How to Help Your Patients Find Trulance In Stock: A Provider's Guide

If your GI or primary care practice regularly prescribes Trulance (plecanatide), you've likely heard from patients who ran into trouble filling their prescription. Whether the issue is pharmacy availability, insurance denial, or cost — these barriers are frustrating for patients and generate unnecessary callbacks to your office. This guide gives your team actionable strategies to proactively reduce those friction points.

Understanding Why Trulance Is Hard for Patients to Find

Trulance is a brand-only medication — no generic exists, and none is expected until at least 2034. Because it serves a relatively small patient population, many pharmacies don't routinely stock it. The drug's high retail price ($749–$830 for 30 tablets) also means pharmacies manage inventory conservatively to avoid holding capital in slow-moving stock. As a result, patients are sometimes turned away or told to wait 1–3 days while the pharmacy places an order.

Insurance barriers add another layer: prior authorization, step therapy (requiring trial of Linzess first), and formulary restrictions can delay access for days or weeks even when the drug is physically available.

Strategy 1: Guide Patients to High-Volume Pharmacy Chains

When e-prescribing Trulance, consider sending the prescription to a large chain pharmacy where your patient is most likely to find it filled same-day or next-day. CVS, Walgreens, and Walmart pharmacies have the highest dispense volumes for brand GI medications and are most likely to carry Trulance on hand or be able to order it quickly. Independent pharmacies and smaller chains are less reliable for this medication.

For patients in rural areas where large chains are sparse, proactively prescribe to a mail-order pharmacy through the patient's insurance plan — this ensures reliable access and often reduces cost.

Strategy 2: Refer Patients to medfinder

When patients call back unable to fill their prescription, one of the fastest resources to give them is medfinder. medfinder calls pharmacies in the patient's geographic area to identify which ones have Trulance in stock, then texts the results directly to the patient. This significantly reduces the number of calls your front desk receives and empowers patients to locate their medication without needing your staff's intervention every time.

Strategy 3: Submit Prior Authorizations at the Point of Prescribing

One of the biggest delays in Trulance access is reactive PA processing — the pharmacy rejects the claim, the patient calls your office, staff submits the PA, and the patient waits. Shifting to proactive PA submission at the time of prescribing eliminates much of this delay.

At the point of care:

1. Check the patient's formulary in your EHR's prescribing module before writing the Rx
2. If PA is required, initiate it through CoverMyMeds, EHR-integrated tools, or your staff PA queue immediately
3. Include documentation of failed OTC laxatives and, if applicable, prior Linzess trial
4. Flag the patient's chart so staff can follow up if the PA isn't approved within 48 hours

Strategy 4: Provide Patients With the Salix Savings Card Information

For commercially insured patients, the Trulance Savings Card from Salix Pharmaceuticals reduces out-of-pocket cost to as little as $25 per prescription for up to 12 fills per year. Have your staff or medical assistant print or send the enrollment link (trulance.com/savings) at the point of prescribing. Many patients are unaware this program exists and end up paying full retail price unnecessarily.

For uninsured or low-income patients, Salix's patient assistance program may provide Trulance at no or reduced cost. Contact Salix Medical Information at 1-800-321-4576 for eligibility details.

Strategy 5: Establish a Preferred Mail-Order Pharmacy Workflow

Mail-order pharmacy is consistently the most reliable access route for brand-only GI medications like Trulance. Unlike retail pharmacies, mail-order operations maintain large specialty drug inventories and can ship a 90-day supply to the patient's home at a lower copay per day.

For patients with frequent trouble refilling at retail, proactively write the prescription for a 90-day supply and specify "dispense as written" on the Rx. Instruct staff to note in the after-visit summary how to set up mail-order with their insurer's pharmacy benefit manager.

Strategy 6: Keep Samples Available for Continuity Gaps

Salix Pharmaceuticals offers professional samples to prescribers through MySampleCloset.com. Maintaining a supply of Trulance samples in your office means you can bridge patients through short-term access gaps — while a prior authorization processes, while a mail-order order ships, or while a pharmacy locates stock.

When Trulance Cannot Be Accessed: Clinical Transition Guidance

If access barriers prove insurmountable for a specific patient, Linzess (linaclotide) offers comparable GC-C agonist efficacy and may have better formulary placement with certain payers. See our guide to Trulance alternatives for a full comparison of clinical options. Generic lubiprostone (Amitiza) is also worth considering for cost-sensitive patients, given its dramatically lower price point.

Summary Checklist for Your Practice

• Send prescriptions to large chain pharmacies (CVS, Walgreens, Walmart)
• Initiate prior authorizations proactively using CoverMyMeds or your EHR tool
• Provide the Salix savings card enrollment link to all commercially insured patients
• Direct patients to medfinder when they can't locate the medication locally
• Stock office samples from Salix for bridging access gaps
• Offer mail-order pharmacy setup assistance for patients needing 90-day supply