Provider Briefing: Xofluza 80 Mg Dose Pack Availability in 2026

Baloxavir marboxil (Xofluza) has become a preferred antiviral for many providers treating acute uncomplicated influenza — and for good reason. A single oral dose, a novel mechanism of action targeting cap-dependent endonuclease, and demonstrated efficacy in both standard-risk and high-risk populations make it an attractive prescribing choice.

However, providers across the country have reported that patients are having difficulty filling Xofluza prescriptions, particularly for the 80 mg dose pack. This article provides an up-to-date overview of Xofluza availability, the factors affecting supply, and practical strategies for ensuring your patients receive timely antiviral treatment.

Shortage Timeline: Where Things Stand

As of February 2026, Xofluza is not listed on the FDA Drug Shortage Database. There is no active shortage declaration from the manufacturer (Genentech) or the FDA.

That said, the clinical reality doesn't always match the regulatory status. During the 2024–2025 flu season, multiple reports emerged of pharmacy-level stockouts, particularly for the 80 mg dose pack. The pattern has continued into the current season:

• October–November 2025: Early flu activity led to increased Xofluza prescriptions. Availability was generally adequate.
• December 2025–January 2026: Peak flu season brought widespread reports of local stockouts, especially at chain pharmacies. The 80 mg dose pack was disproportionately affected.
• February 2026: Availability is improving in some regions but remains inconsistent. Independent pharmacies and specialty/online pharmacies report better stock levels than large chains.

Prescribing Implications

The intermittent availability of Xofluza creates several challenges for prescribers:

The 48-Hour Window

Xofluza, like all influenza antivirals, must be initiated within 48 hours of symptom onset. When patients can't fill the prescription promptly, the treatment window closes. This makes prescribing decisions time-sensitive in a way that differs from most medications.

Weight-Based Dosing and the 80 mg Pack

The 80 mg dose pack is indicated for patients weighing ≥80 kg. Given that the average adult male in the U.S. weighs approximately 90 kg, a significant proportion of your adult patients will require this formulation. Pharmacies that stock only 40 mg tablets may not have sufficient inventory to fill an 80 mg prescription without dispensing two separate tablets.

Prior Authorization Barriers

Some payers require prior authorization or step therapy (trial of oseltamivir) before covering Xofluza. This can introduce additional delays that compound the availability problem. Consider having your staff initiate the PA process proactively if your patient population frequently encounters these barriers.

The Availability Picture

Understanding why Xofluza availability is inconsistent helps inform your clinical workflow:

• No generic competition. Baloxavir marboxil remains patent-protected with no generic equivalent available. This limits supply to a single manufacturer.
• Seasonal demand concentration. Unlike chronic medications with steady demand, antiviral prescriptions spike dramatically during a 3–4 month window, creating supply-chain pressure.
• Pharmacy economics. At a wholesale acquisition cost that places the retail price between $200–$280, many pharmacies limit on-hand inventory due to carrying costs and expiration risk.
• Formulation-specific gaps. The 80 mg dose pack sees lower overall volume than the 40 mg pack, leading some pharmacies to stock only the more common formulation.

Cost and Access Considerations

Cost remains a significant access barrier for many patients:

• Cash price: $200–$280 for the 80 mg dose pack
• Commercial insurance: Copays vary; manufacturer coupon available (as low as $35, up to $70 savings)
• Direct-to-patient program: Genentech offers Xofluza for $50 cash pay through Alto Pharmacy, Amazon Pharmacy, and Cost Plus Drugs
• Patient assistance: The Genentech Patient Foundation provides Xofluza to eligible uninsured/underinsured patients (1-877-GENENTECH / 436-3683)

For patients without insurance, directing them to the $50 cash pay program can be the difference between treatment and no treatment. Our provider's guide to helping patients save money on Xofluza covers these programs in detail.

Tools and Resources for Providers

Several tools can help streamline the process of getting Xofluza to your patients:

MedFinder for Providers

MedFinder offers real-time pharmacy availability data that can help your staff identify pharmacies with Xofluza in stock before sending the prescription. This reduces the likelihood of patients arriving at a pharmacy only to find the medication unavailable.

Prescribing Alternatives Proactively

Consider a tiered prescribing approach during peak flu season:

1. First choice: Xofluza — send the prescription to a pharmacy confirmed to have it in stock
2. Backup: Include a note in your EHR or provide the patient with a printed backup prescription for oseltamivir in case Xofluza is unavailable
3. For patients who can't take oral medications: Refer to an infusion center or ED for peramivir (Rapivab) IV

Direct-to-Patient Pharmacy Options

For patients comfortable with mail-order or online pharmacy services, the following participate in Genentech's $50 cash pay program:

• Alto Pharmacy
• Amazon Pharmacy
• Cost Plus Drugs

Sending an e-prescription directly to one of these pharmacies can improve both availability and affordability for your patients.

Looking Ahead

Several developments may affect Xofluza availability in the coming years:

• No generic timeline. There is currently no indication of when generic baloxavir marboxil will become available in the U.S.
• Expanded indications. Xofluza's approval for post-exposure prophylaxis (2020) has broadened its use, potentially increasing demand further.
• Pipeline antivirals. Several next-generation influenza antivirals are in clinical development, though none are expected to reach the market before 2027–2028.

For the foreseeable future, the combination of brand-only supply and seasonal demand surges means that Xofluza availability will likely remain a recurring challenge during flu season.

Final Thoughts

Xofluza 80 Mg Dose Pack remains an excellent single-dose treatment option for influenza, but providers should plan for intermittent availability, especially during peak season. A proactive approach — confirming pharmacy stock before prescribing, maintaining backup prescriptions for alternatives, and directing patients to cost-saving programs — can help ensure your patients receive timely antiviral treatment.

For real-time availability data and additional provider resources, visit MedFinder for Providers. You may also find our guide on helping patients find Xofluza in stock useful for your clinical workflow.