Wondering why Besifloxacin (Besivance) is so hard to find? Learn the top reasons for limited availability and what you can do to get your prescription filled in 2026.
If you've been prescribed Besifloxacin eye drops — sold under the brand name Besivance — you may have run into a frustrating problem: your pharmacy doesn't have it in stock. You're not alone. Many patients across the country are struggling to fill this prescription, and the reasons go beyond a simple supply issue.
Besifloxacin is a fourth-generation fluoroquinolone antibiotic eye drop used to treat bacterial conjunctivitis (commonly known as pinkeye). It was approved by the FDA in May 2009 and is manufactured exclusively by Bausch + Lomb. Unlike many other ophthalmic antibiotics, Besifloxacin was designed specifically for topical eye use — it was never developed as an oral or systemic antibiotic, which gives it a unique advantage in targeting eye infections without contributing to broader antibiotic resistance.
Besifloxacin ophthalmic suspension 0.6% is prescribed for treating bacterial conjunctivitis, an infection of the membrane covering the outside of the eyeball and the inside of the eyelids. The typical dosing is one drop in the affected eye(s) three times a day, spaced 4 to 12 hours apart, for 7 days.
It works by inhibiting two essential bacterial enzymes — DNA gyrase and topoisomerase IV — effectively stopping bacteria from replicating and repairing their DNA. This dual-target mechanism is what makes Besifloxacin particularly effective and helps reduce the likelihood of bacteria developing resistance.
One of the biggest factors making Besifloxacin difficult to find is that no generic version exists. Besivance is protected by patents that extend through November 2030. Without generic competition, Bausch + Lomb remains the sole manufacturer. This means the entire national supply depends on a single company's production capacity and distribution decisions.
When a medication has no generic alternatives, pharmacies may be less likely to keep it in stock, especially if demand in their area is low. Many pharmacies prioritize stocking generics because they're more commonly prescribed and more affordable.
Besivance carries a retail cash price of approximately $230 to $350 for a single 5 mL bottle. For many independent and chain pharmacies, stocking an expensive brand-name eye drop that may not sell frequently is a financial risk. Pharmacies have limited shelf space and budgets, so they tend to stock lower-cost, higher-turnover medications like generic moxifloxacin (Vigamox) or ofloxacin (Ocuflox) instead.
Because Besifloxacin is brand-only, many insurance plans place it on non-preferred or specialty tiers, resulting in higher copays. Some plans require prior authorization before they'll cover it — roughly 3 in 10 ACA enrollees and 8 in 10 Medicaid enrollees face this hurdle. Additionally, step therapy requirements may force patients to try cheaper generic fluoroquinolones first before insurance will approve Besivance.
These insurance restrictions reduce the overall number of Besifloxacin prescriptions filled, which further discourages pharmacies from keeping it on hand.
With Bausch + Lomb as the only manufacturer, any disruption in their production or distribution can have an outsized impact on availability. While Besifloxacin is not currently listed on the FDA's official drug shortage database, intermittent supply gaps can occur at the distribution level — meaning your local pharmacy may be temporarily unable to order it even when it's technically available nationally.
The fastest way to find Besifloxacin in stock near you is through Medfinder. Medfinder checks real-time pharmacy inventory across multiple locations so you can see exactly which pharmacies have Besivance available without calling around.
Independent pharmacies often have more flexibility in ordering specialty or brand-name medications. They may be able to special-order Besivance for you, sometimes with next-day delivery from their wholesaler. Don't overlook smaller pharmacies in your area.
If Besifloxacin remains unavailable, your doctor may be able to prescribe an alternative ophthalmic antibiotic. Options like generic moxifloxacin (Vigamox), ofloxacin (Ocuflox), or ciprofloxacin (Ciloxan) are widely available and much more affordable. Erythromycin ophthalmic ointment is another option, especially for patients who prefer an ointment over drops.
If cost is part of the access barrier, the Bausch + Lomb Access Program can bring your copay down to as little as $25 for commercially insured patients. For uninsured patients, the Bausch + Lomb Patient Assistance Program may provide the medication at no cost to those who qualify. Learn more about saving money on Besifloxacin.
If you've been unable to fill your Besifloxacin prescription for more than a day or two, don't wait. Bacterial conjunctivitis can worsen without treatment, and delaying antibiotic therapy increases the risk of complications. Contact your prescriber to discuss switching to an available alternative, or use Medfinder to find a pharmacy that has it in stock right now.
Besifloxacin is an effective antibiotic eye drop, but its brand-only status, high cost, insurance barriers, and single-source manufacturing all contribute to the difficulty patients face finding it. The good news is that there are concrete steps you can take — from using pharmacy-finding tools like Medfinder to exploring generic alternatives and savings programs.
If you're struggling to find Besifloxacin, don't give up. With the right approach, you can get the treatment you need. For a broader look at the availability picture, check out our Besifloxacin shortage update for 2026.
You focus on staying healthy. We'll handle the rest.
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