Your Patient Needs Addyi — Now What?

You've diagnosed your patient with hypoactive sexual desire disorder (HSDD), discussed treatment options, and determined that Addyi (Flibanserin) is the right choice. The clinical decision was straightforward — but getting the medication into your patient's hands often isn't.

Addyi's limited retail distribution means that simply sending a prescription to your patient's preferred pharmacy frequently results in a callback: "We don't carry that." This guide provides a practical workflow for ensuring your patients can actually access the medication you prescribe.

Current Availability: What You Need to Know

Addyi is not in an FDA-reported shortage, but its distribution model creates real access barriers:

• PhilRx mail-order pharmacy is the primary dispensing channel (always in stock)
• Most major chain pharmacies (CVS, Walgreens, Walmart) do not routinely stock Addyi
• Some independent pharmacies carry it or can special-order it
• No generic Flibanserin is available (estimated May 2028)
• REMS is no longer required — removed by FDA in April 2019

For the full availability picture, see our companion briefing: Addyi shortage: what providers need to know in 2026.

Why Patients Can't Find Addyi

Understanding the patient experience helps you anticipate and prevent access issues:

1. Pharmacy doesn't stock it: Patient arrives at pharmacy, told it's not in stock and can't be ordered quickly
2. Sticker shock: Patient learns the retail price is $800–$1,173/month and abandons the prescription
3. Insurance denial: Patient's plan doesn't cover Addyi or requires prior authorization they weren't expecting
4. Confusion about alternatives: Patient is told by pharmacy staff that "there's nothing they can do" and gives up

Each of these scenarios is preventable with the right prescribing workflow.

What Providers Can Do: 5 Steps

Step 1: Set Expectations During the Visit

Before writing the prescription, let your patient know:

• Addyi may not be available at their regular pharmacy
• The best route is typically PhilRx mail-order pharmacy
• Cash pricing through PhilRx is $149/month (vs. $800+ retail)
• With insurance and the Addyi coupon, cost may be as low as $20/month
• The medication is taken at bedtime and should be discontinued after 8 weeks if no improvement

This simple conversation dramatically reduces prescription abandonment.

Step 2: Route the Prescription to PhilRx

The single most impactful step you can take is sending the prescription directly to PhilRx rather than the patient's retail pharmacy. PhilRx:

• Always has Addyi in stock
• Automatically applies the manufacturer coupon
• Handles prior authorization for insured patients
• Ships directly to the patient with free delivery

Electronic prescribing to PhilRx is available through most EHR systems. Fax is also accepted. Details at addyihcp.com.

Step 3: Provide the Addyi Coupon Information

Give your patient the website addyicoupon.com so they can activate the manufacturer's savings program. This is especially important for:

• Commercially insured patients (can reduce copay to $20/month)
• Cash-pay patients (reduces cost from $800+ to $149/month through PhilRx)

Note: The manufacturer coupon is not valid for patients with government insurance (Medicare, Medicaid, Tricare).

Step 4: Use Medfinder for Local Pharmacy Options

If your patient strongly prefers in-person pharmacy pickup, use Medfinder for Providers to check which pharmacies near them currently have Addyi in stock. This can be done by your clinical staff during the visit or provided as a resource for the patient to check on their own.

Step 5: Document the Access Plan

Note in the patient's chart:

• Prescription routed to PhilRx (or specific pharmacy)
• Coupon information provided
• Expected cost to patient
• Follow-up timeline (8 weeks for efficacy assessment)

This helps with continuity of care and reduces duplicate callbacks about access issues.

When to Consider Alternatives

If your patient cannot access or tolerate Addyi, consider these alternatives:

• Vyleesi (Bremelanotide): FDA-approved for HSDD in premenopausal women; as-needed subcutaneous injection; no alcohol restriction; different distribution challenges and cost (~$900–$1,000/month)
• Off-label testosterone: Low-dose compounded cream/gel; requires lab monitoring; typically $30–$80/month; better evidence in postmenopausal women
• CBT/sex therapy referral: Can be used alone or combined with medication; often covered by insurance mental health benefits
• Ospemifene (Osphena): If low desire is secondary to dyspareunia in postmenopausal patients

For a comprehensive comparison, see our guide to Addyi alternatives.

Workflow Tips for Your Practice

Create a Prescribing Template

If you prescribe Addyi regularly, create an EHR template or order set that includes:

• Addyi 100 mg tablet, #30, take 1 tablet at bedtime daily
• PhilRx as the default pharmacy
• Standard patient instructions (bedtime dosing, alcohol precautions, 8-week assessment)
• Linked patient handout with coupon information

Train Front-Desk and Nursing Staff

Ensure your team knows:

• Addyi requires PhilRx or verified pharmacy routing
• The coupon website to share with patients
• How to respond to patient calls about access issues
• When to escalate to the prescriber for alternative options

Leverage Telehealth

Addyi's mail-order model is well-suited to telehealth. The entire workflow — consultation, prescribing, and medication delivery — can be completed without an in-person visit. This can expand access for patients in underserved areas.

Final Thoughts

Addyi is an effective treatment for HSDD, but its access model requires providers to take an active role in ensuring patients can fill their prescriptions. By routing prescriptions to PhilRx, providing coupon information upfront, and using tools like Medfinder, you can significantly reduce prescription abandonment and improve treatment outcomes.

For cost-saving strategies to share with patients, see our guide on helping patients save money on Addyi.