Why Is Premarin So Expensive?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
Posted on

Many women need cheaper options for hormone replacement. One of the most commonly prescribed estrogens for women is Premarin, and it’s so darn expensive. This is because there is no generic form of Premarin and will not likely ever be. Premarin is the brand name for conjugated estrogens used to treat symptoms of menopause and to prevent osteoporosis.

Why doesn’t a generic for Premarin exist?

Well, because we don’t really know what’s in it. The active ingredients in Premarin have not been defined so a generic synthetic version cannot be approved, at least not yet. Premarin comes from the urine of pregnant mares and contains a number of different estrogens. Per the FDA: The generic products have not been shown to contain the same active ingredients, and therefore to work the same, as the original drug in treating women with menopausal symptoms and preventing osteoporosis.

Which estrogens may be cheaper than your Premarin?

  1. Estradiol. Estradiol is a generic option that comes in a pill or a patch. Climara patch is the brand name estradiol patch and Estrace is the brand name cream or pill.
  1. Estropipate tablets are a generic form of the brand name Ogen.
  1. Activella is a brand name that has a generic option. The generic is a combination estrogen + progesterone pill: estradiol/norethindrone.

Which other estrogens may be the same price as Premarin?

An estrogen-only patch called Vivelle-Dot and two combinations of estrogen + progesterone: Premphase and Prempro.

Which estrogens will likely be even more expensive than Premarin?
Elestrin, Enjuvia, Menostar, Combipatch and Climara Pro patch. All of those are brand names that will cost you.

It is always worth talking to your doctor about a switch to a cheaper option.

Dr O.

Drugs featured in this story

Filed under