How Much Is Vagifem Without Insurance?
Key takeaways:
Vagifem is a brand-name vaginal insert or tablet that is used to treat atrophic vaginitis, or dry, inflamed, or thinned vaginal walls. This hormone replacement therapy suppository is a lab-made form of estrogen.
If you don’t have insurance, the cost of an 8-dose package of 10 mcg brand-name Vagifem inserts is about $211.10.
What you’ll pay for Vagifem will depend on factors including your prescribed dosage, fill amount, and pharmacy used.
Table of contents
Vagifem (estradiol vaginal tablets) is a brand-name menopause hormonal therapy, or MHT, medication. It’s used to treat atrophic vaginitis, or dry, inflamed, or thinned vaginal walls caused by low estrogen levels. These symptoms often happen during menopause. Vagifem is a vaginal tablet containing estradiol, a lab-made form of the hormone estrogen, which can help alleviate atrophic vaginitis symptoms. Vaginal inserts may not work well, however, for nonvaginal menopause symptoms such as hot flashes.
Vagifem is also available as generic estradiol vaginal tablets, as well as the branded generic Yuvafem.
Vagifem basics
The chart below provides a summary of basic information about Vagifem.
Understanding menopause: Learn more about menopause, the phase of life when your menstrual cycle ends and your hormones change, including potential symptoms and treatments during this transition.
Vaginal estrogen treatments that may be right for you: Review different estrogen suppositories and creams to help with urinary and vaginal symptoms during and after menopause.
Menopause hormonal therapy (MHT) options: There are many estrogen and other hormone therapies, including patches, pills, and shots that treat menopause symptoms.
Vagifem Basics
| Brand name | Vagifem |
| Generic names | Estradiol, Yuvafem (branded generic) |
| Dosage | One 10 mcg suppository every day for two weeks, then twice a week thereafter (with 2 to 3 days in between doses) |
| How supplied | 18-dose pack (for the first month of treatment) 8-dose pack (for subsequent months) |
| FDA-approved uses |
|
| Benefits |
|
| Side effects |
|
Is Vagifem covered by insurance?
Some health insurance plans cover brand-name Vagifem. Check your plan’s summary of benefits and coverage and formulary (its list of covered medications) to determine whether Vagifem is covered.
How insurance covers Vagifem
Almost all Medicaid plans cover Vagifem, but only about 1 in 5 Affordable Care Act (ACA, also known as Obamacare) plans and 63% of all other commercial insurance plans cover this medication. Less than 10% of Medicare prescription plans cover Vagifem.
Many health insurance plans covering this medication require enrollees to get a prior authorization or do step therapy, including for more than half of people who are covered by Medicaid.
The following chart shows your likelihood of coverage, as well as prior authorization and step therapy requirements, for various types of insurance plans:
Insurance Coverage for Vagifem (10 mcg suppositories)
Insurance type | Enrollees covered for this medication | Enrollees required to get a prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
Commercial (not including plans purchased through an ACA marketplace) | 62.9% | 10.5% | 6.04% |
21.1% | 13.1% | 0.03% | |
Medicare, including original Medicare and Medicare Advantage plans | 7.4% | 1% | 2.15% |
Medicaid, including state-run and managed care plans | 99.4% | 56.2% | 0.92% |
Source: Managed Markets Insight & Technology, LLC™, as of December 13, 2024. (See methodology below.)
Tips if Vagifem isn’t covered by your insurance
If your insurance doesn’t cover Vagifem, here are a few options to try:
Talk to your prescriber about alternatives, including generic options.
Ask for an exception from your prescription medication formulary. Keep in mind that you may be required to do step therapy or get a prior authorization to be covered.
If you request a formulary exception that is denied, file an appeal with your plan.
Use a GoodRx coupon for potential savings.
Consider changing your prescription medication coverage during your next open enrollment period.
How much does Vagifem cost without insurance?
If you don’t have health insurance, what you’ll pay for Vagifem will depend on factors such as:
Medication type (brand name or generic)
Number of inserts
Geographic location
Pharmacy used
The charts below detail the average retail prices for a monthly maintenance dose (8 tablets) of brand-name and generic Vagifem.
Vagifem Cost
Dosage | Average retail price |
|---|---|
10 mcg (8 inserts) |
Generic Vagifem Costs
Ways to save on Vagifem without insurance
Although Vagifem may be affordable even without insurance, there are still ways to save money on this medication.
1. Use a GoodRx coupon
With a GoodRx coupon, you may be able to pay a lower price for your Vagifem prescription. You may be able to get an 8-dose package of 10 mcg brand-name Vagifem inserts for as low as $171.19 with a GoodRx coupon.
Here’s how to get a coupon:
Visit www.goodrx.com, or install the GoodRx app on your mobile device.
Type “Vagifem” in the search field.
Choose the correct quantity and location.
Click or tap on “Search prices” to find prices at pharmacies near you.
Choose to receive your coupon via text or email, or print it out.
Show the coupon at the pharmacy when you pick up your medication. Or present the coupon to your pharmacy staff when you first receive your prescription. This will help prevent delays at the pickup counter.
2. Compare prices at various pharmacies
GoodRx can help you easily compare costs at different pharmacies so that you can find the best Vagifem price. Prices can vary widely, even at pharmacies in the same area.
3. Ask your prescriber about alternatives
If you are concerned about the cost of Vagifem, talk to your prescriber. There may be another medication that adequately treats your condition and fits your budget.
4. Use tax-advantaged healthcare funds
If you have a health savings account (HSA), flexible spending account (FSA), or health reimbursement arrangement (HRA), using those funds to buy your medication can reduce your out-of-pocket costs through tax savings.
The bottom line
Vagifem (estradiol vaginal tablets, Yuvafem), is a brand-name menopause hormonal therapy prescribed to help reduce vaginal irritation, dryness, and thinning associated with menopause. After the first 2 weeks, you’ll insert Vagifem just twice per week, about 2 to 3 days apart.
Some insurance plans cover Vagifem, but your coverage may include only a generic version. Without insurance, the cost of an 8-dose package of 10 mcg generic Vagifem (estradiol) inserts is about $144.19. You may be able to save money on the medication by comparing pharmacy prices, asking your prescriber about alternative medications, or using a GoodRx coupon.
Why trust our experts?
Methodology
We obtained national prescription coverage data for each medication from Managed Markets Insight & Technology (MMIT). The data reflects health insurance coverage as of December 2024.
We calculated the percentage of enrollees in plans that cover each medication by dividing the number of enrollees covered for the medication within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel.
We determined the percentage of enrollees in plans with a prior authorization requirement by calculating the proportion of enrollees in plans that required prior authorization for the medication within each channel.
Finally, we measured the percentage of enrollees in plans with a step therapy requirement by calculating the proportion of enrollees in plans that imposed step therapy requirements for the medication in each channel.
These estimates, derived from national MMIT coverage data, provide insight into health insurance coverage for each medication. They take into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total number of enrollees covered by various insurance channels, including the ACA, commercial (excluding ACA) plans, Medicare, and Medicaid (both state-run and managed care plans).
References
Medicaid.gov. (n.d.). Managed care.
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