Your Patients Are Struggling to Find Xolair — Here's How You Can Help

As a prescriber, you've likely heard from frustrated patients who can't get their Xolair (Omalizumab) prescription filled. Whether it's a specialty pharmacy backorder, a prior authorization delay, or simply limited supply in your area, the Xolair access challenge has become a routine headache for allergy, pulmonology, and immunology practices.

You can't fix the global supply chain, but you can take concrete steps to help your patients stay on treatment. This guide outlines the current availability landscape, the key reasons patients struggle to find Xolair, and five practical things your practice can do to improve access.

Current Xolair Availability in 2026

Xolair supply has improved since the acute shortages of 2024, but it's not back to normal. Here's a snapshot:

• Prefilled syringes and autoinjectors are generally more available than lyophilized powder vials.
• Availability varies by region — urban areas with multiple specialty pharmacies tend to have better access.
• The biosimilar Omlyclo (Omalizumab-igec) is entering the market but isn't universally stocked yet.
• Higher-dose patients (e.g., 375 mg, requiring multiple syringes) may face more difficulty because their prescriptions consume more supply per fill.

The underlying issue is that demand — driven primarily by the February 2024 food allergy indication — continues to exceed what the manufacturing base was designed for. Capacity is expanding, but biologic production scale-up is a multi-year process.

Why Your Patients Can't Find Xolair

Understanding the barriers from the patient's perspective helps you intervene more effectively:

1. Specialty Pharmacy Limitations

Most patients are directed to a single specialty pharmacy by their insurer. If that pharmacy is out of stock, the patient may not know they have other options — or how to pursue them.

2. Prior Authorization Bottlenecks

Prior authorization is required by virtually all payers. Delays in PA processing can mean the medication isn't ordered until after approval comes through, at which point stock may have shifted.

3. Lack of Real-Time Visibility

Patients (and many practices) don't have easy access to real-time stock information across multiple pharmacies. They end up making phone call after phone call with no guarantee of results.

4. Cost Barriers

Even when Xolair is available, patients without adequate insurance or financial assistance may not be able to afford it. Cash prices range from $1,500 to $4,000+ per injection.

5. Limited Awareness of the Biosimilar

Many patients don't know that an FDA-approved biosimilar (Omlyclo) exists, and some are hesitant about switching from the brand they know.

What Providers Can Do: 5 Steps

Step 1: Check Availability Before Prescribing

One of the most impactful things you can do is verify that a pharmacy has Xolair in stock before sending the prescription. This saves your patients days or weeks of waiting and calling.

Medfinder for Providers lets you check real-time Xolair availability at specialty pharmacies near your patient. Incorporate this into your prescribing workflow to match prescriptions with available supply.

Step 2: Maintain Multiple Specialty Pharmacy Relationships

Don't rely on a single specialty pharmacy or distributor. Establish relationships with 2-3 specialty pharmacy partners so you have backup options when one is out of stock.

If your practice administers Xolair in-office through a buy-and-bill model, work with multiple distributors (e.g., McKesson, AmerisourceBergen, Cardinal Health) to diversify your supply sources.

Step 3: Proactively Discuss the Biosimilar

Omlyclo (Omalizumab-igec) is clinically equivalent to Xolair. Proactively discussing it with patients serves two purposes:

1. It provides an alternative source of supply when brand-name Xolair is unavailable.
2. It may offer cost savings, which can improve adherence and reduce financial toxicity.

Address common patient concerns head-on: biosimilars meet the same FDA standards for safety and efficacy. They are not "knockoffs" — they are rigorously tested biologic alternatives.

Step 4: Streamline Prior Authorization

PA delays compound the supply problem. Steps to streamline:

• Submit PAs as early as possible — ideally before the patient's current supply runs out.
• Use electronic PA (ePA) platforms when available.
• Keep templates for letters of medical necessity ready for common Xolair indications.
• Track PA status proactively rather than waiting for the pharmacy or insurer to follow up.

Step 5: Connect Patients With Financial Assistance

Cost barriers can be just as limiting as supply barriers. Ensure your staff is familiar with:

• Genentech Co-pay Program: Can reduce commercial copays to $0 per dose
• Genentech Patient Foundation: Free medication for qualifying uninsured/underinsured patients
• Support for You Program: Comprehensive support including financial navigation, injection training, and nurse support
• NeedyMeds and RxAssist: Independent databases of patient assistance programs

For a patient-friendly resource on savings, share How to Save Money on Xolair in 2026 or refer to the provider-focused cost guide at How to Help Patients Save Money on Xolair.

When to Consider Alternatives

If Xolair remains unavailable and a treatment gap is clinically unacceptable, consider alternative therapies based on the patient's indication:

• Asthma: Dupixent (Dupilumab) for type 2/allergic phenotype; Nucala (Mepolizumab) or Fasenra (Benralizumab) for eosinophilic phenotype; Tezspire (Tezepelumab) as a broad option regardless of biomarkers.
• CRSwNP: Dupixent is the primary biologic alternative.
• CSU: Escalate antihistamine dosing (up to 4x standard), consider off-label Cyclosporine for refractory cases.
• Food allergy: No biologic alternative exists. Ensure the patient has emergency epinephrine and reinforce allergen avoidance. Consider oral immunotherapy (Palforzia for peanut allergy).

Patient-facing information on alternatives: Alternatives to Xolair.

Workflow Tips for Your Practice

• Build a Xolair access checklist that your clinical staff follows for every Xolair prescription: check stock → submit PA → enroll in financial assistance → confirm delivery/appointment.
• Designate a point person (nurse, medical assistant, or pharmacy coordinator) to manage biologic access issues. Centralizing this function reduces dropped balls.
• Educate patients on self-injection when appropriate. Home injection via prefilled syringe or autoinjector reduces dependence on in-office supply and gives patients more flexibility in which specialty pharmacy they use.
• Track your outcomes. Keep a log of how many patients experience access delays, how long the delays last, and what resolved them. This data can support advocacy efforts and help you refine your process.

Final Thoughts

The Xolair shortage has added a layer of complexity to managing patients with severe allergic conditions. But with the right systems in place — from real-time stock checking with Medfinder to proactive biosimilar discussions to streamlined PA workflows — your practice can minimize disruptions and keep patients on treatment.

The goal isn't perfection; it's preparation. The more proactive your practice is about supply verification and patient support, the fewer emergency calls you'll get from patients who can't find their medication.

Related resources for providers:

• Xolair Shortage: What Providers Need to Know in 2026
• How to Help Patients Save Money on Xolair

Resources to share with patients:

• How to Find Xolair in Stock Near You
• Xolair Shortage Update for Patients