Rezdiffra Availability in 2026: What's Really Going On?

If you've been trying to get your hands on Rezdiffra (Resmetirom) and hitting roadblocks, you might be wondering: is there a shortage? The answer is more nuanced than a simple yes or no.

As of early 2026, Rezdiffra is not listed on the FDA's or ASHP's official drug shortage lists. However, that doesn't mean patients aren't struggling to access it. The unique distribution model, insurance barriers, and high cost create real-world availability challenges that feel a lot like a shortage — even if the supply itself isn't the issue.

Here's everything you need to know about Rezdiffra availability in 2026.

Is Rezdiffra Still in Shortage?

Technically, no. Rezdiffra has not been placed on any official drug shortage list since its FDA approval in March 2024. Madrigal Pharmaceuticals has maintained its manufacturing supply, and the drug continues to be produced and distributed.

However, the practical experience of many patients tells a different story. Because Rezdiffra is only available through specialty pharmacies, many patients find that:

• Their local pharmacy can't get it
• The specialty pharmacy has processing delays
• Insurance prior authorization takes weeks
• The out-of-pocket cost is prohibitive without coverage

So while there isn't a manufacturing shortage, there is a significant access gap between patients who need the drug and those who can actually get it.

Why Is Rezdiffra So Hard to Find?

Several factors contribute to the difficulty patients face:

Specialty Pharmacy Distribution

Rezdiffra is not available at retail pharmacies. It's distributed through a limited network of specialty pharmacies, which means you can't just walk into your local drugstore and pick it up. This model is common for high-cost, complex medications but creates bottlenecks for patients.

Prior Authorization Requirements

Almost every insurance plan requires prior authorization (PA) for Rezdiffra. Your doctor must submit documentation proving you have MASH with F2–F3 fibrosis and no decompensated cirrhosis. This process can take days to weeks, and denials are common.

Limited Prescriber Awareness

As a first-in-class medication approved less than two years ago, not all doctors are familiar with Rezdiffra. Many primary care physicians may not know it exists, and some gastroenterologists are still building experience with the prescribing process.

For a complete breakdown, see our article on why Rezdiffra is so hard to find in 2026.

How Much Does Rezdiffra Cost in 2026?

The wholesale acquisition cost (WAC) of Rezdiffra is approximately $47,400 per year, or about $3,950 per month for a 30-day supply. This applies to both the 80 mg and 100 mg doses.

Here's what cost looks like in different scenarios:

• With commercial insurance + copay card: As low as $0 per fill
• With commercial insurance (no copay card): Specialty tier copays can range from $100 to $500+ per month
• With Medicare Part D: Subject to the plan's formulary; may fall under the catastrophic coverage phase
• Without insurance: Full cash price of approximately $3,950–$4,116 per month

For detailed savings strategies, check out our guide on how to save money on Rezdiffra in 2026.

Are There New Options for MASH Patients?

While Rezdiffra remains the only FDA-approved MASH medication, the treatment landscape is evolving:

• Semaglutide continues to show strong results in MASH clinical trials and may receive a MASH-specific indication in the coming years
• Efruxifermin (Akero Therapeutics) and Pegozafermin (89bio) are FGF21 analogs in late-stage trials
• Lanifibranor (Inventiva) is a pan-PPAR agonist in Phase 3 trials

These pipeline drugs could eventually give patients more options, but for now, Rezdiffra stands alone as the approved treatment. Learn about current alternatives in our article on alternatives to Rezdiffra.

How to Find Rezdiffra in Stock Right Now

If you need Rezdiffra today, here are the most effective steps:

1. Use Medfinder

Medfinder helps you search for pharmacy availability in real time. Search for Rezdiffra and your location to find specialty pharmacies that can fill your prescription.

2. Contact Madrigal Patient Support

Call 1-877-219-7770 (Monday–Friday, 8 AM–8 PM ET) or visit madrigalpatientsupport.com. They can help with:

• Insurance benefits verification
• Prior authorization support
• Copay savings card enrollment ($0 copay for eligible commercially insured patients)
• Patient assistance programs

3. Work With Your Prescriber

Make sure your hepatologist or gastroenterologist has submitted all required PA documentation. Ask about peer-to-peer reviews if your PA has been denied.

4. Consider the Copay Savings Card

Commercially insured patients may qualify for Madrigal's copay savings card, which can reduce your out-of-pocket cost to as little as $0 per fill. Enroll at rezdiffra.com/copay-sign-up.

For more tips, read our detailed guide on how to find Rezdiffra in stock near you.

Final Thoughts

Rezdiffra isn't in a traditional manufacturing shortage, but the access barriers are very real. Between specialty pharmacy restrictions, prior authorization hurdles, and a nearly $48,000 annual price tag, getting this medication takes effort and patience.

The good news: the tools and support programs exist to help you get through the process. Use Medfinder, lean on your healthcare team, and take advantage of Madrigal's patient support resources. Rezdiffra is a game-changing treatment for MASH, and it's worth fighting for access.