Provider Briefing: The Uceris Shortage in 2026

As a prescriber managing patients with mild to moderate ulcerative colitis, you've likely encountered the downstream effects of ongoing Budesonide ER supply disruptions. This article provides a concise clinical summary of the current Uceris shortage — where things stand, what it means for your prescribing decisions, and practical resources to help your patients access their medication.

Shortage Timeline

The supply constraints affecting Budesonide ER products have evolved over several years:

• 2022-2023: Significant supply disruptions began affecting both brand Uceris and generic Budesonide ER tablets. Manufacturing delays and raw material sourcing issues created widespread stockouts. The Uceris rectal foam (2 mg) was added to the FDA drug shortage list.
• 2024: Supply improved modestly for the oral tablet form but remained inconsistent for the rectal foam. Regional variability became significant — some markets had adequate stock while others faced persistent shortages.
• 2025: The FDA continued to list Budesonide rectal foam intermittently. Oral tablet availability stabilized further as generic manufacturers (including Teva Pharmaceuticals) increased production capacity.
• 2026 (current): The oral tablet (9 mg ER) is reasonably available in most markets, with generic Budesonide ER providing the most reliable supply. The rectal foam remains intermittently constrained. Regional disparities persist.

Prescribing Implications

The ongoing supply situation creates several practical considerations for prescribers:

Generic Substitution

Generic Budesonide ER 9 mg tablets are FDA-approved, therapeutically equivalent (AB-rated), and generally more available than brand Uceris. Unless there is a specific clinical reason to require brand-name Uceris, prescribing for generic substitution is strongly recommended to improve your patient's chances of filling the prescription.

Avoid writing "dispense as written" (DAW) unless clinically necessary, as this limits pharmacy flexibility during supply constraints.

Step Therapy and Prior Authorization

Most commercial and government insurance plans require step therapy (typically requiring a documented trial of Mesalamine) and/or prior authorization before covering Budesonide ER. These requirements remain in place regardless of shortage status.

Clinical recommendation: Submit prior authorization paperwork proactively when initiating Budesonide ER therapy, rather than waiting until the patient is at the pharmacy. This reduces the risk of treatment gaps.

Formulation Awareness

There are multiple oral Budesonide formulations on the market with different release profiles and indications:

• Uceris / Budesonide ER tablets (9 mg): Colonic release — indicated for ulcerative colitis
• Entocort EC / Budesonide delayed-release capsules (3 mg): Ileal/ascending colonic release — indicated for Crohn's disease
• Budesonide delayed-release capsules (generic, 3 mg): Same as Entocort EC

These formulations are not interchangeable. Ensure that prescriptions clearly specify the extended-release tablet formulation when treating ulcerative colitis.

Current Availability Picture

Based on current market data:

• Generic Budesonide ER 9 mg tablets: Most widely available option. Multiple generic manufacturers are active. Availability is good in most major metro areas, with some gaps in rural and smaller markets.
• Brand Uceris tablets: Available but less commonly stocked due to cost ($1,400-$2,330 per 30 tablets). Many pharmacies will need to special-order.
• Uceris rectal foam: Intermittent availability. Continue to monitor the FDA drug shortage database for updates.

For real-time pharmacy-level availability data, Medfinder for Providers offers search tools that can help your practice identify pharmacies with current stock in your area.

Cost and Access Considerations

Medication cost remains a significant access barrier for many patients:

• Brand Uceris retail price: $1,400-$2,330 for 30 tablets
• Generic Budesonide ER with discount cards: As low as $194 for 30 tablets
• Average generic retail price: $627 for 30 tablets

Savings resources to share with patients:

• Manufacturer savings card: Bausch Health/Salix offers copay assistance as low as $30 per fill for commercially insured patients
• Patient assistance programs: Bausch Health PAP (bauschhealthpap.com, 1-855-770-0424) provides free medication to eligible uninsured/underinsured patients
• Prescription Hope: Offers Uceris for $70/month for qualifying patients
• Discount cards: GoodRx, SingleCare, and similar services can reduce generic costs to under $200

For a patient-facing resource on savings, direct patients to our guide: How to Save Money on Uceris in 2026.

Tools and Resources for Your Practice

For Providers

• Medfinder for Providers — Real-time pharmacy availability search
• FDA Drug Shortage Database — Official shortage status
• ASHP Drug Shortage Resource Center — Clinical guidance on shortage management

For Patients

• Medfinder — Pharmacy availability checker
• How to Find Uceris in Stock Near You
• Alternatives to Uceris

Alternative Prescribing Options

When Budesonide ER is unavailable, consider these alternatives based on disease severity and patient factors:

1. Mesalamine (5-ASA): First-line for mild to moderate UC. Available as oral formulations (Asacol HD, Lialda, Pentasa, Apriso) and rectal formulations (Canasa, Rowasa). Widely available and well-tolerated. Suitable for both induction and maintenance.
2. Prednisone: For moderate flares requiring more rapid control. Universally available and inexpensive. Use as short-term bridge therapy with appropriate taper. More systemic side effects than Budesonide.
3. Sulfasalazine: Older 5-ASA option. Very inexpensive and widely available. More side effects than newer Mesalamine formulations. Consider for cost-sensitive patients without sulfa allergy.
4. Biologic step-up: For patients failing conventional therapy, consider Stelara, Zeposia, Rinvoq, or biosimilar Infliximab/Adalimumab per current AGA guidelines.

For a patient-facing comparison of alternatives, share: Alternatives to Uceris.

Looking Ahead

The Budesonide ER supply situation is expected to continue improving through 2026 as generic manufacturers expand capacity. However, the rectal foam formulation may remain constrained for the near term. Prescribers should continue monitoring the FDA shortage database and maintain contingency plans for patients on Budesonide therapy.

Proactive steps — prescribing for generic substitution, initiating prior authorizations early, and connecting patients with availability tools like Medfinder — can significantly reduce treatment interruptions.

Final Thoughts

The Uceris shortage has been a persistent challenge for both providers and patients managing ulcerative colitis. While the trajectory is positive, vigilance remains important. Equipping your practice with the right tools and your patients with the right resources is the most effective way to navigate the current landscape.

For additional provider resources, see our guide on how to help your patients find Uceris in stock and how to help patients save money on Uceris.