There are a few alternative pharmacies in the U.S. and Canada that sell it. I stumbled on this link below for example, but have not verified whether they currently stock it. I tried it some years back for a couple months without noticing any benefit for my UC, however- and this is a big however- I believe that the person I had transport it over from Germany was unable to keep it at the recommended cool temperature for the two days it was in transit, so it may have lost its viability by the time I got it. I emailed Mutaflor about
how much viability is lost over time if not refrigerated, and their only reply was to repeat the instructions for refrigeration (duh!).
http://www.cocoonnutrition.org/catalog/advanced_search_result.php?keywords=MUTAFLOR&x=0&y=0