Menopause Medication Prices Are Up 58% Over the Last Decade
Key takeaways:
The list prices for menopause medications have gone up almost 60% over the last 10 years.
Some medications can cost patients around $100 out of pocket per prescription.
Insurance coverage is uneven. Some drugs are covered, while others face tough restrictions, making access harder.
Menopause is a key stage in a woman’s life. So the need for affordable, accessible care is more critical than ever. But higher medication prices and more coverage restrictions have left many women struggling to afford the relief they need.
Over the last 10 years, the list prices for menopause medications have risen by 58%. Some medications remain affordable with insurance coverage. But others come with high out-of-pocket costs and heavy restrictions like prior authorization and step therapy.
Women taking menopause medications spend an average of $14.33 out of pocket per prescription. However, that number hides the costs of some medications that aren’t well covered.
The coverage divide
Insurers don’t treat all menopause medications equally. Some drugs have better coverage than others, leaving women at the mercy of their plans.
Mimvey, Jinteli, estradiol, and estradiol-based medications like estradiol valerate and estradiol/norethindrone are among the best covered. That makes them more accessible for many patients.
But other medications, like Brisdelle and Veozah, face tougher hurdles for coverage. Insurance companies often require prior authorization or step therapy for these drugs, meaning patients have to try other medications before they can get coverage.
Medications with high out-of-pocket costs
Even when women can get their prescriptions filled, the cost isn’t always manageable. Activella has the highest cost of any medication for menopause symptoms, at over $100 per prescription. Estrace and Prefest also come with high prices.
While some patients can rely on more affordable options, many are stuck footing big bills.
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The price hikes aren’t just a reflection of inflation or rising drug development costs. They also highlight the growing gap between what insurers cover and what patients need.
What’s behind the spike?
Price increases tend to hit menopause treatments hard due to limited generic options and complex regulatory requirements.
That said, list prices for menopause medications have been slowly dropping since September 2020. This dip is likely due to new generic options coming to the market.
The most popular menopause medications
Certain medications have become staples for women managing menopause symptoms. Estradiol, Dotti, Premarin, and Veozah rank among the most popular choices based on prescription fills.
Estradiol, a form of estrogen, is widely used in various forms — patches, tablets, and creams — to help with symptoms like hot flashes and vaginal dryness.
Dotti, an estradiol patch, offers a convenient way to maintain hormone levels. That makes it a common pick for women seeking relief.
Premarin, derived from estrogen compounds, has been a go-to medication for decades.
Veozah is the only medication approved to block neurokinin B, a chemical that triggers hot flashes.
Healthcare professionals and patients continue to trust these medications because they effectively treat menopause symptoms. Despite their popularity, however, their rising list prices are forcing women to make tough decisions about treatments based on affordability.
The bottom line
The cost of menopause care is going up. A 58% hike in list prices since 2014 has made some medications nearly unaffordable for those without comprehensive insurance coverage.
Women need more transparent pricing, fewer restrictions, and better insurance coverage to get the care they need during this natural yet often challenging phase of life.
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Methodology
List price: This analysis is based on the GoodRx List Price Index, a model created by GoodRx researchers. The index takes into account published list prices set by drug manufacturers for medications dispensed in community retail pharmacies. The list price index starts on December 31, 2013 and uses the 2013 fourth quarter drug mix and published list prices on December 31, 2013. It ends on September 30, 2024.
Medications included in the Menopause List Price Index include Activella, Alora, Amabelz, Angeliq, Bijuva, Brisdelle, Cenestin, Climara, Climara Pro, Combipatch, Covaryx, delestrogen, depo-estradiol, Divigel, Dotti, Duavee, Elestrin, Enjuvia, esterified estrogens/methyltestosterone, estrace, Estraderm, estradiol, estradiol (cream), estradiol (patches), estradiol (tablet), estradiol valerate, estradiol/norethindrone, estradiol/progesterone, Estrasorb, Estratest, Estrogel, estropipate, Etyqa, Evamist, Femhrt, Femring, Femtrace, Fyavolv, Imvexxy, Intrarosa, Jevantique, Jevantique lo, Jinteli, Lopreeza, Menest, Mimvey, Minivelle, Ogen, Osphena, paroxetine (Brisdelle), Prefest, Premarin, Premphase, Prempro, Veozah, and Vivelle-dot.
This cohort of medications is intended to include medications indicated to treat menopause. But it may not include all medications used for menopause. Some of the medications are also indicated for conditions other than menopause.
Prescription fill rate: Using a representative sample of U.S. prescription fills, we calculated the fill percent for each medication by taking the fill count for a medication as a percentage of fills for all medications, excluding vaccines. We calculated fill rates for claims filled between January 1, 2021 through September 15, 2024. The top 10 drugs shown had the highest fill count in September.
Out-of-pocket spent: We calculated average out-of-pocket spend per condition using a representative sample of U.S. prescription fills from January 1, 2023 through September 15, 2024. Amounts paid were normalized based on the dispensed quantity to a 30-day supply, based on total days supplied at the time of dispensing.
Commercial insurance coverage: We sourced prescription insurance coverage from Managed Markets Insight and Technology, LLC™, a trademark of MMIT, as of October 9, 2024. Data reflects the share of commercial and health exchange covered lives for the most common form and dosage of each medication.
