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

As a prescriber of Kesimpta (Ofatumumab) for relapsing multiple sclerosis, you've likely heard from patients who are struggling to access their medication. Despite adequate manufacturer supply, the specialty pharmacy distribution model and insurance access barriers can create significant delays that put patients at risk for treatment gaps and disease progression.

This guide provides a practical, step-by-step framework for helping your patients find Kesimpta in stock and stay on therapy.

Current Availability Snapshot

As of early 2026:

• FDA shortage status: None. Kesimpta is not on the FDA drug shortage list.
• Manufacturer supply: Adequate. Novartis has not reported production constraints.
• Distribution: Exclusively through specialty pharmacies. Not available at retail pharmacies.
• Primary barriers: Insurance prior authorization, step therapy requirements, specialty pharmacy coordination, and patient cost burden.

Why Your Patients Can't Find Kesimpta

Understanding the root causes helps you address them proactively:

1. Patients Search Retail Pharmacies First

Many patients instinctively call their local CVS, Walgreens, or independent pharmacy when trying to fill a new prescription. Kesimpta, as a refrigerated biologic, is not stocked at retail pharmacies. Patients who don't understand this may conclude that Kesimpta is "out of stock everywhere" or in shortage.

2. Prior Authorization Delays

Most commercial and Medicare Part D plans require prior authorization for Kesimpta. Processing times range from 48 hours to several weeks, depending on the payer and completeness of submitted documentation. Incomplete submissions are the most common cause of preventable delays.

3. Step Therapy Gatekeeping

Many payers require documented failure of one or more first-line DMTs before approving high-efficacy biologics. For patients with highly active disease who need to start high-efficacy therapy immediately, this creates a clinical and administrative burden.

4. Specialty Pharmacy Onboarding

Even after insurance approval, the specialty pharmacy onboarding process — including benefits verification, patient intake, copay assistance enrollment, and shipping coordination — can add several additional days to the timeline.

What Providers Can Do: 5 Steps

Step 1: Initiate Prior Authorization at the Point of Treatment Decision

Don't wait until the prescription is written and submitted to a pharmacy. Begin the PA process as soon as you and the patient agree on Kesimpta. Many EMR systems support electronic PA submission. Include comprehensive clinical documentation upfront:

• Confirmed MS diagnosis with subtype (CIS, RRMS, active SPMS)
• Recent MRI evidence of disease activity
• Relapse history
• Prior DMT history with dates, duration, and reasons for discontinuation
• Relevant contraindications to alternative therapies

Step 2: Route Prescriptions to the Correct Specialty Pharmacy

Verify the patient's in-network specialty pharmacy before submitting the prescription. Common Kesimpta-dispensing specialty pharmacies include:

• Accredo
• BriovaRx
• CVS Specialty
• Express Scripts Specialty
• AllianceRx Walgreens Pharmacy

If your practice doesn't have a standard workflow for specialty pharmacy referrals, consider establishing one. A designated staff member who manages specialty pharmacy coordination can dramatically reduce access delays.

Step 3: Enroll Patients in Financial Assistance Early

Cost is a significant barrier for many patients. Proactively enrolling patients in financial assistance programs at the time of prescribing can prevent downstream delays:

• Kesimpta Access Card: Up to $18,000/year in copay assistance for commercially insured patients. 97% pay $0 out of pocket. Patients denied coverage can receive free Kesimpta for up to 12 months. Enroll at start.kesimpta.com.
• Novartis Patient Assistance Foundation: Free medication for eligible uninsured or underinsured patients. Call 1-800-277-2254.

Step 4: Use Medfinder to Track Availability

Medfinder for Providers allows you to search specialty pharmacy availability for Kesimpta and other hard-to-find medications. It's a free resource that can help your care team quickly identify which pharmacies can fill your patients' prescriptions.

Step 5: Monitor and Follow Up

Don't assume the process is running smoothly after submitting the PA and prescription. Common failure points include:

• PA requests that are pended or denied without notification
• Specialty pharmacy intake calls that patients miss or ignore
• Copay assistance enrollment that stalls due to missing documentation
• Shipping delays or patient address issues

Build a follow-up cadence into your workflow: check PA status at 48 hours, confirm specialty pharmacy receipt at 1 week, and verify patient has received medication before the scheduled first injection date.

Alternative Therapies When Access Fails

If Kesimpta access cannot be achieved in a clinically acceptable timeframe, consider these alternatives:

• Ocrevus (Ocrelizumab): Same anti-CD20 mechanism, IV infusion every 6 months. Different insurance coverage pathway may provide faster access for some patients.
• Tysabri (Natalizumab): Highly effective monoclonal antibody for relapsing MS. Monthly IV infusion. Requires JCV antibody monitoring.
• Mavenclad (Cladribine): Oral short-course therapy given over 2 years. Suitable for highly active relapsing MS.
• Aubagio (Teriflunomide): Daily oral tablet. Lower efficacy but easier access; may serve as bridge therapy while pursuing Kesimpta authorization.

For patient-facing guidance, direct patients to: Alternatives to Kesimpta.

Workflow Tips for MS Practices

Based on best practices from high-volume MS practices, here are workflow optimizations to reduce Kesimpta access friction:

• Designate a specialty pharmacy coordinator. One staff member who owns the PA submission, specialty pharmacy referral, and financial assistance enrollment process for all biologic prescriptions.
• Create a PA checklist. Standardize the documentation package for Kesimpta PAs to minimize incomplete submissions and denials.
• Use the Novartis hub services. Enrolling patients through start.kesimpta.com provides access to dedicated support staff who can assist with benefits investigation, PA support, and appeals.
• Track patients in a shared system. Use your EMR or a shared tracking spreadsheet to monitor each patient's Kesimpta access status from prescription to first injection.
• Educate patients upfront. Set expectations at the time of prescribing: explain that Kesimpta comes through a specialty pharmacy, may take 2–4 weeks for first fill, and requires financial assistance enrollment. Informed patients are less likely to fall through the cracks.

Final Thoughts

Kesimpta's access challenges in 2026 are structural, not supply-related. With proactive PA management, specialty pharmacy coordination, and early financial assistance enrollment, most patients can access Kesimpta without significant treatment delays. Tools like Medfinder for Providers can further streamline the process.

For the broader picture on Kesimpta access, see our provider shortage briefing. For patient savings guidance to share with your patients, see how to save money on Kesimpta.