How to Help Your Patients Find Collagenase in Stock: A Provider's Guide

Your Patients Need Collagenase — Here's How to Help Them Get It

You've assessed the wound, determined that enzymatic debridement is the right approach, and written the prescription for Collagenase Santyl Ointment. Now your patient calls back: their pharmacy doesn't have it in stock.

This scenario plays out in wound care practices across the country. Collagenase Santyl is the only FDA-approved enzymatic debriding ointment in the US, manufactured exclusively by Smith+Nephew with no generic available. While the 2023-2024 shortage has resolved, finding Santyl at a retail pharmacy still requires effort — and your patients often need your help navigating it.

This guide provides actionable steps you and your care team can take to ensure patients get the wound care they need.

Current Availability

As of 2026, Collagenase Santyl is being actively produced by Smith+Nephew in both 30g and 90g tube sizes. The ASHP-reported shortage that began in August 2023 was officially resolved in October 2024.

However, availability at the pharmacy level remains inconsistent for several reasons:

• Low dispensing volume: Many chain pharmacies don't stock Santyl routinely because they fill relatively few prescriptions for it
• Specialty product classification: Some pharmacies categorize it as a specialty item that must be special-ordered
• Single manufacturer: Without generic competition, there's only one source in the supply chain

For a detailed analysis of the shortage and its resolution, see our provider briefing on the Collagenase shortage.

Why Patients Can't Find Collagenase

Understanding the patient experience helps you provide better guidance. Patients commonly report these barriers:

1. "My pharmacy says they don't carry it" — Most large chain pharmacies don't keep Santyl in regular inventory. The patient may need to request a special order or find a different pharmacy.
2. "It's too expensive" — Without insurance, a 30g tube costs $333–$437. Even with insurance, copays can be a surprise if patients aren't aware of available savings programs.
3. "I don't know where else to look" — Patients often don't realize that independent pharmacies, specialty pharmacies, and mail-order options exist.
4. "I ran out and can't get a refill in time" — Patients on ongoing wound care may experience gaps if their pharmacy runs out between orders.

What Providers Can Do: 5 Actionable Steps

Step 1: Direct Patients to Medfinder

Medfinder for Providers offers real-time pharmacy stock checking for Collagenase and other hard-to-find medications. You or your care coordinator can use it to identify pharmacies near the patient that actually have Santyl available — before sending the prescription.

This eliminates the frustrating cycle of the patient going to a pharmacy, being told it's out of stock, coming back to you, getting a new pharmacy, and repeating the process.

Step 2: Build a Pharmacy Network

Establish relationships with pharmacies that reliably stock Santyl. Consider:

• Independent pharmacies: Often have multiple wholesaler relationships and can source products more flexibly
• Wound care specialty pharmacies: Stock Santyl as a core product — it's central to their business
• Hospital outpatient pharmacies: May have Santyl available through their institutional purchasing agreements
• Mail-order pharmacies: Can provide reliable ongoing supply for patients with established prescriptions

Maintain a list of 2-3 "Santyl-friendly" pharmacies that your front desk or care coordinators can share with patients.

Step 3: Enroll Patients in Savings Programs

Cost barriers are real. Help patients access these programs:

• Smith+Nephew Copay Assistance Card: Patients pay the first $50; company covers up to $250 per fill. Available for up to 6 fills per year with a $1,000 annual maximum. Open to insured and uninsured patients. Enroll at santyl.com/card.
• Smith+Nephew Patient Assistance Program (PAP): For uninsured or underinsured patients who meet income criteria. Requires both prescriber and patient signatures. Fax applications to 833-965-1621 or email patientassistanceprogram.us@pap.smith-nephew.com.
• GoodRx and other discount cards: Can reduce the cash price to approximately $347 for a 30g tube.

For a comprehensive patient-facing resource, share our guide on saving money on Collagenase.

Step 4: Prescribe Proactively

Help patients avoid gaps in their wound care supply:

• Send prescriptions early: Don't wait until the current tube runs out. Send refill prescriptions 1-2 weeks before the patient expects to need more.
• Specify tube size thoughtfully: The 90g tube offers more value per gram and reduces refill frequency for patients with larger or multiple wounds.
• Include DAW (Dispense as Written) if needed: While there's no generic, specifying the brand can prevent pharmacy confusion.
• Coordinate with the pharmacy: A quick call from your office to a pharmacy can sometimes expedite orders or confirm availability before the patient arrives.

Step 5: Have a Backup Plan

When Collagenase isn't available or isn't appropriate, be ready with alternatives:

• In-office sharp debridement: The fastest option — can be performed at the point of care and billed under CPT codes for wound debridement
• Medihoney: Medical-grade honey products for autolytic debridement; widely available and often less expensive
• Hydrogel dressings: Maintain moist wound environment; good for dry wounds with thin eschar
• Combination approaches: Sharp debridement for initial bulk removal, followed by Medihoney or hydrogel for maintenance

For a patient-facing comparison of alternatives, share our guide on alternatives to Collagenase.

Alternatives to Collagenase: Quick Reference

Here's a clinical summary for common alternative debridement approaches:

• Medihoney (Active Leptospermum Honey)Mechanism: Autolytic; creates moist, low-pH, antibacterial wound environment
• Best for: Partial-thickness wounds, mild to moderate necrotic tissue
• Availability: Widely available OTC in gel, paste, and dressing forms
• Cost: Generally less expensive than Santyl

Hydrogel Dressings (Intrasite, DuoDERM, Curafil)

• Mechanism: Autolytic; hydrates wound bed and softens eschar
• Best for: Dry wounds, thin eschar, maintaining moisture
• Availability: Widely available at pharmacies and medical supply stores
• Cost: Variable; generally affordable

Sharp Debridement

• Mechanism: Mechanical; direct tissue removal with scalpel/curette
• Best for: Thick eschar, heavily necrotic wounds, urgent situations
• Availability: Requires trained provider; in-office or bedside
• Cost: Billable under wound debridement CPT codes

Workflow Tips for Your Practice

Integrating Collagenase prescribing into your wound care workflow can reduce patient access barriers:

• Pre-appointment: When scheduling wound care visits where debridement is likely needed, have staff confirm pharmacy availability
• At the visit: Discuss cost openly — many patients don't fill prescriptions because of unexpected sticker shock. Mention the copay card proactively.
• Post-visit follow-up: Include a check on prescription fill status in your wound care follow-up protocol. If the patient hasn't filled the prescription, investigate why.
• Care coordinator role: Empower your wound care coordinator or nurse to handle pharmacy sourcing and savings enrollment. This removes the burden from the patient and the provider.

Patient-Facing Resources to Share

Point your patients to these Medfinder guides:

• What Is Collagenase? Uses, Dosage, and What You Need to Know
• How to Find Collagenase in Stock Near You
• How to Save Money on Collagenase
• Collagenase Side Effects: What to Expect

Final Thoughts

Helping patients access Collagenase requires more than writing a prescription. In 2026, it means knowing which pharmacies stock it, proactively addressing cost barriers, and having alternative debridement strategies ready when needed.

The tools exist — from Medfinder for Providers to Smith+Nephew's savings programs — but they require awareness and workflow integration. By building pharmacy relationships, enrolling patients in assistance programs, and prescribing proactively, you can ensure that wound care doesn't stall because of a pharmacy stock issue.

For more provider resources, visit medfinder.com/providers.