5 Ways to Save on Premarin Vaginal Cream for Menopause

If you’re over the age of 50, you may have started to experience menopause symptoms, such as vaginal dryness. Premarin Vaginal Cream (conjugated estrogens) is a popular option for relief of vaginal menopause symptoms.

Premarin Vaginal Cream is a form of menopausal hormone therapy (MHT) — previously called hormone replacement therapy. It’s one of the first-choice options for managing vaginal menopause symptoms, such as dryness or pain during sex. Currently, there’s no generic for Premarin Vaginal Cream, and there may never be.

Here, we’ll answer your questions about Premarin Vaginal Cream and share some ways to save.

What is Premarin Vaginal Cream?

Premarin Vaginal Cream contains conjugated estrogens. It’s used to treat vaginal symptoms of menopause. It works by raising levels of estrogen in and around the vagina. Menopause symptoms are primarily caused by naturally dropping levels of estrogen in the body.

As its name suggests, you should apply Premarin Vaginal Cream into the vagina. The medication comes with a reusable applicator that you should wash between uses. But your prescriber may also suggest using your finger to apply the cream in some cases.

Premarin Vaginal Cream dosages vary depending on your symptoms and response. It’s common to apply a dose once a day when you first start using it. After a few weeks, the typical dosage is once daily or twice weekly, depending on your symptoms. For daily use, your prescriber may have you apply it for 21 days, followed by a 7-day break.

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Below, we cover five ways you can save on Premarin Vaginal Cream.

Good to know: Premarin Vaginal Cream doesn’t work for body-wide menopause symptoms, such as hot flashes. This is because not much medication from the cream reaches your bloodstream. Discuss other options with your healthcare team. You may need a medication that treats all menopause symptoms, such as oral Premarin (conjugated estrogens) tablets.

Savings tip #1: Use your insurance

The best way to save on Premarin Vaginal Cream is to use your insurance. Many insurance plans cover it. But some plans require a prior authorization or step therapy before they will cover Premarin Vaginal Cream. And it’s possible your prescription may have a higher copay compared to vaginal estrogen products that have a generic version available.

If your insurance plan doesn’t cover Premarin Vaginal Cream, ask your prescriber’s office about filing an appeal. The exact process will depend on your insurance, but it often requires that you work with your prescriber to submit an appeal letter.

Savings tip #2: Pay as little as $25 per prescription with a savings card

Pfizer (the maker of Premarin) offers a manufacturer coupon for Premarin Vaginal Cream. To qualify, you must have commercial insurance. So if you have a government-funded insurance plan, such as Medicare or Medicaid, you wouldn’t be able to use this copay card. If you’re using this card, be sure to check the expiration date for the savings.

Savings tip #3: Apply for a patient assistance program

Pfizer also offers a patient assistance program for people who are uninsured. This program is also available for people with government-funded insurance plans who meet certain financial requirements. Be sure to ask if the assistance runs indefinitely or if it expires after a period of time or number of refills.

Savings tip #4: Use GoodRx

Anyone with a valid prescription, regardless of insurance status, can use GoodRx to buy a 30 gm tube of Premarin Vaginal Cream at an exclusive cash price of $249. This tube typically lasts for about 6 months if you’re using it twice a week. That works out to about $41.50 per month.

EXPERT PICKS: WHAT TO READ NEXT

• Compare your options: Premarin Vaginal Cream (conjugated estrogens) is one of several available menopause treatments. Learn about the different options and how to save on them.

• What to expect: Pharmacists review notable Premarin Vaginal Cream side effects — from headaches to vaginal discharge — and how to manage them.

• Typical dosages: Learn about typical Premarin Vaginal Cream dosages here.

Here’s how to get the coupon:

• Visit www.goodrx.com or install the GoodRx app on your mobile device.

• Type “Premarin Vaginal Cream” in the search field.

• Click or tap on “Start saving” to find prices at pharmacies near you.

• Select your pharmacy from the list.

• You’ll see a box on your screen that says “Price without insurance.” If you’re on a mobile device, this box will be underneath the list of pharmacies and option for the manufacturer copay card. If you’re on a computer or laptop, this box will be on the right-hand side of your screen.

• Choose to receive your coupon via email or text, print it out, or save your coupon on the GoodRx app.

• Show the coupon at the pharmacy when you pick up your medication. If possible, provide the coupon information to your pharmacy staff early in the filling process, such as when you first get your prescription. This can help prevent delays at the pickup counter.

Savings tip #5: Talk to your prescriber about alternatives

Other than Premarin Vaginal Cream, there are many other menopausal hormone therapy options available. While none of them are made from conjugated estrogens, they work in similar ways to relieve symptoms.

Premarin Vaginal Cream vs. vaginal estradiol

Estradiol (Estrace, Vagifem, Estring) is another popular type of vaginal estrogen. There are several things that set estradiol and Premarin Vaginal Cream apart. Despite these distinctions, they all work similarly well. So experts don’t recommend one vaginal estrogen over the others for treating vaginal symptoms of menopause.

One of the biggest differences is the type of estrogen each medication contains. Estradiol products contain lab-made estrogen that acts like the natural estradiol in your body. Premarin contains conjugated estrogens. It’s naturally derived from the urine of pregnant horses. That’s actually how it got its name: Pregnant mare’s urine.

Another difference is the available dosage forms for each medication. Premarin Vaginal Cream is the only vaginal product that contains conjugated estrogens. Vaginal estradiol comes in a few different forms:

• Vaginal cream: Estrace (brand-name), estradiol (generic)

• Vaginal tablets: Vagifem (brand-name), Yuvafem (generic), estradiol (generic)

• Vaginal insert: Imvexxy (brand-name)

• Vaginal ring: Estring (brand-name)

Good to know: Femring (estradiol acetate) is another vaginal ring that contains estradiol. But this medication contains higher amounts of hormones than other vaginal estrogens. Because of this, it can also treat body-wide menopause symptoms. Your prescriber would likely consider other vaginal estrogen products before Femring if you’re only having vaginal symptoms.

How to save on vaginal estradiol products

There are many ways to save on vaginal estradiol products, which are available as both brand-name and generic medications. Here are a few of them:

• Estradiol vaginal cream: This is available as both a brand-name medication (Estrace) and a lower-cost generic (estradiol). Generic estradiol cream’s price at certain pharmacies is as low as $24.00 for a 42.5 gm tube with a free GoodRx discount.

• Estradiol vaginal tablets: They are available as a brand-name medication (Vagifem) as well as two different lower-cost generics (Yuvafem and estradiol). GoodRx can help you save over 70% off the average retail price of the generic versions.

• Imvexxy: This is available as a brand-name medication. If you have commercial insurance, you may be eligible to pay as little as $35 using a savings card from the manufacturer.

• Estring: This is available as a brand-name medication, but a copay card can lower your cost to $25 per ring (90-day supply) if you have commercial insurance. GoodRx also offers exclusive savings on the cash price of $249 per ring, regardless of insurance status. A patient assistance program is also available.

When will generic Premarin be available?

It’s possible that Premarin Vaginal Cream will never have a generic version.

As discussed, the medication’s active ingredient comes from the urine of pregnant horses. And its exact blend of estrogens hasn’t been defined. Because of this, other pharmaceutical manufacturers are unable to make a generic version.

Think of it like trying to replicate a meal you had at a restaurant. Without a recipe, you can’t fully reproduce it. Maybe you’d come close, but the result wouldn’t be identical. And when it comes to approving generic medications, the FDA requires manufacturers to create exact copies of the active ingredients.

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Written by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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