Helping Patients Navigate the Budesonide Shortage

When patients call your office because they can't fill their Budesonide prescription, it creates a cascade of problems — interrupted treatment, potential flare-ups, increased phone volume, and added burden on your clinical staff. The Budesonide shortage has been particularly challenging because it affects multiple specialties and patient populations simultaneously.

This guide provides practical, actionable steps you and your staff can implement to help patients find Budesonide — and manage the situation efficiently when they can't.

Current Budesonide Availability

As of early 2026, availability varies by formulation:

• Generic oral capsules (3 mg): Intermittent availability — the most problematic formulation. Some regions have adequate supply while others do not.
• Pulmicort Respules: Seasonal shortages, worse during fall/winter respiratory seasons.
• Pulmicort Flexhaler: Generally available but with occasional gaps at specific pharmacies.
• Uceris (brand, 9 mg tablets): Available but expensive ($1,200-$1,800/month cash).
• Tarpeyo (brand, 4 mg): Available through specialty pharmacies.
• Rhinocort (OTC nasal spray): Widely available at $12-$20.

For a detailed clinical overview, see our provider shortage briefing.

Why Patients Can't Find Budesonide

Understanding the root causes helps you counsel patients and set expectations:

1. Generic manufacturer consolidation — fewer companies making oral Budesonide means less production redundancy.
2. Complex formulation — delayed-release and extended-release manufacturing is harder to scale than immediate-release medications.
3. Demand growth — expanding indications (microscopic colitis, EoE, IgA nephropathy) have increased the patient base.
4. Distribution imbalances — large chains get priority allocation, leaving independent pharmacies and some regions underserved.
5. Seasonal factors — inhaled formulations face higher demand during respiratory illness seasons.

What Providers Can Do: 5 Actionable Steps

Step 1: Check Availability Before the Patient Leaves

The single most impactful thing you can do is verify availability before sending a prescription into the void. Use Medfinder for Providers to quickly check which pharmacies near your patient currently have Budesonide in stock. This takes 30 seconds and can save your patient multiple pharmacy visits and a frustrated callback to your office.

Consider making this a standard step in your prescribing workflow for Budesonide and other shortage-affected medications.

Step 2: Send Prescriptions to Pharmacies With Confirmed Stock

Once you've identified a pharmacy with Budesonide available, e-prescribe directly to that location. If your patient's usual pharmacy is out, most patients are willing to travel to a different pharmacy — especially if you can tell them exactly where to go.

Independent pharmacies and hospital outpatient pharmacies often have stock when chain pharmacies don't. Building relationships with 2-3 independent pharmacies in your area can create a reliable fallback network.

Step 3: Write Prescriptions With Flexibility

Small prescribing decisions can make a big difference during shortages:

• Allow generic substitution unless there's a clinical reason to specify a brand.
• Write for available quantities. If a pharmacy has a partial supply, consider writing for what's available now and a follow-up prescription for the remainder.
• Consider 90-day prescriptions when supply is available — this reduces the frequency of refill-related shortage encounters.
• Note the specific formulation needed. "Budesonide 3 mg delayed-release capsules" is more helpful than just "Budesonide 3 mg" since the pharmacy won't confuse it with extended-release or other formulations.

Step 4: Have a Ready Alternative Plan

For patients who truly cannot find Budesonide, have a pre-established alternative protocol ready:

For Crohn's disease / IBD patients:

• Prednisone 20-40 mg daily with taper (higher side effect profile — discuss with patient)
• Mesalamine for mild UC maintenance (limited Crohn's evidence)
• Accelerate biologic/immunomodulator initiation if patient was heading that direction anyway

For asthma patients:

• Fluticasone propionate (equivalent ICS potency — adjust dose accordingly)
• Beclomethasone or Mometasone as additional ICS alternatives
• For pediatric patients on Respules: assess whether MDI with spacer/mask is feasible

For detailed alternative options, see our alternatives guide (also shareable with patients).

Step 5: Connect Patients With Financial Resources

The shortage often pushes patients toward more expensive options. Help them access financial support:

• Discount cards: GoodRx, SingleCare can reduce generic Budesonide costs by 20-50%
• Manufacturer programs: Salix/Bausch copay assistance for Uceris; Calliditas TARGET Support for Tarpeyo; AstraZeneca AZ&Me for Pulmicort
• Patient assistance: NeedyMeds, RxAssist, and manufacturer patient assistance programs for uninsured/underinsured patients
• Direct patients to our Budesonide savings guide

Therapeutic Alternatives at a Glance

• Prednisone: $5-$15/course — effective but more side effects; best for short-term flare management
• Mesalamine: $30-$150/month generic — non-steroidal; best for mild UC
• Fluticasone (inhaled): $30-$80 generic inhaler — equivalent ICS for asthma
• Beclomethasone (inhaled): $250-$350 — alternative ICS option

Workflow Tips for Your Practice

Integrate shortage management into your daily workflow:

• Designate a "shortage point person" — one staff member who monitors availability and handles shortage-related patient calls.
• Create a patient handout with tips for finding Budesonide, including the Medfinder link and a list of local independent pharmacies.
• Set up prior authorization templates for brand alternatives (Uceris, Tarpeyo) so they're ready to submit quickly when needed.
• Track patterns — note which pharmacies consistently have stock and share that information proactively with patients.
• Consider batch refill coordination — if you have multiple Budesonide patients, coordinate with a pharmacy to secure larger orders.

Final Thoughts

The Budesonide shortage demands proactive practice management. By checking availability before prescribing, directing patients to stocked pharmacies, having alternative plans ready, and connecting patients with financial resources, you can significantly reduce the burden on both your patients and your staff.

Medfinder for Providers is a free tool that can be integrated into your workflow in minutes. For the clinical picture, revisit our Budesonide shortage briefing for providers.