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

When a patient finishes a chemotherapy cycle and needs G-CSF support, the last thing they should have to worry about is finding their medication. But with ongoing intermittent shortages of Filgrastim products including Neupogen, that's exactly what's happening to patients across the country.

As a provider, you're in a unique position to bridge the gap. Your relationships with distributors, your clinical knowledge of alternatives, and your access to tools can make the difference between a patient getting their medication on time — or facing a dangerous gap in G-CSF therapy.

This guide offers practical, actionable steps your practice can take today to help patients navigate Neupogen availability challenges in 2026.

Current Availability Landscape

The Filgrastim market in 2026 includes five products:

• Neupogen (Filgrastim) — Amgen (original brand)
• Zarxio (Filgrastim-sndz) — Sandoz
• Nivestym (Filgrastim-aafi) — Pfizer/Hospira
• Releuko (Filgrastim-ayow)
• Nypozi (Filgrastim-szfi) — approved 2024

Availability varies by product, formulation strength, pharmacy channel, and region. Biosimilars generally have better supply than brand Neupogen. Specialty pharmacies and oncology-focused distributors tend to have more consistent stock than retail chains.

Long-acting alternatives — Neulasta (Pegfilgrastim) and its biosimilars — represent a separate supply chain and may be available when short-acting products are not.

Why Patients Can't Find Neupogen

Understanding the patient experience helps you provide better support:

• Limited retail availability: Many retail pharmacies don't routinely stock injectable biologics like Filgrastim
• Insurance restrictions: Plans may require specific specialty pharmacies that are backordered
• Information gaps: Patients don't know which pharmacies carry G-CSF products or how to search for alternatives
• Cold-chain requirements: Some patients are concerned about handling refrigerated injectables
• Cost barriers: Even when available, high out-of-pocket costs prevent some patients from filling prescriptions

What Providers Can Do: 5 Practical Steps

Step 1: Prescribe Flexibly

Write prescriptions for "Filgrastim" rather than specifying a brand when clinically appropriate. This allows pharmacists to dispense whichever Filgrastim product is currently in stock — brand Neupogen, Zarxio, Nivestym, Releuko, or Nypozi.

If your state requires specific product designation, consider including a note such as "biosimilar substitution permitted" or writing separate prescriptions for multiple products that the pharmacy can attempt to fill in order of preference.

Step 2: Use Real-Time Availability Tools

Medfinder for Providers enables your practice to search for Filgrastim product availability at pharmacies near your patients in real time. Integrate this into your workflow:

• Check availability before sending the prescription to avoid routing patients to out-of-stock pharmacies
• Provide patients with specific pharmacy recommendations where the product is available
• Empower your nursing staff or patient navigators to use Medfinder proactively

Step 3: Maintain In-Office G-CSF Supply

For practices using the buy-and-bill model, stocking Filgrastim products in-house provides a critical safety net during shortages:

• Work with multiple specialty distributors to maintain supply
• Stock at least two different Filgrastim products (e.g., Zarxio and Nivestym) for redundancy
• Monitor ASP reimbursement rates to ensure financial sustainability
• In-office administration eliminates the patient's need to navigate retail pharmacy shortages entirely

Step 4: Proactively Address Insurance Barriers

Prior authorization delays can cost patients critical days of G-CSF therapy. Reduce friction by:

• Submitting prior authorizations before the patient finishes their chemotherapy cycle
• Keeping updated formulary information for your major payers
• Using "urgent" or "expedited" PA request pathways when available
• Documenting medical necessity clearly — especially when requesting a non-preferred product due to shortage of the preferred one
• Appealing denials with supporting shortage documentation from the FDA or ASHP databases

Step 5: Connect Patients with Financial Assistance

Cost should never prevent a patient from receiving G-CSF therapy. Have your team proactively screen patients for assistance programs:

• Amgen Safety Net Foundation: Free Neupogen for uninsured/underinsured patients (income ≤400% FPL). Call 1-888-4AMGEN-1.
• Patient Access Network (PAN) Foundation: Co-pay assistance for cancer supportive care medications
• HealthWell Foundation: Financial assistance for eligible patients
• Biosimilar savings: Simply switching to a biosimilar can save patients 15–30% — from $300–$450 per injection (brand Neupogen) to $200–$350 (biosimilar)

For more cost-saving strategies, see our provider's guide to helping patients save money on Neupogen.

When to Consider Alternatives

If Filgrastim products remain unavailable, consider these alternatives for eligible patients:

• Neulasta (Pegfilgrastim): Long-acting G-CSF requiring one injection per chemotherapy cycle. Ideal for patients with adherence challenges or when daily Filgrastim supply is unreliable. Also available as the Onpro on-body injector.
• Pegfilgrastim biosimilars: Udenyca, Nyvepria, Fylnetra, and Stimufend offer additional options with potentially different availability.
• Granix (Tbo-filgrastim): A related short-acting G-CSF that may be available from a different supply chain.

For a complete comparison of alternatives, share our patient-facing post on alternatives to Neupogen with your patients.

Workflow Tips for Your Practice

Build shortage resilience into your daily operations:

• Assign a point person: Designate a staff member (nurse navigator, pharmacy tech, or clinical coordinator) to monitor G-CSF supply and serve as the patient contact for availability questions
• Batch PA submissions: For patients on recurring chemotherapy cycles, submit prior authorizations for G-CSF in advance — not day-of
• Maintain a pharmacy network list: Keep an updated list of specialty pharmacies, hospital outpatient pharmacies, and independent pharmacies that reliably stock Filgrastim products in your area
• Bookmark Medfinder for Providers: Make it a standard tool in your practice's shortage management workflow
• Educate patients early: At the start of chemotherapy, proactively discuss G-CSF therapy, potential supply challenges, and what to do if they can't find their medication
• Document everything: When shortages cause treatment modifications, document the shortage as the reason in the patient's chart — this supports future insurance appeals and quality reporting

Final Thoughts

Neupogen shortages put an unfair burden on patients who are already navigating one of the most difficult experiences of their lives. As providers, we can't control the supply chain — but we can control how we respond. Prescribing flexibly, using availability tools, maintaining in-office supply, and proactively addressing insurance and cost barriers can make a tangible difference for your patients.

Visit Medfinder for Providers to start searching for Filgrastim availability in your area. For the latest shortage information, see our provider shortage briefing.