Rezdiffra is hard to find in 2026 due to specialty pharmacy restrictions, prior authorization, and high demand. Learn why and what you can do about it.
You got your prescription for Rezdiffra (Resmetirom), and now you're running into walls trying to actually fill it. Your local pharmacy doesn't carry it. The specialty pharmacy has a waitlist. Your insurance needs more paperwork. Sound familiar?
Rezdiffra was approved by the FDA in March 2024 as the first and only medication specifically for metabolic dysfunction-associated steatohepatitis (MASH), formerly known as NASH. It was a breakthrough moment for the millions of Americans living with this serious liver condition. But getting the drug into patients' hands has been a different story.
In this article, we'll explain exactly why Rezdiffra is so hard to find in 2026 and what steps you can take to get your prescription filled.
Rezdiffra is the brand name for Resmetirom, a thyroid hormone receptor-beta (THR-β) agonist made by Madrigal Pharmaceuticals. It works by activating a specific receptor in your liver that helps reduce fat buildup, inflammation, and scarring.
It's prescribed for adults with noncirrhotic MASH who have moderate to advanced liver fibrosis (stages F2 to F3). The drug comes as a once-daily tablet in three strengths: 60 mg, 80 mg, and 100 mg. Your dose depends on your body weight — 80 mg if you weigh less than 220 pounds, or 100 mg if you weigh 220 pounds or more.
For a deeper dive into the medication itself, check out our guide on what Rezdiffra is, its uses, dosage, and what you need to know.
There are several reasons patients struggle to get their hands on Rezdiffra. Here are the biggest ones:
Unlike common prescriptions you can pick up at your local CVS or Walgreens, Rezdiffra is distributed through a limited network of specialty pharmacies. This means your regular pharmacy simply doesn't stock it and can't order it for you.
Specialty pharmacies handle medications that are complex, high-cost, or require special handling. While this ensures proper oversight, it also creates a bottleneck. You may need to enroll with a specific specialty pharmacy, set up delivery, and coordinate with your doctor's office — all of which takes time.
Nearly every insurance plan — including commercial insurance, Medicare, and Medicaid — requires prior authorization (PA) before they'll cover Rezdiffra. This means your doctor has to submit paperwork proving you meet specific criteria, such as:
The PA process can take anywhere from a few days to several weeks. If the initial request is denied, your doctor may need to file an appeal, adding even more time.
Rezdiffra carries a list price of approximately $47,400 per year — roughly $3,950 per month. Even with insurance, copays for specialty medications can be steep. Without insurance, filling a Rezdiffra prescription is out of reach for most patients.
This high price point means pharmacies are cautious about stocking the drug, and some insurance plans place it on the highest formulary tier or exclude it altogether. For tips on reducing your costs, see our article on how to save money on Rezdiffra in 2026.
Rezdiffra is the only FDA-approved drug for MASH. There's no generic version and no direct competitor on the market yet. When a drug is this new and this unique, the supply chain takes time to mature. Specialty pharmacy networks are still being built out, and awareness among prescribers is still growing.
Additionally, because MASH affects an estimated 6 to 8 million Americans with significant fibrosis, demand for Rezdiffra is expected to grow steadily — potentially outpacing the current distribution infrastructure.
If you're having trouble finding Rezdiffra, here are practical steps you can take:
Tools like Medfinder can help you locate pharmacies that have Rezdiffra in stock. Instead of calling pharmacy after pharmacy, you can search online and get real-time availability information.
Your prescriber's office is your best ally in navigating prior authorization. Ask them to:
Madrigal Pharmaceuticals offers a comprehensive support program for Rezdiffra patients. They can help with:
Call 1-877-219-7770 (Monday–Friday, 8 AM–8 PM ET) or visit madrigalpatientsupport.com.
Your doctor or Madrigal Patient Support can tell you exactly which specialty pharmacies carry Rezdiffra. Once you're connected with the right pharmacy, they can coordinate delivery directly to your home.
For more detailed strategies, read our guide on how to find Rezdiffra in stock near you.
If access barriers are keeping you from starting treatment, talk to your doctor about alternatives. While no other drug is FDA-approved specifically for MASH, some medications are used off-label:
Learn more in our article on alternatives to Rezdiffra if you can't fill your prescription.
Rezdiffra represents a major step forward for patients with MASH — but getting access to it in 2026 still takes patience and persistence. The combination of specialty pharmacy distribution, prior authorization requirements, and high costs creates real barriers that millions of patients are navigating right now.
The good news is that resources exist to help. Between Madrigal's patient support program, tools like Medfinder, and your healthcare team, there are concrete steps you can take to get your prescription filled. Don't give up — this medication could make a real difference in your liver health.
You focus on staying healthy. We'll handle the rest.
Try Medfinder Concierge FreeMedfinder's mission is to ensure every patient gets access to the medications they need. We believe this begins with trustworthy information. Our core values guide everything we do, including the standards that shape the accuracy, transparency, and quality of our content. We’re committed to delivering information that’s evidence-based, regularly updated, and easy to understand. For more details on our editorial process, see here.
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