Why Is Besivance So Hard to Find? [Explained for 2026]

You have a prescription for Besivance (besifloxacin) in hand, but when you call your local pharmacy, they say they're out of stock. Sound familiar? You're not alone. Even though Besivance is not currently on the FDA's official drug shortage list, many patients run into difficulty filling this prescription quickly. Here's why — and what you can do about it.

What Is Besivance and Why Does It Matter?

Besivance is a brand-name antibiotic eye drop containing besifloxacin, a fourth-generation fluoroquinolone approved by the FDA in 2009. It's prescribed to treat bacterial conjunctivitis — commonly called pink eye — in adults and children aged 1 year and older. The standard regimen is one drop in the affected eye(s) three times daily for 7 days.

What makes Besivance unique is its DuraSite formulation — a mucoadhesive polymer delivery system that keeps the active ingredient on the ocular surface for up to 12 hours. This is a meaningful advantage for patients who need high bacterial eradication rates. Ophthalmologists and optometrists often prefer it for resistant or more severe bacterial conjunctivitis cases.

Is There an Official Besivance Shortage?

As of 2026, Besivance is not listed on the FDA's official drug shortage database. However, "not on the shortage list" doesn't mean "easy to find." Patients and providers regularly report difficulty filling Besivance prescriptions at community pharmacies. The root cause is less about manufacturing problems and more about how the drug is stocked and distributed.

Why Do Pharmacies Often Not Have Besivance in Stock?

Several factors make Besivance a consistently difficult prescription to fill on the same day:

No generic is available. Besivance's patents are estimated to extend through November 2030, meaning pharmacies can't stock a cheaper generic substitute. Without a generic driving high prescription volume, many pharmacies simply don't keep it on the shelf.

Low demand at individual pharmacies. Bacterial conjunctivitis is seasonal and episodic. Most pharmacies only stock a limited number of Besivance bottles at a time, so they run out quickly when there's a cluster of prescriptions.

High price discourages routine stocking. At $230–$350 per bottle at retail, pharmacies are cautious about carrying large quantities of a product that may sit on the shelf.

Brand-only status. When a medication is brand-only, pharmacies stock it based on anticipated demand. If they don't see many prescriptions, they won't reorder proactively.

Specialty distribution. Eye care-specific medications are sometimes distributed through specialty channels, meaning your corner drugstore might need to special-order it even when the drug is widely available nationally.

How Hard Is It to Find Besivance Compared to Other Antibiotic Eye Drops?

Compare Besivance to a generic like ciprofloxacin ophthalmic or moxifloxacin — those are widely stocked because they're inexpensive generics that pharmacies order in bulk. Besivance doesn't have that advantage. This makes calling around to multiple pharmacies or using a service like medfinder much more worthwhile for Besivance patients.

What About Insurance and Prior Authorization Causing Delays?

Insurance complications add another layer of difficulty. About 30% of ACA plan enrollees and 80% of Medicaid enrollees face prior authorization requirements for Besivance. This means your doctor may need to submit a prior authorization request before your insurance will cover it — a process that can take days. During that time, you either pay out of pocket or wait.

Some plans also apply step therapy, meaning they require patients to try a cheaper alternative first (like generic ciprofloxacin eye drops) before approving coverage for Besivance. If your doctor believes Besivance is clinically necessary, they can document this and request an exception.

What Can You Do If You Can't Find Besivance?

There are several concrete steps you can take right now:

Use medfinder. medfinder calls pharmacies near you to check who has Besivance in stock, so you don't have to make a dozen phone calls yourself.

Call chain pharmacies directly. Larger chains like CVS, Walgreens, and Rite Aid can check neighboring store inventory. Ask specifically if they can transfer stock from another location.

Ask your prescriber about alternatives. Moxifloxacin (Vigamox) is a comparable fourth-generation fluoroquinolone with a generic version widely available at $15–$40. If your case doesn't require Besivance specifically, this is a practical backup.

Try an eye care specialty pharmacy. Independent pharmacies near ophthalmology practices often keep a better stock of specialty eye medications.

Check mail-order options. If your infection is not severe and you can wait 1–2 business days, mail-order pharmacies (through your insurer or a specialty pharmacy) may be able to ship Besivance to your door.

The Bottom Line

Besivance is not in an official shortage, but its brand-only status and specialty stocking patterns make it harder to fill than most antibiotics. Don't waste time calling pharmacy after pharmacy on your own. Check out our guide on how to find Besivance in stock near you for a step-by-step approach.

If you're ready to find a pharmacy that has Besivance in stock now, medfinder can help by calling pharmacies near you on your behalf.