Soolantra Access Issues: What Providers and Prescribers Need to Know in 2026

For dermatologists, primary care physicians, and advanced practice providers managing rosacea, Soolantra (ivermectin 1% cream) has become a trusted and effective component of the treatment toolkit since its FDA approval in December 2014. Clinical trial data demonstrates its superiority over metronidazole gel for reducing papules and pustules in moderate-to-severe papulopustular rosacea.

However, prescribing Soolantra is only part of the equation. Ensuring patients actually receive and use it is increasingly challenging. This guide summarizes the current access landscape in 2026 and provides practical strategies to support your rosacea patients.

Current FDA Shortage Status: No Active Shortage

As of 2026, Soolantra is not listed on the FDA's drug shortage database. Galderma Laboratories maintains production of both brand-name Soolantra and generic ivermectin 1% cream. There is no supply chain or manufacturing disruption on record.

The access challenges your patients face are almost entirely driven by three factors: price, insurance coverage rules, and inconsistent pharmacy stocking. Understanding these barriers helps you anticipate them and proactively support your patients.

Insurance Coverage Landscape in 2026

Coverage for Soolantra varies significantly across payer types. Here's what to expect:

Commercial plans: Many formularies place Soolantra on Tier 3 or higher, resulting in higher cost-sharing. Step therapy requirements are common, requiring documentation that patients have failed metronidazole, azelaic acid, or similar agents before Soolantra is covered.

Medicare Part D: Coverage is plan-dependent. Some plans cover Soolantra; others require prior authorization or exclude it from formulary. Patients should review their specific plan's formulary.

Medicaid: State Medicaid formularies vary widely. Prior authorization is common. Some states may not cover Soolantra at all and require generic topical alternatives first.

Prior Authorization: What Documentation Supports Approval

When filing prior authorization requests for Soolantra, the following documentation typically strengthens approval:

Documented diagnosis of papulopustular (inflammatory) rosacea with severity grading (IGA scale preferred)

Documentation of prior failure or inadequate response to metronidazole topical and/or azelaic acid (dates and duration of trials help)

Documentation of why step therapy alternatives are contraindicated or inappropriate (e.g., allergy, intolerance, or clinical reason for Soolantra as first-line)

Medical literature supporting Soolantra's superiority over metronidazole for moderate-to-severe papulopustular rosacea (two Phase 3 RCTs, n=1,371 subjects)

The Cost Barrier: Patient Assistance and Coupon Options

Even with insurance, many patients face high copays. For uninsured or underinsured patients, the retail cost of brand-name Soolantra ($378–$974+ for 45g) is prohibitive. Here are the savings options to communicate to patients:

GoodRx / SingleCare coupons: Generic ivermectin 1% cream can be obtained for approximately $93–$101 for a 45g tube—a 75%+ reduction from retail price.

Galderma CAREConnect: Galderma's patient assistance program may provide Soolantra at reduced or no cost to eligible patients. Phone: 855-280-0543.

Prescribe generic: Consider prescribing generic ivermectin 1% cream to allow coupon use and maximize pharmacy availability.

Provide office samples: Soolantra samples from Galderma representatives can bridge patients during PA processing or financial assistance application.

Pharmacy Stocking: What Providers Should Know

Some patients will call your office after failing to find Soolantra at their local pharmacy. It's worth advising patients proactively that not all pharmacies stock Soolantra or generic ivermectin cream. Recommending that they call ahead, use a prescription price comparison tool, or use a service that calls pharmacies for them can prevent prescription abandonment.

Consider recommending medfinder for providers as a resource. medfinder calls pharmacies near the patient to identify where their prescription can be filled. You can also read our expanded guide: How to Help Your Patients Find Soolantra in Stock.

Clinical Summary: Key Soolantra Data Points for Practice

FDA-approved December 2014 for inflammatory lesions of rosacea in adults

Two Phase 3 RCTs (n=1,371): superior to vehicle at week 12 for IGA success and lesion count reduction

Head-to-head trial: superior to metronidazole 0.75% gel for reducing inflammatory lesion counts (p<0.001 at week 16)

Adverse event rate ≤1% in clinical trials; no systemic adverse events observed

No CYP450 interactions at therapeutic topical concentrations

Not a controlled substance; can be prescribed by dermatologists, PCPs, and advanced practice providers