A practical guide for eye care providers on helping patients access Xdemvy. Learn 5 key steps, specialty pharmacy workflow tips, and alternative treatments.
You've diagnosed Demodex blepharitis, prescribed Xdemvy (Lotilaner ophthalmic solution 0.25%), and now your patient is calling back because they can't find it at their pharmacy. This scenario plays out daily in eye care practices across the country — not because Xdemvy is in shortage, but because its distribution model requires a different approach than typical ophthalmic prescriptions.
This guide provides practical steps your team can implement to help patients access Xdemvy efficiently, reducing callbacks and improving treatment initiation rates.
As of 2026, Xdemvy is not in shortage. The FDA has not listed any supply disruptions, and Tarsus Pharmaceuticals continues to manufacture the product. The availability challenges patients encounter are entirely related to the limited distribution drug (LDD) model — Xdemvy is only dispensed through approved specialty pharmacies, not retail pharmacies.
This is an important distinction. When a patient calls saying "my pharmacy doesn't have Xdemvy," it almost always means the prescription was sent to a retail pharmacy that cannot stock the product, or that prior authorization is still pending.
Understanding the common barriers helps your team address them proactively:
If Xdemvy is prescribed to a standard retail pharmacy (even a CVS or Walgreens retail location), the pharmacy will be unable to fill it. The prescription must go to a specialty pharmacy division.
The majority of insurance plans require prior authorization for Xdemvy. While the specialty pharmacy typically initiates this process, incomplete documentation can cause delays. Over 85% of insured patients have coverage, but the PA process can take 3-7 business days.
Patients accustomed to same-day prescription pickup may not understand the specialty pharmacy workflow. When told their medication will be shipped to their home in several days, some patients assume there's a problem.
If insurance is denied or the patient hasn't been connected to savings programs, the cash price of approximately $1,850 for a full course can stop patients from filling the prescription. Many don't realize they may be eligible to pay $0 with the savings card.
Route all Xdemvy prescriptions directly to an approved specialty pharmacy. The primary options include:
If your EHR doesn't easily identify specialty pharmacy locations, consider creating a saved pharmacy entry for your preferred Xdemvy specialty pharmacy. This eliminates the most common access barrier.
To expedite prior authorization, include the following with every Xdemvy prescription:
Complete documentation significantly reduces PA processing time and denial rates.
Before the patient leaves your office, set expectations about cost and connect them with savings programs:
The specialty pharmacy will also screen for savings eligibility at the point of dispensing, but mentioning it upfront builds patient confidence in the process.
Tell patients during the office visit:
This simple conversation dramatically reduces patient anxiety and follow-up calls.
Tarsus Pharmaceuticals offers several practice-level resources:
For patients who cannot access Xdemvy due to cost, insurance denial, or preference, evidence-based alternatives include:
For a patient-facing comparison of these options, share our article on alternatives to Xdemvy.
Consider implementing these workflow improvements for Xdemvy prescriptions:
A simple checklist at the point of prescribing can ensure nothing is missed:
If your practice prescribes Xdemvy regularly, having one team member serve as the specialty pharmacy point person can streamline the process and reduce confusion.
Medfinder's provider tools can help your team check pharmacy availability in real time, so you can direct patients to pharmacies with stock on hand. This is particularly useful for patients who need the medication quickly or prefer in-store pickup.
Xdemvy access is a workflow challenge, not a supply challenge. By routing prescriptions correctly, including complete documentation, proactively discussing savings, and setting patient expectations, your practice can minimize access barriers and improve treatment initiation rates for Demodex blepharitis.
The bottom line: most patients can start Xdemvy within 5-7 days of diagnosis when the prescription workflow is optimized.
Additional provider resources:
You focus on staying healthy. We'll handle the rest.
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