,000 units/2 mL

Bill appropriately: Myobloc is billed by units under HCPCS — check current CMS coding guidelines for the current J-code

Option 2: Establish a Relationship with a Specialty Pharmacy

If in-office stocking isn't feasible, establishing a referral relationship with a specialty pharmacy that carries Myobloc is the next best option. The following networks may carry it:

Accredo (Express Scripts) — national specialty pharmacy with neurology drug expertise

CVS Specialty — separate network from retail CVS; handles cold chain injectables

Walgreens Specialty — specialty pharmacy division

Hospital outpatient pharmacies affiliated with neurology or movement disorder centers

When referring a patient to a specialty pharmacy, confirm that:

The pharmacy is in-network for the patient's insurer

Prior authorization is in place or submitted before the patient calls

The pharmacy can ship with cold chain packaging if the patient will not pick up in person

Option 3: Point Patients to medfinder

For patients who need to locate Myobloc on their own, medfinder is a practical tool: patients enter their medication, dosage, and zip code, and medfinder calls pharmacies to check availability, then texts the results. For your practice, medfinder's provider portal can facilitate patient referrals when pharmacy search is needed.

Managing Prior Authorization for Myobloc Patients

PA is the single greatest access barrier for new Myobloc patients. To streamline the process:

Submit PA requests at least 4–6 weeks before the planned injection date

Document type A toxin history clearly: product names, doses, treatment dates, and clinical response or lack thereof

Include neutralizing antibody testing results if available

For denials, pursue peer-to-peer review — most insurance medical directors will authorize Myobloc when there's a clear clinical rationale for type A failure

Patient Financial Assistance

For commercially insured patients facing high cost-sharing, the Myobloc copay program offers $0 medication and administrative service costs up to $4,000 per year. For uninsured or underinsured patients, a patient assistance program (PAP) may be available through Supernus Pharmaceuticals. Encourage your office staff to proactively check eligibility for these programs for any new Myobloc patient.

For more on the insurance landscape and access strategies, see: Myobloc: What Providers Need to Know in 2026.