Your Patient Can't Find Alitretinoin — Here's How You Can Help

As a provider who treats AIDS-related Kaposi sarcoma, you've likely received calls from patients unable to fill their Alitretinoin (Panretin Gel) prescriptions. The ongoing manufacturing-related shortage has made this specialty medication increasingly difficult to source, and patients are looking to you for guidance.

This guide offers practical, actionable steps you can take to help your patients locate Panretin Gel, navigate the shortage, and maintain continuity of care.

Current Availability Snapshot

As of early 2026, Panretin Gel (Alitretinoin 0.1% topical gel) remains in limited supply:

• Manufacturer: Advanz Pharma — production has been impacted by manufacturing issues since mid-2025.
• FDA intervention: In December 2025, the FDA authorized the sale of EU-labeled Panretin Gel in the US market to supplement supply.
• No generic: There is no FDA-approved generic version of Alitretinoin topical gel.
• Distribution: Primarily through specialty pharmacy channels. Retail chain pharmacies rarely stock this product.

For the clinical overview of the shortage, see our shortage briefing for prescribers.

Why Your Patients Can't Find Alitretinoin

Understanding the supply chain dynamics helps explain the patient experience:

• Single-source product: With only one manufacturer and no generic, any disruption creates a complete supply bottleneck.
• Specialty distribution: Panretin Gel is a high-cost product ($6,000 to $7,500 per tube) that moves through specialty pharmacy channels. Most patients' regular pharmacies have never stocked it.
• Limited patient population: The relatively small number of patients using Panretin means pharmacies don't prioritize keeping it in stock — and when they do have it, quantities are minimal.
• Prior authorization delays: Insurance requirements for prior authorization can add days or weeks to the fulfillment process, during which available stock may be claimed by other patients.

What Providers Can Do: 5 Practical Steps

Step 1: Use Medfinder for Providers to Locate Stock

Medfinder for Providers offers real-time pharmacy inventory checks for Alitretinoin and other hard-to-find medications. Instead of having your staff call pharmacies individually, you can search availability across multiple networks in seconds. Share results directly with patients or use them to route prescriptions to pharmacies that currently have stock.

Step 2: Leverage Your Specialty Pharmacy Relationships

If your practice has established relationships with specialty pharmacies — particularly those in oncology or HIV/AIDS treatment networks — reach out to them directly. These pharmacies often have access to supply channels that retail pharmacies don't, including the FDA-authorized EU-labeled Panretin inventory.

Consider designating a preferred specialty pharmacy for all your Panretin prescriptions during the shortage to consolidate demand and improve fill rates.

Step 3: Submit Prior Authorizations Proactively

Don't wait for the pharmacy to initiate the prior authorization process. Submitting PAs proactively — ideally before the patient needs a refill — can prevent delays that cause patients to miss doses. Include clinical documentation supporting the medical necessity of Panretin specifically, as payers may suggest alternatives during a shortage.

Step 4: Contact Eisai Directly

As the US distributor, Eisai may have visibility into supply that isn't apparent through standard pharmacy channels. Their medical affairs team can sometimes facilitate access for patients in critical need. They also administer a Patient Assistance Program for eligible patients.

Step 5: Prepare Alternative Treatment Protocols

Having a documented alternative treatment protocol ready allows you to pivot quickly when Panretin is unavailable. This avoids treatment gaps and gives patients confidence that they won't be left without care. Recommended alternatives include:

• Intralesional Vinblastine — First-line alternative with strong evidence for localized KS
• Topical Imiquimod 5% (Aldara) — Off-label use with demonstrated efficacy in clinical studies
• Topical Timolol — Emerging off-label option with limited but positive case series data
• Localized radiation therapy — For refractory or extensive localized disease

For detailed clinical information on each alternative, see our alternatives to Alitretinoin guide.

Workflow Tips for Managing the Shortage

Integrating shortage management into your clinical workflow can reduce the burden on your staff and improve patient outcomes:

Early Refill Protocol

Instruct patients to begin their refill process at least 3 to 4 weeks before they need a new tube. This provides a buffer for supply delays, prior authorization processing, and specialty pharmacy shipping.

Patient Education Materials

Provide patients with written or digital resources about the shortage and what they can do. Direct them to:

• How to find Alitretinoin in stock
• How to save money on Alitretinoin
• Alitretinoin shortage update for patients

Staff Training

Ensure your front desk and nursing staff understand the shortage situation and can answer basic patient questions. A simple FAQ document for your team can prevent unnecessary call-backs and reduce patient anxiety.

Document Shortage Impacts

Keep records of treatment interruptions caused by the shortage. This documentation may be useful for insurance appeals, PA renewals, and clinical decision-making if patients experience disease progression during gaps in treatment.

Final Thoughts

The Alitretinoin shortage is a significant barrier to care for patients with AIDS-related Kaposi sarcoma, but providers are uniquely positioned to help. By leveraging tools like Medfinder for Providers, maintaining specialty pharmacy relationships, and having alternative protocols ready, you can ensure that your patients receive uninterrupted care despite the supply disruption.

For the broader clinical context, review our prescriber shortage briefing, and see our guide on helping patients save money on Alitretinoin for financial support resources.