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

Rocklatan (netarsudil/latanoprost ophthalmic solution 0.02%/0.005%) is not listed in the FDA or ASHP drug shortage databases as of 2026. Alcon, the manufacturer, has not issued any formal shortage notifications. From a supply chain perspective, Rocklatan is technically available through standard pharmaceutical distribution channels.

However, a significant portion of your patients who are prescribed Rocklatan will have difficulty filling their prescriptions. Understanding why — and having a clinical playbook ready — is increasingly important for glaucoma practices and eye care providers in 2026.

The Clinical Landscape: What Rocklatan Offers and Why It's Prescribed

Rocklatan is the only FDA-approved fixed-dose combination of a Rho kinase (ROCK) inhibitor and a prostaglandin F2α analog. Its four mechanisms of action — increased trabecular meshwork outflow (netarsudil), uveoscleral outflow (latanoprost), reduced aqueous production (netarsudil), and reduced episcleral venous pressure (netarsudil) — distinguish it from all other combination glaucoma drops.

In the MERCURY 1 and MERCURY 2 Phase 3 clinical trials, Rocklatan demonstrated statistically superior IOP reduction compared to both of its individual components at every measured time point. The average IOP reduction was 1–3 mmHg greater than netarsudil or latanoprost alone over 3–12 months. More than 60% of patients achieved ≥30% IOP reduction, and nearly twice as many patients reached an IOP of ≤16 mmHg compared to latanoprost alone.

These outcomes make Rocklatan particularly valuable for patients with moderate-to-high baseline IOPs, patients who have failed or partially responded to prostaglandin monotherapy, and patients where reducing the number of drops improves adherence.

Why Access Remains a Challenge Despite No Formal Shortage

The access barriers your patients face are largely structural:

• No generic available until ~2034. Rocklatan is protected by patents. The retail price of $450–$482 per 2.5 mL bottle (one month's supply) significantly limits which pharmacies choose to stock it.
• Prior authorization requirements. The majority of commercial insurance plans require PA for Rocklatan. Step therapy requirements (requiring prior trial of generic latanoprost or other agents) are common. This creates delays and documentation burden on your practice.
• Medicare and Medicaid coverage variability. Medicare Part D may or may not cover Rocklatan depending on the plan's formulary. Some plans require additional documentation. Medicaid coverage varies significantly by state.
• Inconsistent pharmacy stocking. Small and medium-sized retail pharmacies often don't carry Rocklatan in inventory. Even large chains may have stocking gaps depending on local demand patterns.

Clinical Impact: What Happens When Patients Miss Doses

IOP rises relatively quickly after discontinuation of prostaglandin-containing drops. For patients with advanced glaucoma or target IOPs in the low-to-mid teens, even brief gaps — 3–7 days — can have clinical significance. Poor adherence driven by access barriers is a leading contributor to glaucoma progression in real-world practice.

When a patient calls your office reporting they can't find Rocklatan, this should trigger a clinical response — not just a referral back to the pharmacy. Having a standing protocol for these calls reduces the risk of undertreated glaucoma.

Clinical Bridge Options When Rocklatan Is Unavailable

The appropriate bridge therapy depends on the clinical context. Here are the most common approaches:

• Generic latanoprost — simplest and cheapest bridge; covers the prostaglandin component of Rocklatan; IOP may rise slightly without netarsudil's trabecular/EVP effects.
• Generic latanoprost + timolol — for patients needing more IOP lowering; timolol provides aqueous suppression to partially compensate for the loss of netarsudil's mechanism.
• Vyzulta (latanoprostene bunod) — dual-mechanism prostaglandin; 1–3 mmHg less IOP lowering than Rocklatan in clinical comparisons; no generic but may be more consistently stocked.
• Latanoprost + Rhopressa (netarsudil) as separate drops — replicates Rocklatan's components; administer at least 5 minutes apart; may be logistically challenging for some patients.

Prior Authorization Support: Best Practices for Your Practice

Streamlining the PA process for Rocklatan can significantly reduce patient access gaps. Consider the following:

1. Document the clinical rationale clearly in the chart at the time of prescribing — IOP history, prior therapy failures, and target pressures.
2. Check the patient's specific formulary before prescribing; some plans cover Rocklatan only on certain tiers or require specific step therapy documentation.
3. For Medicare Part D patients, confirm plan formulary coverage before prescribing and consider an appeal if denied.
4. Alcon's support line for healthcare providers is 800-222-8103. Alcon also offers provider samples — useful for bridge therapy while PA is being resolved.

How medfinder Supports Your Patients With Access Challenges

When patients contact your practice unable to fill their Rocklatan, referring them to medfinder for providers can help. medfinder contacts pharmacies in the patient's area to find which ones can fill the prescription, then texts the patient the results. This reduces administrative burden on your staff and helps patients maintain treatment continuity.

Summary and Next Steps

Rocklatan's access challenges in 2026 are real and predictable. Building a protocol for PA support, bridge prescribing, and patient referral to medfinder will reduce the number of patients who experience treatment gaps. For a step-by-step guide on helping patients find Rocklatan, see How to Help Your Patients Find Rocklatan in Stock. For the patient-facing overview, see the Rocklatan Shortage Update for Patients.