Your Patients Can't Find Pulmicort — Here's How You Can Help

The budesonide inhalation shortage is generating a steady stream of calls to your office: patients who can't fill their prescriptions, pharmacies requesting therapeutic alternatives, and parents worried about their child's asthma control. It's a real clinical and operational challenge.

This guide covers practical steps your practice can take to help patients find Budesonide — or get on an effective alternative — with minimal disruption to your workflow.

Current Availability: What You Need to Know

As of early 2026, here's the supply picture:

• Budesonide inhalation suspension (generic Respules): Active shortage. Teva has the 0.5 mg/2 mL on back order (estimated late March 2026 resupply). Other presentations intermittently available.
• Pulmicort Flexhaler 180 mcg: Available, though supply varies by market.
• Pulmicort Flexhaler 90 mcg: Permanently discontinued by AstraZeneca.
• Generic budesonide DPI: Increasingly available at lower cost.

Stock levels vary significantly between pharmacies — even within the same city. What's out of stock at one CVS may be available at an independent pharmacy three blocks away.

For the full shortage timeline and background, see our provider shortage briefing.

Why Patients Can't Find It

Understanding the barriers your patients face helps you address them more effectively:

• Limited manufacturers: Few companies produce generic budesonide inhalation products. When the primary supplier has issues, the whole market feels it.
• Pharmacy ordering limitations: Chain pharmacies often can only order from their designated wholesaler. If that wholesaler is out, the pharmacy is out — even if supply exists elsewhere.
• Patients don't know where to look: Most patients will try their usual pharmacy, hear "out of stock," and not know what to do next. Many give up or go without.
• Cost barriers at alternative pharmacies: Even when patients find stock at a different pharmacy, the out-of-pocket cost may be different — especially if the new pharmacy isn't in their insurance network.

5 Things Your Practice Can Do Right Now

Step 1: Direct Patients to Medfinder

Medfinder for Providers lets you (and your patients) check which pharmacies near them have Budesonide in stock in real time. This single step can eliminate the "call 10 pharmacies" frustration for your patients.

Consider adding the Medfinder link to:

• Your patient portal messages about the shortage
• Your front desk's shortage FAQ script
• Printed handouts for affected patients

Step 2: Pre-Identify Alternative Pharmacies

Use Medfinder to identify 2-3 pharmacies in your area that currently have budesonide in stock. When a patient calls about a shortage issue, your staff can proactively suggest these pharmacies — and send the prescription there directly.

Independent pharmacies and hospital outpatient pharmacies are often the most reliable during shortages.

Step 3: Have a Therapeutic Alternative Ready

Don't wait until a patient calls in crisis. Develop a practice-level protocol for budesonide substitution:

• Adults/adolescents: Fluticasone propionate (Flovent HFA/Diskus or generic) is the most common switch. Beclomethasone (QVAR), mometasone (Asmanex), and ciclesonide (Alvesco) are also options.
• Pediatrics (4+): Fluticasone HFA with spacer/mask. QVAR RediHaler for ages 4+.
• Pediatrics (under 4, nebulizer-dependent): This is the most challenging population. If budesonide suspension is unavailable, consider whether the child can transition to MDI with spacer/mask. If not, short-term bridge therapy may be needed while supply is located.

For detailed alternative guidance, see our provider shortage briefing and the patient-facing alternatives guide.

Step 4: Proactively Address Prior Authorization

If switching a patient to an alternative ICS, check their formulary first. Many alternatives may require prior authorization or have step therapy requirements. Some insurers have implemented shortage exceptions — it's worth calling the payer to ask about expedited PA during the active budesonide shortage.

Tips to speed up the PA process:

• Document the shortage as the reason for the switch in the PA request
• Include ASHP shortage database reference
• Request an exception to step therapy based on supply unavailability

Step 5: Address Cost Proactively

Patients who are forced to switch pharmacies or formulations may face unexpected costs. Help them prepare:

• Mention that generic budesonide is available for as low as $45-$70 with discount cards
• Point them to AstraZeneca's AZ&Me program if uninsured (azandmeapp.com)
• Suggest checking prices at GoodRx, SingleCare, or RxSaver before filling

For a complete breakdown, share our patient guide on saving money on Pulmicort.

Workflow Tips for Your Practice

Create a Shortage Communication Template

Draft a standard message for your patient portal or phone system explaining the current budesonide shortage, what patients should do, and where to find help. This reduces incoming calls and empowers patients to take action.

Sample message points:

• Acknowledge the shortage exists
• Direct them to medfinder.com to check pharmacy stock
• Let them know alternatives are available
• Provide your office's preferred callback number for prescription changes

Designate a Shortage Point Person

Having one staff member (or rotating responsibility) who monitors shortage updates and manages related prescription changes can streamline workflow. This person can check ASHP updates weekly and maintain a list of pharmacies with current stock.

Review Your Nebulizer-Dependent Patient List

If your practice has a significant pediatric asthma population, proactively identify patients on budesonide inhalation suspension and reach out before they run out. A proactive call or portal message is much more efficient than handling the crisis after they've already missed doses.

Final Thoughts

The budesonide inhalation shortage is a real burden on practices and patients alike. But with the right tools and a proactive approach, you can minimize treatment gaps and reduce the operational strain on your team.

Start by directing patients to Medfinder for Providers. Have your alternative protocols ready. And communicate early — the patients who hear from you before they're out of medication will have the smoothest experience.

For additional resources, see our guide to helping patients save money on Pulmicort.