If you’re over the age of 50, you may have started to experience some of those difficult menopause symptoms. Hot flashes, fatigue, night sweats, osteoporosis…not fun.
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 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 on Premarin?
When will generic Premarin be available?
Premarin’s patent protection expired in 2012, so other manufacturers are allowed to create a generic with the same active ingredients, but none have been approved. Why? The answer lies in how Premarin is made.
The estrogens in Premarin are made from – wait for it – the urine of pregnant mares. Yes, horse pee. Because of this, the active ingredients in Premarin have not been defined, and the FDA will not approve a synthetic version. Moral of the story, we may never see a Premarin generic.
So, how can I save on Premarin?
While Premarin is expensive, there are ways to save.
- Use a manufacturer coupon. Pfizer offers a manufacturer coupon for both the vaginal cream and the tablets. With the Premarin Co-Pay Card, you can pay as little as $15 for a 30-day supply of tablets, and with the Premarin Her Source program, you can pay as little as $15 for the vaginal cream. Restrictions do apply, so be sure to contact the program to see if you qualify.
- Try a patient assistance program. Pfizer also offers a patient assistance program to help eligible patients receive their prescription of Premarin at no cost. This applies to both the tablets and the vaginal cream. Patient assistance programs are typically for low-income, uninsured patients, so call Pfizer Pathways at 1-877-744-5675 to see if you qualify.
- Fill a 90-day supply. While this only applies to the Premarin tablets, a longer prescription can help shave off more on your out-of-pocket costs. You will need to talk to your doctor, as you will need a new prescription to fill for a higher quantity.
- Appeal your coverage. Premarin is covered by most Medicare and insurance plans, but if your plan won’t cover the drug’s cost, keep in mind that you can always ask your doctor about submitting an appeal. Some plans require prior authorizations—meaning you need permission from your insurance plan and a special request from your doctor before you can fill your prescription. If you have insurance, call your provider and ask how to get this process started. In fact, on average 50% of people who appeal to their insurance get coverage, so it’s worth a try.
In addition to these savings tips, there are also other affordable alternatives to Premarin. More on that below.
Are there any cheaper alternatives to Premarin?
There are many forms of estrogens available to treat symptoms of menopause or 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 your risk of osteoporosis, just like Premarin. Both estradiol/norethindrone and Premarin have potential side effects caused by the hormone, so the only big difference is the price. While Premarin can cost over $200 for a 30-day supply, the cash price for generic estradiol/norethindrone is around $50.
Estropipate (Ogen) is another alternative also used to treat symptoms of menopause and prevent osteoporosis. While it is affordable, estropipate only comes in tablet form, so it wouldn’t be a proper substitution for those using the tube of 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 fill for any of these alternatives.
Does Premarin have any side effects?
Since Premarin is a hormone, there can be a lot of side effects. Women taking Premarin may experience headache, abdominal pain, breast pain, nausea, back pain, insomnia, or depression.
Premarin can also increase the risk for more serious side effects, like uterine and breast cancer, blood clots, and stroke.
The most frequently performed outpatient surgery in the United States is cataract surgery. After your cataract procedure, your doctor will prescribe several eye drops with the goal of suppressing inflammation and improving pain. Whether after a cataract or Lasik procedure, or if prescribed for another reason, these drops may cost you an arm and a leg. Here is what you need to know.
Antibiotic eye drops
There are some good affordable generic options now for antibiotic eye drops. While Besivance is an expensive brand name antibiotic eye drop still prescribed, there are cheaper antibiotic eye drops available:
- Moxifloxacin (Vigamox) 0.5%
- Gatifloxacin (Zymaxid) 0.5%
- Tobramycin/dexamethasone (Tobradex)
- Ciprofloxacin 0.3%
While some eye doctors like the newer brand antibiotic eye drops because they believe there is less antibiotic resistance to the newer drops, many have shifted over to generic options with better cost and higher compliance.
Steroid eye drops
These are given to reduce inflammation after cataract surgery, and this is where the brand name eye drops are going to cost you. Lotemax, Alrex, and Durezol are expensive drops often prescribed. More reasonable priced brand name steroid eye drops are Vexol and Maxidex, but there is a good cheaper option:
- Prednisolone acetate 1% (Pred-Forte/OmniPred). Remember that steroid eye drops vary in their potency, so prednisolone drops are used 4-5 times a day, while some other drops are more potent and are used twice a day.
NSAID eye drops
Non-steroidal anti-inflammatory (NSAID) eye drops can help to reduce swelling, pain, and light sensitivity after cataract surgery. So, adding it to a regimen with steroid eye drops may be better, but it may cost you. Prolensa, Nevanac, and Ilevro are newer expensive options. Good generic options include:
If cost is an issue, ask about the generic NSAID options, but keep in mind that they reportedly sting more and need to be used several times a day as opposed to once daily.
Bottom line? Shop around for generic options and check out prices on GoodRx. Otherwise, these drops are going to cost you.
You prescribe your patients medicine to help them get better. Can you help them understand drug costs, too? With GoodRx, the answer is yes.
Patients look to their doctors and health professionals for answers about their health, but as health insurance and prescription pricing standards shift over time, patients are increasingly seeking advice on the cost of their drug as well.
It’s hard for anybody to know everything about drug pricing, let alone what any medication might cost at the pharmacy. GoodRx is here to bridge that gap by giving doctors drug price info so they can advise their patients with confidence and accuracy.
How does GoodRx help physicians?
- Better adherence = better outcomes. If a patient can’t afford their medication, they are less likely to stay on their treatment course which will ultimately hurt their health even more. As a physician, you can encourage positive outcomes by ensuring patients have access to low drug prices and savings.
- Better patient satisfaction. Patients feel the impact of rising prescription costs every day. Tools like GoodRx can help patients feel empowered and knowledgeable about their health choices, and build trust between doctor and patient.
- Dedicated customer support. GoodRx offers real-time support (online help center or call 888-799-2553) to anyone who needs help checking their drug costs or getting their prescription filled. We have a large team of patient advocates trained to help, and physicians can offer patients these services through GoodRx for free.
- Saving time and money for the practice. Medical practices save time by having all the information they need in one place – be it the GoodRx physician mobile app, EHR integrations, or the GoodRx website. In fact, a dermatologist submitted a cost analysis study to JAAD, saying “my office has needed to hire one less office staff member and that I save about 1-2 hours of my time per week.”
GoodRx currently partners with about 200,000 medical practices to offer value-add services and help physicians take better care of their patients. And we often see this in action online, too:
@RosenthalHealth Airduo generic form of advaire available at Walgreens with GoodRx for $50. I have a lot patients using it.
@RossNesbit @hswapnil @NephRodby @KatieKwonMD @medrants @S_brimble Tell your patients to use GoodRx. Ten-fold price spread.
@webbbieone @CateIynnLoweII Love that app! Good ol UHG doesn’t cover mine, I tell my old folks how to use it all the time. Once helped a lady with an antibiotic not covered by Medicare that was around $280, and goodrx brought it down to $85ish. Still high but WAY better!
The bottom line is, doctors, nurses, and other providers are trusted advisors when it comes to managing their patients’ health – and that often includes making sense of drug pricing. GoodRx is essentially a free prescription savings adherence tool for medical practices.
Want to get started? Request a free Doctor Kit, which comes with printed materials for your office, like brochures and counter cards.
You can also read more about the benefits physicians get from helping patients reduce their prescription costs in this recent interview.