Provider Briefing: Uceris Supply Disruption in 2026

If your patients with ulcerative colitis have been reporting difficulty filling their Uceris (Budesonide) prescriptions, they're not imagining it. The Uceris supply — particularly the rectal foam formulation — has been subject to intermittent disruptions since 2022, and the situation remains fluid heading into 2026.

This briefing provides a concise overview of the current supply landscape, prescribing implications, cost considerations, and practical tools to help your patients maintain continuity of care.

Timeline of the Uceris Supply Disruption

The Uceris shortage didn't happen overnight. Here's how it has unfolded:

• 2020-2021: COVID-19 pandemic strains pharmaceutical supply chains broadly. Specialty products with complex manufacturing (including aerosol formulations) begin experiencing delays.
• 2022: Uceris rectal foam first appears on the FDA Drug Shortage Database. Patients begin reporting difficulty finding the foam at retail pharmacies nationwide.
• 2023: Manufacturing disruptions intensify. Bausch Health, the sole brand manufacturer, works to address production bottlenecks. Generic Budesonide ER tablets become more widely available, partially offsetting the shortage for oral formulations.
• 2024: Supply improves modestly for the oral tablet form but remains inconsistent for the rectal foam. Regional variability becomes significant — some markets have adequate stock while others face persistent shortages.
• 2025: The FDA continues to list Budesonide rectal foam intermittently. Additional generic manufacturers enter the extended-release tablet market, improving oral availability and reducing costs.
• Early 2026: The rectal foam remains the primary challenge. The oral tablet (both brand and generic) is more readily available in most markets.

Prescribing Implications

The shortage creates several considerations for clinical practice:

Formulation Selection

When initiating Budesonide therapy for UC, consider which formulation the patient is most likely to be able to fill:

• Extended-release tablets (9 mg): More reliably available, especially generics. Appropriate for mild to moderate UC regardless of disease location.
• Rectal foam (2 mg/actuation): Preferred for distal UC (extending up to 40 cm from the anal verge) but harder to source. If selecting foam, advise patients to verify stock before sending the prescription.

Generic Substitution

Generic Budesonide ER tablets are therapeutically equivalent to brand-name Uceris tablets. Encouraging or permitting generic substitution can improve your patients' ability to fill their prescriptions and reduce costs from $1,200-$1,800/month (brand) to $300-$600/month (generic).

Note: Generic Budesonide rectal foam is not widely available as of early 2026.

Step Therapy and Prior Authorization

Most commercial and government insurance plans require step therapy (typically requiring a trial of Mesalamine) and/or prior authorization before covering Uceris. This can delay therapy initiation by days to weeks. Consider:

• Submitting prior authorization proactively at the time of prescribing, not when the patient reports a denial
• Documenting previous Mesalamine trials (or clinical rationale for bypassing) clearly in the request
• Keeping template PA letters on file for Uceris to expedite the process

Current Availability Picture

As of early 2026, here's the general availability landscape:

• Brand Uceris ER tablets: Available at most retail and mail-order pharmacies
• Generic Budesonide ER tablets: Widely available through multiple manufacturers
• Brand Uceris rectal foam: Intermittent availability; specialty pharmacies and some independents tend to have more consistent stock than large chains
• Generic Budesonide rectal foam: Not widely available

Availability varies significantly by region. Urban areas with multiple pharmacy options tend to have better access than rural communities with limited choices.

Cost and Access Considerations

High costs compound the availability problem. Even when patients find Uceris, they may struggle to afford it:

• Brand tablets cash price: $1,200-$1,800/month
• Brand foam cash price: $800-$1,500 per canister (approximately 2-week supply)
• Generic tablets cash price: $300-$600/month
• Typical insurance copay: $50-$150+ (Tier 3/specialty tier)

Patient Assistance Resources

• Bausch Health Savings Card: Eligible commercially insured patients may pay as low as $30/fill
• Bausch Health Patient Assistance Foundation: For uninsured/underinsured patients meeting income criteria
• Discount programs: GoodRx, SingleCare, and other coupon platforms may offer savings on generic Budesonide

For detailed patient-facing cost information, you may direct patients to: How to Save Money on Uceris in 2026.

Tools and Resources for Your Practice

Medfinder for Providers

Medfinder for Providers allows clinical teams to check real-time pharmacy stock for Uceris and other medications. This can be integrated into your prescribing workflow to identify pharmacies with available stock before sending the prescription — reducing patient callbacks and treatment delays.

Alternative Therapy Options

When Uceris is unavailable, consider these evidence-based alternatives:

1. Mesalamine (5-ASA): First-line for mild to moderate UC. Oral (Lialda, Apriso, Pentasa) and rectal (Canasa, Rowasa) formulations. Well-tolerated for long-term use.
2. Hydrocortisone rectal foam/enema: Alternative topical corticosteroid for distal UC. More systemic absorption than Budesonide but widely available.
3. Prednisone: Systemic corticosteroid for moderate-severe flares. Short-term use with taper. Readily available and inexpensive.
4. Entocort EC (Budesonide DR capsules): Same active ingredient, different release site (ileum/ascending colon). Off-label for UC but may be appropriate in selected patients.

For a patient-facing comparison: Alternatives to Uceris.

Looking Ahead

Several trends may improve the Uceris supply situation over time:

• Generic expansion: Additional generic manufacturers entering the Budesonide ER tablet market have already improved oral availability and should continue to stabilize supply and pricing.
• Manufacturing investment: Bausch Health has indicated ongoing investment in production capacity for specialty formulations.
• FDA oversight: The FDA continues to monitor the shortage and work with manufacturers to expedite resolution.

However, the rectal foam formulation is likely to remain more vulnerable to supply disruptions in the near term due to its inherent manufacturing complexity and limited producer base.

Practical Recommendations for Your Practice

1. Check stock before prescribing foam formulations using Medfinder for Providers
2. Default to generic ER tablets when clinically appropriate to maximize fillability
3. Submit prior authorization proactively — don't wait for pharmacy rejection
4. Maintain a list of specialty pharmacies in your area that stock GI medications
5. Discuss backup plans with patients at the time of prescribing (alternative medications, alternative pharmacies)
6. Document step therapy history thoroughly to prevent repeated PA denials

Final Thoughts

The Uceris supply disruption underscores a broader challenge in specialty medication access. As prescribers, we can mitigate the impact on our patients through proactive prescribing practices, awareness of the current supply landscape, and use of modern tools to verify pharmacy stock in real time.

For more information and real-time stock checking, visit Medfinder for Providers.