Kevzara Shortage: What Providers and Prescribers Need to Know in 2026

As a rheumatologist, internist, or other prescriber managing patients on Kevzara (sarilumab), staying current on its availability and access landscape is critical to maintaining continuity of care. While Kevzara is not currently in an FDA drug shortage, your patients are likely facing real obstacles that delay initiation or interrupt therapy. This guide outlines what providers need to know in 2026—and what you can do to protect your patients' access.

Current Availability Status of Kevzara (Sarilumab)

As of 2026, sarilumab is not listed on the FDA Drug Shortage Database and is commercially available through specialty pharmacy distribution channels. Sanofi and Regeneron manufacture Kevzara using recombinant DNA technology in Chinese Hamster Ovary cell suspension culture. The supply chain appears stable, with no manufacturing alerts from either company.

Importantly, there is no FDA-approved biosimilar for sarilumab in the US market as of 2026. This distinguishes Kevzara from tocilizumab, which now has multiple approved biosimilars. Payers increasingly favor tocilizumab biosimilars as step therapy or preferred formulary placement, which creates additional friction for Kevzara prescriptions.

Why Your Patients Are Still Having Access Problems

Even without a supply shortage, several systemic barriers continue to delay Kevzara initiation and refills:

Prior authorization burden: Virtually every commercial payer requires PA for Kevzara. PA criteria typically require documented failure of at least one conventional DMARD (usually methotrexate) and often at least one other biologic or targeted synthetic DMARD (step therapy). PA timelines range from 1 to 14+ business days depending on payer.

Formulary tier placement: Kevzara sits on Specialty Tier 4 or Tier 5 on most commercial formularies, meaning significant patient cost share before savings programs are applied.

Step therapy requirements: Many PBMs and payers require documented failure of a TNF inhibitor (often an adalimumab biosimilar) before approving an IL-6 inhibitor. This can delay appropriate therapy by months for newly biologic-eligible patients.

Specialty pharmacy routing: Prescriptions that are sent to out-of-network specialty pharmacies are often rejected or significantly delayed. Payer-preferred specialty pharmacies vary by plan and can change during formulary transitions.

Prior Authorization: Clinical Documentation Requirements

A complete PA submission for Kevzara typically requires the following clinical documentation:

Confirmed diagnosis of RA, PMR, or pJIA with ICD-10 code

Documentation of DMARD failure or intolerance (drug name, dose, duration, reason for discontinuation)

If step therapy required: documentation of prior biologic trial and failure/intolerance

Current disease activity documentation (joint counts, DAS28-ESR or DAS28-CRP, patient global assessment, HAQ-DI score)

Baseline labs: CBC with differential (ANC ≥2000/mm3 required), platelet count (≥150,000/mm3), ALT/AST levels, lipid panel, and negative TB test (IGRA or TST within 12 months)

Written clinical justification for why Kevzara is the preferred agent over alternatives

What Prescribers Can Do to Streamline Kevzara Access

Submit PA documentation at the time of the prescribing visit, not after. This avoids patients leaving the appointment expecting a medication that won't arrive for weeks.

Use KevzaraConnect's provider hub to manage PA submissions, track status, and access free trial supply vouchers (1-844-538-9272 or kevzara.com/hcp).

Confirm the patient's insurance-preferred specialty pharmacy before sending the prescription. Out-of-network routing is one of the most common and avoidable causes of delay.

Recommend medfinder to patients who are having difficulty. medfinder.com/providers is a resource that helps patients locate pharmacies that can fill their specialty prescriptions.

When to Consider Switching Patients to Tocilizumab or Another Alternative

With tocilizumab biosimilars now widely available, some clinicians are considering or being asked about non-medical switching from Kevzara to a tocilizumab biosimilar—primarily driven by payer preference or cost. The ASCERTAIN trial demonstrated comparable efficacy between sarilumab and tocilizumab IV, and clinical observational data support maintained disease control when switching between the two agents.

If a patient's Kevzara access is being persistently blocked by payer step therapy requiring tocilizumab first, consider the following clinical pathway: trial the payer's preferred agent with a documented plan to switch back to sarilumab if needed. This approach may be the most practical path to getting the patient on therapy in a timely manner.

Safety Monitoring Protocol Reminders for Kevzara

For prescribers initiating or continuing Kevzara, the recommended monitoring schedule per the prescribing information includes:

CBC with differential and liver function tests (ALT/AST) at baseline, 4–8 weeks after starting, then every 3 months

Fasting lipid panel at baseline and 4–8 weeks after initiating therapy

TB screening (IGRA or TST) before initiation; chest X-ray as clinically indicated

Dose reduction to 150 mg every 2 weeks if ANC falls to 500–1000/mm3, or platelets to 50,000–100,000/mm3, or ALT/AST elevates to >3× ULN

Discontinue if ANC <500/mm3, platelets <50,000/mm3, or ALT/AST >5× ULN; do not resume until values recover

Provider Resources

For providers looking for tools to help patients locate their Kevzara prescription, visit medfinder.com/providers. You can also read our detailed provider resource: How to Help Your Patients Find Kevzara In Stock.