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

The Difluprednate shortage has created a recurring headache for ophthalmology and optometry practices: you prescribe the medication, and your patient can't fill it. The calls come back to your office. Surgical timelines get delayed. Uveitis flares go undertreated.

As a provider, you have tools and influence that your patients don't. This guide offers a practical, step-by-step approach to helping patients navigate the shortage and get the treatment they need.

Current Availability Snapshot

As of early 2026, the Difluprednate supply situation looks like this:

• Brand Durezol (Novartis/Alcon): Generally available at pharmacies, but priced at $250–$400 per 5 mL bottle — prohibitive for many patients without strong insurance coverage
• Generic Difluprednate (Dr. Reddy's): Available in some markets with limited production capacity — prices range from $45–$120 with discount cards
• Generic Difluprednate (Exelan): On long-term back order since April 2024, no estimated return date

The functional shortage is primarily in affordable generic supply. Brand-name product exists but creates a significant cost-access gap.

Why Patients Can't Find It

Your patients are encountering several barriers simultaneously:

• Generic supply gaps: Chain pharmacies that rely on a single wholesaler may be completely out of generic Difluprednate
• Cost shock: When pharmacies only have brand Durezol, patients face unexpected out-of-pocket costs of hundreds of dollars
• Insurance hurdles: Some plans require step therapy through Prednisolone Acetate before covering Difluprednate, or impose prior authorization that delays access
• Information asymmetry: Patients don't know which pharmacies have stock and end up calling many locations without success

Patients recovering from surgery or managing uveitis can't afford delays. Your proactive intervention can make the difference.

What Providers Can Do: 5 Steps

Step 1: Verify Availability Before Prescribing

Build a pharmacy availability check into your pre-surgical workflow. Before the patient leaves your office (or before the day of surgery), verify that their preferred pharmacy has Difluprednate in stock.

How to do this efficiently:

• Use Medfinder for Providers to check real-time availability at pharmacies near your patient
• Designate a staff member (tech, coordinator, or front desk) to run this check for all surgical patients
• If the patient's pharmacy doesn't have stock, identify an alternative pharmacy that does and send the prescription there

Step 2: Prescribe With a Backup Plan

When Difluprednate supply is uncertain, consider a two-tier prescribing approach:

1. Prescribe Difluprednate as the primary medication
2. Provide a written or electronic backup prescription for Prednisolone Acetate 1% or Dexamethasone 0.1% with adjusted dosing instructions
3. Clearly document the backup plan in the patient's chart and discuss it with the patient

This empowers the patient and their pharmacist to act quickly if Difluprednate is unavailable, without needing to contact your office for a new prescription — especially important over weekends and holidays.

Step 3: Leverage Independent and Specialty Pharmacies

Chain pharmacies tend to experience shortages more acutely because they use centralized distribution. Independent pharmacies often have more sourcing flexibility. Build a list of reliable local sources:

• Independent community pharmacies with ophthalmic specialty experience
• Hospital outpatient pharmacies — especially those connected to ophthalmology departments
• Compounding pharmacies — some can compound ophthalmic steroid preparations when commercial products are unavailable (verify sterility standards)
• Specialty mail-order pharmacies — useful for uveitis patients who need ongoing supply and can plan ahead

Maintain a reference list at your front desk so staff can quickly direct patients to pharmacies with better availability.

Step 4: Help Patients Navigate Cost Barriers

When patients face high out-of-pocket costs for brand Durezol, have your staff ready to share these resources:

• Discount cards: GoodRx and SingleCare can reduce generic Difluprednate to $43–$49
• Novartis copay card: For commercially insured patients, the Novartis Patient Savings Co-Pay Card at copay.novartispharma.com can lower brand Durezol copays
• Patient assistance (uninsured): Novartis Patient Assistance Foundation at pap.novartis.com provides Durezol at no cost to qualifying patients
• Prescription Hope: Offers Durezol for $70/month for eligible patients

Consider printing a one-page handout with these options for your surgical packet or post-visit instructions. For a comprehensive patient-facing guide, direct patients to How to Save Money on Difluprednate.

Step 5: Communicate Proactively With Patients

Don't wait for the panicked call. At the time of prescribing:

• Explain that Difluprednate is in shortage and they may need to try multiple pharmacies
• Provide the backup plan (Step 2) and make sure they understand it
• Share the Medfinder resource so they can search availability independently
• Give clear instructions on what to do if they can't fill the prescription within 24 hours — who to call at your office and what the next step will be

Therapeutic Alternatives to Consider

When Difluprednate is truly unavailable and you need to switch therapies, here are the primary alternatives ranked by potency:

1. Prednisolone Acetate 1% (Pred Forte) — Most widely available and affordable (~$10–$30 generic). Strong anti-inflammatory. Requires vigorous shaking; may need more frequent dosing than Difluprednate.
2. Dexamethasone 0.1% (Maxidex) — High potency, comparable to Difluprednate. Available generically (~$15–$40). Good penetration for anterior segment inflammation.
3. Loteprednol Etabonate 0.5% (Lotemax) — Lower potency but significantly lower IOP risk. Best for mild cases or steroid responders. Generic available (~$30–$80).
4. Fluorometholone 0.1% (FML) — Mildest option. Suitable only for surface inflammation. Not appropriate for post-surgical or uveitis management.

For a detailed comparison, see Alternatives to Difluprednate.

Workflow Tips for Your Practice

• Create a shortage protocol: Document your practice's standard operating procedure for when Difluprednate is unavailable, including preferred alternatives, dosing adjustments, and patient communication templates
• Update EMR templates: Add a shortage note and backup prescription option to your post-surgical medication templates
• Track local availability: Have a staff member check Medfinder or call key pharmacies weekly to maintain an up-to-date list of sources
• Batch communications: If you have multiple patients affected, consider a practice-wide communication (patient portal message, email, or flyer) explaining the shortage and available resources

Final Thoughts

Drug shortages are an unavoidable reality in healthcare, but how your practice responds determines patient outcomes. By building availability checks into your workflow, prescribing with backup plans, and equipping patients with tools like Medfinder and discount programs, you can minimize the impact of the Difluprednate shortage on your patients' care.

For the latest on the shortage, see our Difluprednate shortage briefing for providers. For a comprehensive provider guide to helping patients save on prescriptions, visit How to Help Patients Save Money on Difluprednate.