How to Help Your Patients Find Zenpep in Stock: A Provider's Guide

When a patient with exocrine pancreatic insufficiency (EPI) calls your office because Zenpep is unavailable at their pharmacy, time matters. Even a few days without pancreatic enzyme replacement therapy (PERT) can cause significant malabsorption and nutritional decline. This guide equips providers and their clinical teams with a practical workflow for helping patients locate Zenpep quickly and navigate shortage situations effectively.

Step 1: Understand Why Zenpep Is Frequently Unavailable

Zenpep faces structural availability challenges that make localized stock-outs common even in the absence of an FDA-declared shortage:

• Brand-only product — no generic alternative with the same formulation
• Eight dose strengths (3,000–60,000 lipase units) each requiring individual inventory
• High per-patient demand — patients may use 90–180+ capsules per month
• Porcine-based manufacturing with limited production redundancy

When patients call your practice about Zenpep availability, your team should be prepared to move through a clear workflow — not simply tell the patient to "call around."

Step 2: Direct Patients to medfinder for Pharmacy Search

The most efficient first step for most patients is to use medfinder. medfinder is a paid service that calls pharmacies near the patient to check which ones have their specific Zenpep strength in stock, then texts results to the patient. This eliminates the need for patients to make dozens of phone calls, which is particularly important for patients who are already managing complex conditions and may have limited energy or mobility.

medfinder covers all medications and dose strengths, including all eight Zenpep strengths. Recommend it proactively to any EPI patient who has experienced or is likely to experience availability issues.

Step 3: Recommend Specialty Pharmacies for Ongoing Supply

Consider referring high-risk EPI patients — those with cystic fibrosis, advanced pancreatic disease, or severe malnutrition — to specialty pharmacies or mail-order services. These pharmacies typically:

• Maintain larger, more consistent inventories of brand-name specialty medications
• Provide 90-day supply options with home delivery
• Have dedicated staff familiar with payer requirements for PERT coverage and prior authorization
• Can coordinate with the manufacturer's support programs (Z-Save® and CF Patient Support Program)

Step 4: Pre-Authorize a Bridge Prescription for an Alternative PERT

One of the most practical things a provider can do for EPI patients is to preemptively document an alternative PERT in the medical record. When Zenpep is unavailable, your office can quickly provide a bridge prescription without a separate visit or extensive evaluation.

Recommended bridge options (in order of accessibility):

1. Creon (AbbVie) — Most widely available PERT; start at equivalent lipase units per meal; clinical data supports comparable fat absorption
2. Pancreaze — Enteric-coated microtablets; approved for CF and other EPI conditions
3. Pertzye — Bicarbonate-buffered formulation; may be especially helpful in patients with suboptimal duodenal pH

Note: Since PERT products are not FDA-interchangeable, each product switch requires a new prescription. Schedule a follow-up 4–6 weeks after any PERT transition to assess clinical response and adjust dosing.

Step 5: Leverage Manufacturer and Financial Support Programs

For patients who struggle with cost in addition to access, the following programs can help:

• Z-Save® (Nestlé Health Science / Aimmune): Copay savings program for commercially insured patients. First fill as low as $0, refills as low as $30. Up to 12 fills per year. Call 1-833-742-0707 or visit zenpep.com/support-programs.
• CF Patient Support Program: For patients with EPI due to cystic fibrosis. Similar savings structure. Not valid for Medicare/Medicaid.
• HealthWell Foundation CF Fund: Income-based assistance for CF patients. Phone: 1-800-675-8416. Website: healthwellfoundation.org/cystic-fibrosis.
• GoodRx / SingleCare: Discount cards that can reduce Zenpep cash price by 20–30% at participating pharmacies.

Step 6: Proactive Patient Counseling at Every Visit

Prevention is more effective than crisis management. At each visit with an EPI patient on Zenpep, address the following:

• "Are you having any trouble filling your Zenpep prescription?"
• "Do you refill before you run out, or do you sometimes run low?"
• "Have you considered a 90-day supply through mail order?"
• "Do you know what to do if your pharmacy runs out?"

Summary Workflow for Providers

1. Direct the patient to medfinder to identify pharmacies with stock.
2. If Zenpep cannot be found within 24–48 hours, write a bridge prescription for Creon or another PERT at equivalent lipase units.
3. Enroll the patient in Z-Save® or the CF Patient Support Program if not already enrolled.
4. Recommend mail-order or specialty pharmacy for ongoing supply if local access is unreliable.
5. Schedule follow-up 4–6 weeks after any PERT product change to assess response.

The Bottom Line

Providers who proactively counsel EPI patients on PERT access strategies can prevent the health consequences of supply gaps. With tools like medfinder, manufacturer savings programs, and specialty pharmacy referrals, most Zenpep availability problems can be resolved without significant treatment interruption. For more clinical background on the shortage landscape, see what providers need to know about the Zenpep shortage.