Your Patients Need Biktarvy. Here's How to Help Them Get It.

As a provider managing HIV patients, you've likely heard from patients who can't find Biktarvy at their pharmacy. It's one of the most frustrating challenges in HIV care right now — not because the drug isn't being made, but because retail pharmacy distribution doesn't always align with specialty medication demand.

Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide) is the most prescribed HIV treatment in the U.S., with 430,000+ active patients. When individual pharmacies run out, the clinical consequences can be real: missed doses, viral rebound risk, and patient anxiety about treatment continuity.

This guide provides five concrete steps you can take to help your patients find and maintain access to Biktarvy, plus workflow tips for your practice.

Current Availability

Biktarvy is not in national shortage as of early 2026. It is not on the FDA Drug Shortage list, and Gilead Sciences reports normal manufacturing capacity. The availability issues are localized pharmacy stock-outs — a distribution problem, not a supply problem.

The challenge is most acute at:

• Large chain retail pharmacies that don't prioritize specialty medication stocking
• Pharmacies in areas with lower HIV patient density
• End-of-month refill periods when inventory is strained

Specialty pharmacies, independent pharmacies with HIV-focused practices, and mail-order pharmacies generally maintain more reliable stock.

Why Patients Can't Find Biktarvy

Understanding the root causes helps you counsel patients and build better pharmacy relationships:

• Single-source brand: No generic exists, so all supply comes from Gilead. Any distribution bottleneck affects availability.
• Inventory economics: A 30-day supply costs $3,500-$4,000 at wholesale. Pharmacies with low HIV patient volume may not invest in keeping it stocked.
• Specialty vs. retail distribution: HIV medications are increasingly channeled through specialty pharmacy networks that don't overlap with standard retail.
• Refill timing clusters: Many patients refill on similar schedules, creating predictable demand surges at individual pharmacies.

Five Steps to Help Your Patients Get Biktarvy

Step 1: Verify Stock Before Prescribing

Before sending a prescription to a specific pharmacy, check whether they actually have Biktarvy in stock. Medfinder for Providers allows you to check real-time inventory across pharmacies in your patient's area.

This simple step — taking 30 seconds at the point of prescribing — can prevent the most common scenario: patient arrives at pharmacy, pharmacy doesn't have it, patient has to start over.

Step 2: Build a Preferred Pharmacy List

Identify 3-5 pharmacies in your area that reliably stock Biktarvy and other antiretrovirals. Include:

• At least one specialty pharmacy
• One or two independent pharmacies with HIV experience
• A mail-order option

Share this list with your front desk and nursing staff so anyone handling prescription routing can default to reliable pharmacies. Update the list quarterly based on patient feedback.

Step 3: Set Up Proactive Refill Workflows

Many stock-out crises happen because patients wait until the last pill to refill. Build proactive refill reminders into your workflow:

• Flag patients at each visit to refill 7 days before their supply runs out
• Send refill reminders via patient portal or text
• For patients with a history of pharmacy problems, consider 90-day prescriptions via mail order

Step 4: Leverage Gilead Support Programs

Gilead's Advancing Access program offers multiple layers of support:

• Copay assistance: $0 copay for eligible commercially insured patients
• Patient assistance: Free medication for qualifying uninsured/underinsured patients
• Insurance navigation: Prior authorization and appeals support
• Pharmacy connection: Can help route prescriptions to pharmacies with available stock

Contact: 1-800-226-2056 or gileadadvancingaccess.com. Designate a staff member to manage enrollment for new patients.

Step 5: Know Your Switch Options

If a patient truly cannot access Biktarvy for an extended period, having a pre-considered switch plan prevents reactive decision-making under pressure:

• Dovato (dolutegravir/lamivudine): Two-drug INSTI regimen. Check: not HBV co-infected, no NRTI resistance history.
• Triumeq (dolutegravir/abacavir/lamivudine): Check: HLA-B*5701 negative, not HBV co-infected.
• Symtuza (darunavir/cobicistat/emtricitabine/TAF): PI-based option. More drug interactions.
• Cabenuva (cabotegravir/rilpivirine): Long-acting injectable. Eliminates pharmacy stock dependence for virologically suppressed patients.

Review each patient's resistance history and co-morbidities proactively so you're not scrambling when availability becomes an issue. See our alternatives to Biktarvy article for patient-facing information you can share.

Workflow Tips for Your Practice

Integrating medication availability awareness into your practice doesn't require a major overhaul. Here are practical workflow adjustments:

• Add a pharmacy check step to your prescription routing process. Before sending, verify stock via Medfinder or call the pharmacy.
• Track availability issues in your EHR. If a patient reports a stock-out, note it. Patterns can inform your preferred pharmacy list.
• Educate patients about refill timing and tools like Medfinder they can use independently.
• Consider 90-day prescriptions for stable patients. Fewer refill events means fewer stock-out risks, and mail-order pharmacies typically offer 90-day supplies with better inventory.
• Designate a medication access coordinator if your practice has the resources. One staff member handling prior authorizations, patient assistance applications, and pharmacy coordination can dramatically reduce patient friction.

Final Thoughts

Biktarvy availability challenges are solvable with the right systems in place. The medication isn't in shortage — it's a distribution problem that responds to proactive pharmacy management, reliable stock-checking tools, and strong manufacturer support programs.

Your patients are counting on uninterrupted HIV therapy. A few workflow adjustments can make the difference between a missed dose and seamless care.

Use Medfinder for Providers to check real-time stock, build your preferred pharmacy network, and ensure your patients always know where to fill their Biktarvy prescription.

Related: Biktarvy shortage: what providers need to know in 2026 | How to help patients save money on Biktarvy