Your Patient Was Prescribed Afrezza — Now What?

You've determined that Afrezza (insulin human inhalation powder) is the right fit for your patient — maybe they have needle aversion, need faster mealtime coverage, or want an alternative to injectable rapid-acting insulin. The clinical decision is made. Now comes the access challenge.

Afrezza's specialty pharmacy distribution model means that prescribing it isn't quite as simple as sending an e-script to CVS. But with the right workflow, you can get your patients their medication reliably and affordably. This guide walks through the practical steps.

Current Availability: What Providers Need to Know

Afrezza is not in shortage and has not been discontinued. It remains available from MannKind Corporation and is dispensed primarily through the ASPN (Afrezza Specialty Pharmacy Network).

However, most retail pharmacies — including CVS, Walgreens, Rite Aid, and Walmart — do not routinely stock Afrezza. If you send a prescription to a standard retail pharmacy, there's a good chance your patient will be told it's unavailable or needs to be special-ordered.

This creates frustration for patients and can lead to treatment delays or abandonment. The solution is routing prescriptions through the right channels from the start.

Why Patients Can't Find Afrezza at Their Regular Pharmacy

Understanding the problem helps you communicate it to patients and set expectations:

• Specialty distribution: Afrezza is classified as a specialty medication and distributed through a dedicated pharmacy network, not standard wholesale channels.
• Low demand visibility: Retail pharmacies stock based on volume. With a smaller patient base than injectable insulins, Afrezza doesn't meet stocking thresholds at most locations.
• Pharmacist unfamiliarity: Many retail pharmacists have limited experience with Afrezza and may incorrectly believe it's discontinued or unavailable.
• Insurance friction: Prior authorization requirements slow down initial fills and can cause patients to give up before getting the medication.

For a patient-facing explanation you can share, see: Why Is Afrezza So Hard to Find?

What Providers Can Do: 5 Steps to Streamline Access

Step 1: Send Prescriptions to ASPN Pharmacies

The most important step is directing your prescription to a pharmacy in the ASPN network, not a retail chain. ASPN pharmacies are set up to:

• Stock and dispense Afrezza
• Handle insurance verification and prior authorization
• Ship directly to the patient's home

Contact AfrezzaAssist at 1-844-323-7399 to identify the nearest ASPN pharmacy for your patient. You can e-prescribe directly to these pharmacies.

Step 2: Initiate Prior Authorization Proactively

Most commercial and Medicare plans require prior authorization for Afrezza. Don't wait for the pharmacy to trigger it — start the process early:

• ASPN pharmacies will fax you a CoverMyMeds key code and an Afrezza PA Checklist
• Complete the PA promptly — approximately 90% of electronic PAs receive a payer response within 24 hours
• Include spirometry results (FEV1), diagnosis, and documentation of why Afrezza is medically necessary (e.g., needle phobia, hypoglycemia with injectables, patient preference for inhaled delivery)

If the PA is denied, patients have the right to appeal. AfrezzaAssist can help navigate the appeals process.

Step 3: Educate Patients on the Patient Direct Program

For patients who are uninsured, underinsured, or whose insurance doesn't cover Afrezza, the Patient Direct program is a critical backup:

• $99 per box of 90 cartridges (any strength)
• Up to 3 boxes per month
• Dispensed through Eagle Pharmacy
• Shipped via FedEx in 3-5 business days
• Works with any valid prescription

Send the prescription to Eagle Pharmacy, and direct patients to enroll at afrezza.com or call 1-844-323-7399.

Step 4: Enroll Insured Patients in the Savings Card

For commercially insured patients, the Afrezza Savings Card can reduce out-of-pocket costs significantly:

• As low as $35 per fill
• Maximum savings of $2,000 per year
• Available for up to 12 fills per year
• Patients can enroll at AFREZZAsavingscard.com

For Medicare patients, the Inflation Reduction Act caps insulin copays at $35/month for covered products. Afrezza coverage under Medicare typically requires PA or appeal.

Step 5: Complete Spirometry Before the First Fill

Afrezza carries a boxed warning for acute bronchospasm in patients with chronic lung disease. Before prescribing:

• Obtain baseline FEV1 via spirometry
• Confirm the patient does not have asthma, COPD, or other chronic lung disease
• Confirm the patient does not currently smoke or recently quit
• Plan follow-up spirometry at 6 months and annually thereafter

Having spirometry results ready also strengthens your prior authorization submission.

Alternatives to Discuss If Afrezza Isn't Accessible

If your patient can't access Afrezza despite these steps, consider these alternatives while continuing to pursue access:

• Lyumjev (insulin lispro-aabc): Ultra rapid-acting injectable; closest in speed to Afrezza
• Humalog (insulin lispro): Standard rapid-acting injectable; widely available and affordable in generic form
• NovoLog (insulin aspart): Standard rapid-acting injectable; widely available
• Apidra (insulin glulisine): Another rapid-acting option, less commonly prescribed

For type 2 patients, GLP-1 receptor agonists (Ozempic, Mounjaro) or SGLT2 inhibitors may reduce or eliminate the need for mealtime insulin. See our full comparison: Alternatives to Afrezza.

Workflow Tips for Your Practice

Here are practical workflow suggestions to reduce Afrezza access friction in your practice:

• Keep a list of ASPN pharmacies for your region. AfrezzaAssist can provide this.
• Use CoverMyMeds for electronic PA submissions — it's faster than fax-based workflows.
• Set up a reminder to complete follow-up spirometry at 6 months and annually.
• Stock patient handouts that explain the specialty pharmacy process. MannKind provides these at afrezzahcp.com.
• Use Medfinder for Providers to check real-time availability and help patients locate pharmacies with Afrezza in stock.
• Designate a staff member to handle Afrezza PAs and pharmacy coordination. This reduces prescriber burden and speeds up access.

Final Thoughts

Afrezza is a clinically valuable option for patients who need mealtime insulin without injections. The access challenges are real but manageable with the right workflow. The key is directing prescriptions to ASPN pharmacies from the start, proactively managing prior authorization, and ensuring patients know about cost-saving programs.

For the broader supply picture, see our provider shortage briefing. For cost guidance to share with patients, see How to Save Money on Afrezza.