Your Patients Want Neffy — Here's How to Help Them Get It

As a prescriber, you've likely seen the enthusiasm around Neffy (Epinephrine nasal spray). Patients and caregivers are asking for it by name. Parents of children with food allergies see it as a breakthrough. Needle-phobic patients finally feel empowered to carry epinephrine.

But then comes the callback: "My pharmacy doesn't have it." Or the message from a frustrated parent who drove to three pharmacies and came home empty-handed.

This guide provides a practical, step-by-step approach to help your patients successfully fill their Neffy prescriptions — and what to do when they can't.

Current Availability: What You Need to Know

Neffy is not in a drug shortage. ARS Pharmaceuticals has manufacturing supply. The challenge is pharmacy-level distribution:

• Many chain pharmacies (CVS, Walgreens, Rite Aid) don't stock Neffy by default at all locations
• Independent pharmacies are generally more responsive but may need to special-order it (1-3 business days)
• Specialty and allergy-focused pharmacies are the most likely to carry it routinely
• The 1 mg pediatric formulation (for patients 15 to <30 kg) launched in May 2025 and has even more limited distribution than the 2 mg dose

Why Patients Can't Find Neffy

Understanding the root causes helps you set expectations and troubleshoot:

1. New product, limited shelf space: Pharmacies stock based on existing demand patterns. Until prescription volume reaches a threshold at a given location, the pharmacy may not automatically stock it.
2. Insurance barriers: Prior authorization requirements or formulary exclusions reduce prescription volume, which in turn reduces pharmacy stocking incentive.
3. Patient confusion: Some patients don't know they can ask for a special order or switch pharmacies. They assume "out of stock" means "unavailable."
4. Wholesaler distribution: Different pharmacy chains use different wholesalers, which may have different stocking levels of Neffy.

What Providers Can Do: 5 Practical Steps

Step 1: Verify Pharmacy Stock Before Sending the Prescription

The single most impactful thing you can do is confirm that the receiving pharmacy has Neffy in stock before sending the electronic prescription. Use Medfinder for Providers to check real-time inventory at pharmacies near your patient's home or workplace.

This one step eliminates the most common frustration point — the patient arriving at a pharmacy that doesn't carry the medication.

Step 2: Build a Preferred Pharmacy List

Maintain a list of pharmacies in your area that regularly stock Neffy. This might include:

• Specific independent pharmacies that have confirmed they carry or will order Neffy
• Specialty pharmacies focused on allergy medications
• Specific chain pharmacy locations (not just the chain name — stock varies by location)

Update this list monthly using Medfinder or by calling pharmacies directly. Share the list with your front desk and nursing staff so anyone processing prescriptions can reference it.

Step 3: Proactively Address Insurance Coverage

When prescribing Neffy, anticipate potential insurance hurdles:

• Check formulary status before the patient leaves the office if possible
• Submit prior authorization proactively with documentation of clinical need (needle phobia, pediatric patient, caregiver concerns, prior auto-injector failure)
• Provide a backup prescription for an alternative (e.g., EpiPen, Auvi-Q, or generic) in case the PA is denied or delayed

Step 4: Connect Patients With Savings Programs

Cost is a real barrier. Make sure your patients know about:

• Co-Pay Savings Program: Commercially insured patients may pay as little as $0 for up to 4 devices
• Patient Assistance Program: Uninsured patients may receive Neffy at no cost
• Savings for uninsured: As little as $25 per prescription through manufacturer programs

Direct patients to neffy.com/savings-and-support or 1-877-MY-NEFFY. For detailed savings information, share our patient savings guide.

Step 5: Educate Patients on Self-Advocacy

Empower your patients with information they can use at the pharmacy:

• They can ask any pharmacist to special-order Neffy — it's not a controlled substance and doesn't require special handling
• They can use Medfinder themselves to check pharmacy inventory before calling or visiting
• They can request the prescription be transferred to a pharmacy that has it in stock
• They should never go without epinephrine — if Neffy isn't available, they should fill an alternative

Alternatives to Discuss With Patients

When Neffy isn't available, have a conversation about alternatives:

• EpiPen / Generic epinephrine auto-injectors: Widely available. 0.3 mg and 0.15 mg doses. Generics from Teva and Viatris cost $150-$350 for a 2-pack.
• Auvi-Q: Compact with voice guidance. Available in 0.1 mg, 0.15 mg, and 0.3 mg. $35 copay program for commercially insured.
• Symjepi: Pre-filled syringe option. May be appropriate for patients comfortable with manual injection.

For a complete patient-facing comparison, refer them to our post on alternatives to Neffy.

Workflow Tips for Your Practice

• Add a Neffy pharmacy check to your prescribing workflow — before finalizing the e-prescription, verify stock via Medfinder or a maintained pharmacy list
• Create a patient handout with Neffy savings information, the Medfinder link, and instructions for requesting a special order at the pharmacy
• Flag patients prescribed Neffy for follow-up within 1-2 weeks to confirm they successfully filled the prescription
• Document prescribing rationale for Neffy over auto-injectors in the chart — this supports any needed prior authorization appeals
• Keep samples or demo devices in office (contact your ARS Pharmaceuticals rep) so patients can practice technique before filling

Final Thoughts

Neffy is a clinically meaningful advance in anaphylaxis management. The availability challenges are temporary and distribution-related — not a supply problem. By incorporating a few simple steps into your prescribing workflow, you can dramatically improve your patients' success in finding and affording Neffy.

Medfinder for Providers is a free tool that can save your practice time and reduce patient callbacks about unfilled prescriptions. For background on the current availability landscape, see our provider shortage briefing.