Your Patients Can't Find Baricitinib — Here's How to Help

When you prescribe Baricitinib (Olumiant), you expect your patient to be able to fill it. But increasingly, patients return to your office frustrated — their pharmacy doesn't stock it, their insurance denied it, or the cost is prohibitive. As a provider, you're often the most effective advocate your patient has.

This guide provides a practical, step-by-step approach to helping patients access Baricitinib in 2026. Whether you're in rheumatology, dermatology, or primary care, these strategies can save your patients time, stress, and gaps in treatment.

Current Baricitinib Availability

As of February 2026, Baricitinib is not in shortage. Eli Lilly, the sole manufacturer of Olumiant, reports stable supply of all tablet strengths (1 mg, 2 mg, and 4 mg).

However, availability at the pharmacy counter is a different story. Because Baricitinib is a specialty medication with a cash price of $2,500 to $3,000 per month, most retail pharmacies don't stock it. Patients are typically routed to specialty pharmacies, which adds complexity and potential delays.

For a broader overview of the supply situation, see our provider shortage briefing.

Why Patients Can't Find Baricitinib

Understanding the common barriers helps you address them proactively:

• Retail pharmacy doesn't stock it: Most big-chain pharmacies don't carry Baricitinib. Patients who try to fill at their regular pharmacy get told it's "unavailable" and assume there's a shortage.
• Insurance requires specialty pharmacy: The prescription needs to be routed to a specialty pharmacy within the patient's plan network.
• Prior authorization pending or denied: Most payers require PA, and the process can take 1-3 weeks. Denials require appeals or peer-to-peer reviews.
• Step therapy not met: The patient may not have tried required first-line agents (Methotrexate, TNF inhibitors) or the documentation is insufficient.
• Cost: Even with insurance, specialty tier copays can exceed $100-500/month, causing patients to abandon the prescription.

What Providers Can Do: 5 Steps

Step 1: Route the Prescription to the Right Pharmacy

Before prescribing, verify which specialty pharmacy the patient's insurance plan uses. Common specialty pharmacies include:

• CVS Specialty
• Accredo (Express Scripts)
• OptumRx Specialty
• AllianceRx Walgreens Pharmacy

Send the prescription directly to the correct specialty pharmacy to avoid delays. If you're unsure which pharmacy to use, call the patient's pharmacy benefits manager (PBM) — the phone number is on the back of their insurance card.

Step 2: Submit Prior Authorization Proactively

Don't wait for a denial. Submit the prior authorization at the time of prescribing. Include:

• Documentation of diagnosis (RA, alopecia areata, etc.)
• History of previous treatments tried and failed
• Lab results (if relevant — e.g., inflammatory markers for RA)
• Clinical rationale for Baricitinib specifically

If your EHR supports electronic prior authorization (ePA), use it. It typically cuts turnaround time from days to hours.

Step 3: Use Real-Time Availability Tools

Medfinder for Providers lets you check which pharmacies have Baricitinib in stock in real time. This is particularly useful when:

• A patient needs the medication urgently
• Their specialty pharmacy has a backorder
• You want to identify local options for patients who prefer not to wait for mail-order delivery

Step 4: Connect Patients with Financial Assistance

Cost is one of the top reasons patients don't fill specialty prescriptions. Proactively share these resources:

• Olumiant Savings Card: Copay as low as $5/month for commercially insured patients. Enroll at olumiant.com or call 1-800-545-5979.
• Lilly Cares Foundation: Free medication for qualifying uninsured/underinsured patients. Apply at lillycares.com or call 1-800-545-6962.
• Discount cards: Services like GoodRx or RxAssist may offer additional savings for patients paying cash.

For a comprehensive resource you can share with patients, see our savings guide for Baricitinib.

Step 5: Follow Up on Access

Don't assume the prescription was filled. Consider building a follow-up workflow:

• Have your medical assistant or care coordinator check in with the patient 7-10 days after prescribing
• Ask: "Were you able to fill your Baricitinib prescription?"
• If not, troubleshoot the specific barrier (PA denial, cost, pharmacy routing)

This simple step can prevent treatment gaps and improve adherence.

Alternatives to Consider

If a patient truly cannot access Baricitinib despite your best efforts, consider these alternatives based on indication:

For Rheumatoid Arthritis:

• Tofacitinib (Xeljanz): JAK1/2/3 inhibitor, 5 mg BID or 11 mg XR QD
• Upadacitinib (Rinvoq): Selective JAK1 inhibitor, 15 mg QD
• Biologic DMARDs: If JAK inhibitor class is inaccessible, consider biosimilar Adalimumab or other TNF inhibitors

For Alopecia Areata:

• Ritlecitinib (Litfulo): JAK3/TEC inhibitor, 50 mg QD — the only other FDA-approved JAK inhibitor for this indication
• Off-label Tofacitinib: Published evidence supports efficacy, though not FDA-approved for AA

See our patient-facing alternatives guide for comparison details.

Workflow Tips for Your Practice

Integrating these steps into your existing workflow doesn't have to be complicated. Here are some practical suggestions:

• Create a specialty medication checklist: For any specialty Rx, verify insurance specialty pharmacy, submit PA, and share financial assistance information — all at the point of prescribing.
• Designate a team member: If possible, assign a medical assistant, nurse, or care coordinator to handle specialty medication access issues.
• Use templates: Create PA letter templates for Baricitinib that include common payer-required elements (diagnosis, prior treatments, rationale).
• Bookmark Medfinder for Providers: Quick access to real-time stock information saves time when patients call about availability.
• Educate patients proactively: At the time of prescribing, set expectations: "This medication may take 1-2 weeks to arrive through your specialty pharmacy. Here's what to expect."

Final Thoughts

Helping patients access Baricitinib requires more than writing a prescription. The specialty medication landscape demands proactive insurance navigation, pharmacy routing, and financial assistance — and providers are uniquely positioned to make this happen.

By building these steps into your workflow and using tools like Medfinder for Providers, you can reduce treatment gaps and keep your patients on the therapy they need.

For the latest on Baricitinib supply and access, see our 2026 provider shortage briefing. For cost resources to share with patients, visit our provider's guide to helping patients save money on Baricitinib.