Your Patient Needs Brexafemme — Here's How to Help Them Get It

You've determined that Ibrexafungerp (Brexafemme) is the right choice for your patient's vulvovaginal candidiasis or recurrent VVC. But prescribing it is only half the battle. Many patients return days later saying they couldn't find it at any pharmacy — and some simply abandon the prescription.

As a provider, there are concrete steps you can take to close the gap between prescribing and filling. This guide outlines what's happening with Brexafemme availability, why patients struggle to find it, and a five-step workflow to improve their chances of success.

For a clinical overview of the availability situation, see Ibrexafungerp shortage: what providers need to know.

Current Availability

Ibrexafungerp is not in formal FDA shortage as of 2026. Scynexis continues to manufacture and distribute Brexafemme through standard wholesale channels. The supply chain is functional — the problem is at the last mile: retail pharmacy stocking.

Because Brexafemme is a low-volume, high-cost, single-source brand product, most community pharmacies don't maintain standing inventory. The drug is available to order, but many patients don't know this — and pharmacists may not proactively offer to order it.

Why Patients Can't Find Ibrexafungerp

Understanding the barriers your patients face can help you anticipate and address them:

• Pharmacy stocking gaps: Chain pharmacies stock based on volume. Brexafemme's low prescription volume means most locations don't carry it
• Insurance friction: Prior authorization and step therapy requirements delay or block access. Some patients give up during the approval process
• Cost shock: Patients who learn the cash price is $700-$900 may abandon the prescription before exploring savings options
• Information gaps: Patients may not know they can request a pharmacy to order the drug, use specialty pharmacies, or access savings programs

5 Steps Providers Can Take to Help Patients Access Brexafemme

Step 1: Direct the Prescription to a Known Source

Rather than sending the prescription to the patient's default pharmacy, identify pharmacies in your area that routinely stock or can quickly order Brexafemme. Options include:

• Specialty pharmacies that focus on less common medications
• Independent pharmacies willing to special-order
• Mail-order pharmacy services for non-urgent situations

Use Medfinder for Providers to search for pharmacies with verified availability in your area.

Step 2: Initiate Prior Authorization Proactively

Don't wait for the pharmacy to trigger a PA denial. If you know the patient's plan requires prior authorization:

• Submit the PA at the time of prescribing
• Document previous treatment failures (especially Fluconazole) to support medical necessity
• For RVVC patients, emphasize the FDA-approved indication for six-month prevention
• Contact Scynexis support (1-888-982-7299) for PA assistance materials

Step 3: Connect Patients With Savings Programs

Before the patient leaves your office, inform them about available financial assistance:

• Brexafemme Savings Card: Eligible commercially insured patients may pay as little as $0 per prescription
• Scynexis Patient Assistance Program: For uninsured or underinsured patients who meet income criteria
• Direct patients to brexafemme.com for enrollment or call 1-888-982-7299

For a comprehensive cost guide to share with patients, see how to save money on Ibrexafungerp.

Step 4: Provide Patients With a Backup Plan

Set expectations with your patient:

• Let them know that finding Brexafemme may require contacting multiple pharmacies
• Recommend Medfinder as a self-service tool for checking availability
• Discuss a therapeutic alternative (e.g., Fluconazole, topical azoles) they can fill immediately if they can't locate Brexafemme in time

Step 5: Follow Up

A brief follow-up (even a quick message through your patient portal) to confirm the patient was able to fill the prescription can make a significant difference. If they couldn't, you can troubleshoot — whether that means directing them to a different pharmacy, escalating a PA, or switching to an alternative.

Therapeutic Alternatives

When Brexafemme is not accessible, the following alternatives may be appropriate depending on clinical context:

• Fluconazole (Diflucan): 150 mg single oral dose for uncomplicated VVC. Generic, $4-$15, universally available. Not appropriate for azole-resistant strains
• Miconazole (Monistat): OTC topical azole. Good for patients who prefer non-oral therapy
• Clotrimazole: OTC topical azole cream/suppository
• Terconazole: Prescription topical for cases not responding to OTC treatments

For azole-resistant cases specifically, Ibrexafungerp remains the most appropriate oral option. Consider specialty pharmacy referral or mail-order to maintain access.

Workflow Tips

To build an efficient workflow around Brexafemme prescribing:

• Create a template in your EHR for Brexafemme PA submissions with standard medical necessity language
• Maintain a pharmacy list of 2-3 pharmacies in your area that reliably stock or order Brexafemme
• Stock patient handouts with savings program information and Medfinder instructions
• Flag RVVC patients for monthly PA renewal reminders

Final Thoughts

The gap between prescribing Ibrexafungerp and patients actually receiving it is a real problem in 2026. But with proactive steps — directing prescriptions to the right pharmacies, initiating PA early, connecting patients with savings programs, and following up — providers can significantly improve fill rates.

Use Medfinder for Providers to streamline the process and help your patients get the treatment they need.