Here’s How to Save on Premarin for Menopause

Luckily, there are medications that can help you through menopause. But, are they affordable?

One of the more commonly prescribed estrogens to treat menopausal symptoms and to prevent osteoporosis is Premarin, but it’s expensive. Premarin is a brand-only medication, and a 30-day supply can cost well over $200. Currently, there is no generic for Premarin, and there may never be.

So, how can you save?



What is Premarin?

Premarin is the brand name for conjugated estrogens, and is used to treat symptoms of menopause and to prevent osteoporosis in women.

Since Premarin is a hormone, it can cause a lot of side effects. Women taking Premarin may experience headache, abdominal pain, breast pain, nausea, back pain, insomnia and depression. Premarin can also increase the risk for more serious side effects like uterine and breast cancer, blood clots, and stroke.


When will generic Premarin be available?

Premarin’s patent protection expired in 2012, so other manufacturers are technically allowed to create generics with the same active ingredients, but none have been approved. Why? The answer lies in how Premarin is made.

The estrogens in Premarin come from—wait for it—the urine of pregnant mares. Since Premarin comes from horse urine, the exact ingredients have not been defined, and the FDA will not approve a synthetic version. Moral of the story: We may never see a Premarin generic.

Luckily, there are other ways you can save.



Savings Tip #1: Use your insurance

The best way to save on Premarin is to use your insurance. Premarin is covered by most insurance plans, but there is a catch. Most plans require that patients submit a prior authorization form or complete step therapy before they will cover the drug. You can learn more about these restrictions here, but in essence, they make getting your drug more complicated.

If you find that Premarin isn’t covered by your insurance plan, ask your doctor about an appeal. The exact process will depend on your insurance, but often requires that you work with your doctor to submit an appeal letter.


Savings Tip #2: Pay as little as $15 per month with a savings card

Pfizer offers a manufacturer coupon for both forms of Premarin: the vaginal cream and the tablets.


Savings Tip #3: Apply for a patient assistance program

Pfizer also offers a patient assistance program for uninsured patients.



Savings Tip #4: Fill a 90-day supply

This tip only applies to the Premarin tablets: Buying a 90-day supply versus a 30-day supply could help you shave off some of the cost for each tablet. If you already have a prescription for Premarin, you will need to talk to your doctor to get a new prescription for a higher quantity.


Savings Tip #5: Talk to your doctor about alternatives

Outside of Premarin, there are many other estrogen medications available to treat symptoms of menopause and to prevent osteoporosis. While none of them are made from conjugated estrogens, in some cases they can be substituted for Premarin.

Estradiol, the generic for Climara and Estrace, is the most popular estrogen used for symptoms of menopause, and it’s more affordable than Premarin—a 30-day supply of estradiol is around $37 with a GoodRx coupon. There is one big difference between estradiol and Premarin, though. While Premarin is a natural hormone, derived from mare urine, estradiol is synthetic, meaning it is made in a lab.

Another alternative, Activella, also has a generic option: estradiol/norethindrone. This combination estrogen-and-progesterone pill is used to relieve symptoms of menopause and lower the risk of osteoporosis, just like Premarin. Both estradiol/norethindrone and Premarin have potential side effects caused by their hormone active ingredients, so the only big difference is the price. While Premarin can cost over $200 for a 30-day supply, the cash price for a month of generic estradiol/norethindrone is around $50.

Estropipate (Ogen) is another alternative also used to treat symptoms of menopause and to prevent osteoporosis. While it is affordable, estropipate only comes in tablet form, which wouldn’t be a proper substitution for the Premarin cream.

Premarin is expensive, so it is always worth talking to your doctor about switching to a more affordable medication, but keep in mind: You will need a new prescription to get any of these alternatives.


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