Your Patients Are Struggling to Find Everolimus — Here's How You Can Help

You've written the prescription, submitted the prior authorization, and counseled your patient on what to expect. But when they go to fill Everolimus — whether it's Afinitor for their cancer or Zortress for their transplant — they hit a wall. The pharmacy doesn't have it. The next pharmacy doesn't either. Phone calls pile up, and treatment gets delayed.

This scenario is all too common with specialty medications like Everolimus. As a prescriber, you're in a unique position to help. This guide outlines practical steps your practice can take to keep patients on therapy without the runaround.

Current Availability: What You Need to Know

In early 2026, the Everolimus supply picture is mixed:

• Generic Everolimus 5 mg and 10 mg tablets have the most stable supply, with multiple manufacturers producing them
• Brand-name Afinitor is available through specialty pharmacy channels but rarely stocked at retail pharmacies
• Afinitor Disperz (dispersible tablets for pediatric and SEGA patients) remains the hardest formulation to source
• Less common strengths (2.5 mg, 7.5 mg) may have intermittent availability
• Zortress is generally available through transplant-focused specialty pharmacies

The overall trend is positive — generic competition has improved availability compared to 2023–2024 — but gaps remain, particularly for specific formulations and strengths.

Why Patients Can't Find It

Understanding the barriers helps you address them proactively:

Specialty Pharmacy Requirements

Most insurers mandate Everolimus dispensing through specialty pharmacies. Patients accustomed to picking up medications at their local CVS or Walgreens may not realize they need to use a different pharmacy entirely. This alone can delay fills by days.

Prior Authorization Delays

Almost all payers require prior authorization for Everolimus. If the PA lapses, expires, or wasn't submitted for a dose change, the pharmacy can't dispense — even if they have it in stock. PA processing times range from 24 hours to 2+ weeks depending on the payer.

Formulation-Specific Shortages

A patient prescribed Afinitor Disperz 3 mg may be told "Everolimus is available" only to discover that only 10 mg generic tablets are in stock. Formulation matters, particularly for patients who cannot swallow whole tablets.

Cost Barriers Masquerading as Supply Issues

Sometimes patients say they "can't get" their medication when the real issue is cost. Specialty tier copays of $1,000–$3,000/month without assistance can effectively make the drug inaccessible. Proactively connecting patients with financial assistance prevents these situations.

What Providers Can Do: 5 Actionable Steps

Step 1: Prescribe with Availability in Mind

When clinically appropriate:

• Prescribe strengths with the most reliable supply (5 mg and 10 mg generic Everolimus)
• Allow generic substitution on the prescription unless there's a clinical reason not to
• For patients who need 7.5 mg, consider whether a combination of available strengths could work (e.g., 5 mg + 2.5 mg)
• Document the indication clearly to streamline prior authorization

Step 2: Establish Specialty Pharmacy Relationships

Identify 2–3 specialty pharmacies that consistently stock Everolimus and build working relationships with them. Benefits include:

• Faster prior authorization processing through familiar channels
• Direct lines to pharmacy staff who know your patients
• Proactive notification when supply issues arise
• Better coordination for refills and dose changes

Recommended specialty pharmacy partners: Accredo, CVS Specialty, OptumRx Specialty, AllianceRx Walgreens Specialty.

Step 3: Use Medfinder to Locate Stock

Medfinder for providers shows real-time Everolimus availability across pharmacies. Integrate this tool into your office workflow:

• Train your pharmacy liaison or nurse coordinator to check Medfinder when patients report access issues
• Share the tool with patients so they can search independently
• Use it to verify stock before sending prescriptions to a new pharmacy

Step 4: Proactively Address Financial Barriers

Don't wait for patients to tell you they can't afford it. At the point of prescribing, connect them with:

• Novartis Co-pay Assistance: Copays as low as $0–$25/month for commercially insured patients
• Novartis Patient Assistance Foundation: Free medication for eligible uninsured/underinsured patients
• Foundation copay support: PAN Foundation, HealthWell Foundation, The Assistance Fund
• Specialty pharmacy financial counselors: Available at most specialty pharmacies to help patients navigate coverage

For detailed cost-saving strategies, direct patients to how to save money on Everolimus.

Step 5: Have a Backup Plan Ready

For each indication you prescribe Everolimus for, identify 1–2 alternative agents you would consider if supply becomes unavailable:

• Renal cell carcinoma: Temsirolimus, Cabozantinib, Axitinib, immunotherapy combinations
• HR+/HER2- breast cancer: Palbociclib, Ribociclib, Abemaciclib (CDK4/6 inhibitors)
• Neuroendocrine tumors: Sunitinib, somatostatin analogs (Lanreotide, Octreotide LAR)
• Transplant rejection: Sirolimus (with appropriate dose adjustment and monitoring)
• TSC-related SEGA: Sirolimus (limited alternatives)

Having a backup plan documented means you can pivot quickly if a patient can't access Everolimus, minimizing treatment interruptions. For patient-facing information, see alternatives to Everolimus.

Workflow Tips for Your Practice

Small process changes can make a big difference in Everolimus access:

Automate PA Renewal Tracking

Prior authorizations for Everolimus typically need renewal every 6–12 months. Track expiration dates and initiate renewals 30 days before expiration to prevent gaps.

Flag Patients on Everolimus

In your EHR, flag patients taking Everolimus so that any care team member can quickly identify them and prioritize refill issues. This is especially important if a shortage announcement comes out — you'll want to proactively reach out to affected patients.

Educate Patients at Initiation

When starting a patient on Everolimus, set expectations:

• Explain that it's a specialty medication that may not be available at their usual pharmacy
• Provide specialty pharmacy contact information
• Walk them through the copay assistance enrollment process
• Advise them to start refills 7–10 days early
• Share resources like Medfinder

Designate a Pharmacy Liaison

If your practice has significant Everolimus prescribing volume, consider designating a staff member as the specialty pharmacy liaison. This person builds relationships with pharmacy contacts, tracks PAs, and serves as the point person when patients have access issues.

Final Thoughts

Everolimus access challenges aren't going away overnight, but they are manageable with the right systems in place. By prescribing strategically, building pharmacy relationships, leveraging tools like Medfinder, and proactively addressing financial barriers, your practice can significantly reduce the burden on patients.

For the clinical perspective on the current shortage, see our companion article: Everolimus shortage — what providers need to know in 2026.

For information on helping patients reduce costs, see how to help patients save money on Everolimus.