Helping Patients Access Xofluza: A Provider's Practical Guide

You've made the clinical decision to prescribe Xofluza 80 Mg Dose Pack for your patient's influenza. But increasingly, the challenge isn't the prescribing decision — it's whether the patient can actually fill it.

During peak flu season, pharmacy-level stockouts of Xofluza have become a recurring issue. For a medication that must be taken within 48 hours of symptom onset, even a short delay can mean the difference between effective treatment and a missed window.

This guide provides actionable steps your practice can take to help patients find and fill their Xofluza prescriptions quickly.

Current Availability Landscape

As of February 2026, Xofluza is not in a formal FDA-listed shortage, but real-world availability is inconsistent:

• Chain pharmacies (CVS, Walgreens, Rite Aid) may have limited or no stock of the 80 mg dose pack during peak season
• Independent pharmacies sometimes maintain better stock of specialty medications
• Online/mail-order pharmacies (Amazon Pharmacy, Alto Pharmacy, Cost Plus Drugs) participate in Genentech's direct-to-patient program and often have better availability
• Hospital outpatient pharmacies may stock Xofluza for discharged patients

The 80 mg dose pack is more frequently out of stock than the 40 mg version because fewer patients require the higher dose, leading pharmacies to stock smaller quantities.

Why Patients Can't Find Xofluza

Understanding the root causes helps you anticipate and address the problem:

Supply-Side Factors

• Single manufacturer: Genentech is the sole producer. No generic competition means no alternative supply sources.
• Seasonal production: Manufacturing ramps up ahead of flu season, but severe or early seasons can outpace projections.
• Formulation specificity: The 80 mg dose pack (for patients ≥80 kg) has lower volume than the 40 mg pack, making it more vulnerable to stockouts.

Demand-Side Factors

• Growing prescriber preference: Single-dose convenience has made Xofluza increasingly popular, driving demand higher each season.
• Expanded indications: The 2020 approval for post-exposure prophylaxis broadened the patient population.
• Patient awareness: Direct-to-consumer awareness of Xofluza has increased, leading to more patient requests.

Distribution Factors

• Pharmacy economics: At $200–$280 retail, Xofluza carries high inventory cost and expiration risk. Many pharmacies minimize on-hand stock.
• Just-in-time ordering: Pharmacies order based on recent demand patterns. A sudden surge can deplete stock before reorders arrive.

What Providers Can Do: 5 Practical Steps

Step 1: Verify Stock Before Prescribing

Before sending a Xofluza prescription, have your staff call the patient's preferred pharmacy to confirm availability. This takes 2–3 minutes and prevents the patient from making a wasted trip.

Better yet, use MedFinder for Providers to check real-time stock across multiple pharmacies in your area. You can direct the prescription to a pharmacy that actually has it.

Step 2: Consider the Two-Tablet Workaround

If the 80 mg dose pack is unavailable but the pharmacy has 40 mg tablets in stock, you can prescribe two 40 mg tablets to be taken together as a single 80 mg dose. This achieves the same therapeutic outcome and may be more readily available.

Make sure the prescription clearly indicates: "Baloxavir marboxil 40 mg — dispense 2 tablets — take both tablets together as a single dose."

Step 3: Send to Online Pharmacies

Genentech's direct-to-patient program makes Xofluza available for $50 cash pay through:

• Alto Pharmacy
• Amazon Pharmacy
• Cost Plus Drugs

These pharmacies often have better availability than retail chains, and the $50 price point eliminates the cost barrier for many patients. For Amazon Pharmacy, patients typically receive the medication within 1–2 days with expedited shipping.

Important timing note: Given the 48-hour treatment window, mail-order is only viable if the patient is early in their symptom course or if same-day/next-day delivery is available in their area.

Step 4: Prepare a Backup Prescription

Adopt a dual-prescription workflow during flu season:

1. Send the Xofluza prescription to the confirmed pharmacy
2. Provide the patient with a backup prescription (paper or e-prescribe on hold) for oseltamivir 75 mg twice daily for 5 days
3. Instruct the patient: "If the pharmacy can't fill the Xofluza, have them fill the Tamiflu immediately. Don't wait."

This ensures the patient receives antiviral treatment regardless of Xofluza availability, without requiring a callback to your office.

Step 5: Educate Your Patients

Provide brief guidance at the point of prescribing:

• "Call ahead to your pharmacy before going — make sure they have it"
• "If they don't have it, try [specific nearby pharmacy] or use MedFinder"
• "If you can't find Xofluza within a few hours, fill the backup Tamiflu prescription instead"
• "Don't wait more than 48 hours from when your symptoms started"

You can direct patients to our article on how to find Xofluza in stock for additional guidance.

Alternatives to Consider

When Xofluza is unavailable, these FDA-approved alternatives should be part of your prescribing toolkit:

• Oseltamivir (Tamiflu): Generic available, $30–$60 cash price, 75 mg twice daily for 5 days. Most widely available antiviral. First-line alternative for most patients.
• Zanamivir (Relenza): Inhaled powder, twice daily for 5 days. Avoid in patients with reactive airway disease. Less commonly stocked but can be ordered.
• Peramivir (Rapivab): Single IV dose, administered in clinical settings. Useful for patients who cannot tolerate oral medications or who are already presenting to an ED or urgent care with IV access.

For a detailed comparison, see our alternatives guide.

Workflow Tips for Your Practice

To minimize disruption during flu season, consider implementing these workflow changes:

Pre-Season Preparation

• Identify 2–3 pharmacies in your area that reliably stock Xofluza and note them in your EHR or staff reference materials
• Establish a relationship with a local independent pharmacy willing to maintain Xofluza inventory
• Brief clinical staff on the dual-prescription workflow

During Flu Season

• Check MedFinder at the start of each clinic day to identify pharmacies with current stock
• Track which pharmacies are filling Xofluza prescriptions successfully and route new prescriptions accordingly
• Consider adding an Xofluza availability check to your MA/nurse intake workflow for patients presenting with flu symptoms

Documentation

• Document in the patient chart when Xofluza is prescribed and whether the backup prescription was activated
• Note the pharmacy used for successful fills to inform future prescribing

Final Thoughts

The clinical value of Xofluza is clear — single-dose convenience, a differentiated mechanism of action, and strong efficacy data. The challenge is purely logistical. By building availability checks, backup prescriptions, and patient education into your flu-season workflow, you can ensure that a pharmacy stockout doesn't become a missed treatment opportunity.

For real-time pharmacy stock data and provider-specific tools, visit MedFinder for Providers. For the latest on supply and pricing, see our provider shortage briefing.