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

Helping patients navigate Actemra (tocilizumab) access challenges is now a regular part of rheumatology practice. Whether the barrier is insurance step therapy, a localized stock shortage, or a patient who simply can't find the right formulation, providers need a systematic approach. This guide gives you the practical tools and communication strategies to help your patients get the medication they need.

Step 1: Identify the Specific Barrier Before Recommending a Solution

When a patient reports they can't get Actemra, the first question is why. The solution depends on the barrier:

• Insurance denial or step therapy: Prior auth required, biosimilar step needed → Prior auth appeal, prescribe preferred biosimilar first
• Pharmacy/infusion center doesn't have it: Localized stock shortage → Direct to alternate pharmacy, use medfinder, consider formulation switch
• Cost is prohibitive without insurance: Patient assistance, co-pay card → Genentech programs (see below)
• Patient is on Medicare: Co-pay card not applicable → Explore PAN Foundation, Genentech Patient Foundation, state programs

Step 2: Activate Genentech's Patient Access Programs

Genentech offers several programs that your office can activate on behalf of patients:

• Actemra Co-pay Program (racopay.com): Commercially insured patients may pay $0 per treatment, up to $15,000 per calendar year. Register at racopay.com or call 1-855-722-6729.
• Genentech Patient Foundation: Free Actemra for uninsured patients or those with incomes within eligibility guidelines. Requires prescriber form and patient consent form. Call 1-888-941-3331 (Mon–Fri 6AM–5PM PST).
• Genentech Access Solutions: Helps navigate insurance and locate supply. Call 1-888-249-4918 or visit genentech-access.com.

Step 3: Direct Patients to the Right Pharmacy Channels

For IV Actemra, the medication is only dispensed through clinical channels — your infusion center or hospital pharmacy. If your affiliated infusion center is out of stock, consider:

• Contacting your authorized distributor (wholesaler) to check available SKUs from different tocilizumab manufacturers
• Checking whether neighboring health systems or infusion suites have available product
• Considering a temporary transition to SC formulation for eligible patients

For SC Actemra, direct patients to specialty pharmacies that distribute biologics. Key national specialty pharmacy contacts:

• CVS Specialty: 1-800-237-2767
• Walgreens Specialty: 1-800-496-8600
• Accredo (Express Scripts): 1-800-803-2523
• Optum Specialty Pharmacy: 1-855-427-4682

Step 4: Have Patients Use medfinder to Check Local Availability

For patients who self-inject Actemra SC and are having trouble finding it at their usual specialty pharmacy, recommend medfinder. medfinder calls pharmacies near the patient to check which ones can fill a prescription, and texts the patient with results. This eliminates the frustrating cycle of patients calling multiple pharmacies on their own.

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Step 5: Manage the Prior Authorization Process Proactively

Prior authorization (PA) is a top contributor to Actemra access delays. Best practices for PA management:

• Submit PA renewals at least 30 days before expiration — most run 12 months
• Include specific clinical data: DAS28 scores, lab values (CRP, ESR), prior therapy failures
• Document any contraindications or intolerances to biosimilar products — this is typically the key to overriding step therapy
• If PA is denied, file a peer-to-peer review with the payer's medical director promptly

Reporting Local Shortages

The ACR encourages providers experiencing local tocilizumab outages to report through the FDA Drug Shortages Public Portal (accessdata.fda.gov/scripts/drugshortages) and to contact the ACR at practice@rheumatology.org for member support. Collective reporting helps flag systemic issues.

For a broader clinical overview of the shortage landscape, see our guide on what providers need to know about the Actemra shortage in 2026.