Provider Briefing: Rybelsus Supply in 2026

The GLP-1 receptor agonist supply crisis has been one of the most significant pharmaceutical access challenges in recent years. As a prescriber, you've likely fielded calls from patients unable to fill their Rybelsus (oral Semaglutide) prescriptions, navigated prior authorization requirements, and weighed alternative therapy decisions — all while managing the clinical needs of patients who depend on these medications.

This briefing provides an updated overview of the Rybelsus supply landscape in 2026, including manufacturing timeline context, prescribing considerations, cost and access factors, and tools to help your patients locate their medication.

Shortage Timeline: How We Got Here

Understanding the trajectory of the GLP-1 shortage helps inform clinical decision-making going forward.

2022–2023: Demand Surge

Prescriptions for Semaglutide products surged beginning in 2022, driven by growing evidence of cardiovascular and weight management benefits, widespread media coverage, and increasing off-label use for weight loss. The FDA formally placed Semaglutide on its drug shortage list in 2023.

2023–2024: Peak Shortage

During this period, patients across the country faced severe difficulty obtaining all Semaglutide formulations. Rybelsus was particularly impacted because it is the only oral GLP-1 option, concentrating demand among injection-averse patients. Novo Nordisk announced multi-billion-dollar manufacturing expansion investments, but production lead times meant relief would take years to materialize.

2025–2026: Gradual Recovery

By late 2025, new manufacturing capacity began coming online. Supply has improved measurably in early 2026, though intermittent stock-outs persist at the pharmacy level, particularly for the 7 mg and 14 mg dose strengths. The 3 mg starter dose is generally more available.

Prescribing Implications

The ongoing supply variability has several practical implications for prescribers:

New Starts vs. Maintenance Patients

Initiating a new patient on Rybelsus requires consideration of whether they'll be able to maintain consistent access. Interruptions in GLP-1 therapy can lead to glycemic deterioration and weight regain. Before prescribing, it may be worth verifying local availability or having the patient check stock using Medfinder for providers.

Dose Escalation Challenges

The standard titration — 3 mg for 30 days, then 7 mg, with optional escalation to 14 mg — assumes consistent supply at each dose level. Some patients report difficulty obtaining the next dose strength during escalation. Consider documenting contingency plans in case a specific strength is temporarily unavailable.

Switching Between Formulations

If a patient cannot access oral Semaglutide, switching to injectable Semaglutide (Ozempic) requires dose adjustment. The oral-to-injectable conversion is not a simple 1:1 ratio due to differences in bioavailability. General guidance:

• Rybelsus 7 mg daily → Ozempic 0.5 mg weekly (approximate equivalence)
• Rybelsus 14 mg daily → Ozempic 1 mg weekly (approximate equivalence)

These are approximate conversions. Individual clinical judgment should guide dosing decisions. For a patient-facing overview of alternatives, see Alternatives to Rybelsus.

Current Availability Picture

As of early 2026, the availability of Rybelsus varies significantly by geography and pharmacy type:

• Chain pharmacies (CVS, Walgreens, Rite Aid) continue to experience the most frequent stock-outs due to high patient volumes
• Independent pharmacies often maintain more reliable supply through flexible wholesaler relationships
• Specialty pharmacies may have dedicated allocation channels for GLP-1 medications
• Mail-order pharmacies generally maintain larger inventories and can provide 90-day supplies

Geographic variability is significant — some regions have normalized supply while others still face constraints. Real-time checking via tools like Medfinder is more reliable than anecdotal reports.

Cost and Access Considerations

Cost remains a major barrier to Rybelsus access for many patients, independent of supply constraints:

• List price: Approximately $900–$1,100 per 30-day supply
• Commercial insurance: Most plans cover Rybelsus but commonly require prior authorization and/or step therapy (typically Metformin trial first). Copays range from $25–$150 depending on formulary placement.
• Novo Nordisk Savings Card: Eligible commercially insured patients can reduce out-of-pocket costs to as low as $10/month (not valid for government insurance)
• Medicare Part D: Coverage varies by plan; the manufacturer savings card is not applicable. Patients may face coverage gap costs.
• Patient Assistance Program: NovoCare PAP provides Rybelsus at no cost to qualifying uninsured/underinsured patients (generally ≤400% FPL). Apply at novocare.com or 1-888-693-8276.
• No generic available: Patent protection extends into the late 2020s.

For a patient-facing guide on reducing costs, direct patients to: How to save money on Rybelsus.

Tools and Resources for Your Practice

Several resources can help you and your staff navigate Rybelsus access challenges:

Medfinder for Providers

Medfinder allows providers and staff to check real-time pharmacy availability for Rybelsus and other medications. This can be integrated into your prescribing workflow to direct patients to pharmacies with current stock.

NovoCare Provider Resources

Novo Nordisk's provider portal offers prior authorization support, sample request forms, and supply updates. Visit novocare.com or contact your Novo Nordisk representative.

Alternative Therapy Quick Reference

When Rybelsus is unavailable, consider these alternatives:

• Ozempic (Semaglutide 0.5–2 mg SC weekly): Same molecule, injectable formulation
• Mounjaro (Tirzepatide 2.5–15 mg SC weekly): Dual GIP/GLP-1 agonist with strong efficacy data
• Trulicity (Dulaglutide 0.75–4.5 mg SC weekly): Established GLP-1 agonist with cardiovascular outcome data
• Jardiance (Empagliflozin 10–25 mg PO daily): SGLT2 inhibitor; different mechanism but oral route with CV/renal benefits

For a step-by-step guide on helping patients navigate access, see: How to help your patients find Rybelsus in stock.

Looking Ahead

Several developments may improve the Rybelsus access landscape in the near term:

• Expanded manufacturing: Novo Nordisk's facility expansions are expected to continue increasing output through 2026 and 2027
• New competitors: Additional oral GLP-1 candidates are in late-stage development from multiple manufacturers, which could ease demand pressure on Rybelsus
• Zepbound availability: The availability of Tirzepatide (Zepbound) for weight management may redirect some demand away from Semaglutide products prescribed off-label for weight loss
• Policy developments: Ongoing discussions about Medicare negotiation of GLP-1 prices could affect access and coverage dynamics

Final Thoughts

The Rybelsus supply situation in 2026 is markedly improved from its nadir in 2023-2024, but it has not fully normalized. Prescribers who proactively plan for supply variability — by establishing alternative therapy protocols, leveraging real-time availability tools like Medfinder, and connecting patients with financial assistance programs — can minimize treatment interruptions and maintain glycemic control for their patients.

Staying informed about the evolving GLP-1 landscape is an ongoing responsibility, but the tools and resources available today make it more manageable than ever.