Trulance Shortage Update: What Patients Need to Know in 2026

If you're a Trulance patient who has been struggling to fill your prescription, you're probably wondering: is there an official Trulance shortage? Is this a supply chain issue, or something else? Here's what you need to know as of 2026.

Is There an Official Trulance Shortage in 2026?

No. As of 2026, Trulance (plecanatide) is not listed on the FDA's official Drug Shortage Database. There is no widespread, declared national supply shortage for this medication. Salix Pharmaceuticals is actively manufacturing and distributing it. However, that doesn't mean every patient has easy access — and the reasons why are worth understanding.

Why Patients Still Struggle to Access Trulance

Even without an official shortage, access problems are real for many Trulance patients. The issues stem from several structural barriers:

Sparse Pharmacy Stocking

Because Trulance is a brand-name-only medication with no generic equivalent, pharmacies manage their inventory conservatively. A pharmacy that sees only one or two Trulance patients per month may not keep it on the shelf at all, ordering it only on demand. This means even patients with valid prescriptions and good insurance may face a 1–3 day wait while the pharmacy restocks.

Prior Authorization Bottlenecks

Trulance requires prior authorization from most insurance plans before coverage is granted. This is a formal process where your doctor must submit documentation to your insurer proving that Trulance is medically necessary for you. The process can take anywhere from a few hours to several days, and if your insurer also requires step therapy (i.e., trying Linzess first), the delay can stretch even longer.

If your prior authorization is denied, you have the right to appeal. Your doctor can submit additional clinical documentation, and many appeals are ultimately successful — especially when the original denial was based on step therapy requirements that you can demonstrate have already been satisfied.

High Out-of-Pocket Cost Without Insurance or Assistance

Trulance's retail price of approximately $749–$830 for a 30-day supply puts it out of reach for many uninsured or underinsured patients. The Trulance Savings Card from Salix Pharmaceuticals can reduce costs to as little as $25 per fill for commercially insured patients, but cash-pay patients (without commercial insurance) don't qualify for this discount.

What to Do If You Can't Fill Your Trulance Prescription

Here are the most effective steps to take:

• Use medfinder. medfinder calls pharmacies near you to check which ones can fill your prescription today, then texts you the results.
• Contact Salix Pharmaceuticals. Call 1-800-321-4576 to ask about patient assistance programs or savings options.
• Ask your doctor to expedite prior authorization. If an insurance issue is causing the delay, your doctor's office can request urgent prior authorization processing or a peer-to-peer review.
• Try a mail-order pharmacy. Mail-order options through your insurance (Express Scripts, OptumRx, CVS Caremark) reliably stock Trulance and can deliver a 90-day supply.
• Ask about Trulance samples. Salix provides professional samples to healthcare providers. Your doctor may be able to provide you a short supply while you work out insurance or availability issues.

Know Your Patient Rights

If your insurance denies coverage of Trulance, you have the right to:

• Request a written explanation of the denial
• File an internal appeal with your insurance company
• Request an external appeal with an independent review organization if your internal appeal is denied
• Ask your doctor to advocate on your behalf through a peer-to-peer review with your insurer's medical director

The Bottom Line

There is no FDA-declared shortage of Trulance in 2026. The challenges patients face are structural — high costs, insurance barriers, and thin pharmacy stocking — not a supply chain crisis. The good news is that with the right strategies, most patients can access their medication. See our guide on how to find Trulance in stock near you for practical steps you can take today.