Clickable Table

Generic Name Brand Name Strength Dosing 90 Day Cost Coverage Comments Category 1 Category 2
Estradiol-17β Gel Estrogel 2.5 g gel = 1.5 mg estradiol QD $100 BC / IA - Covered Hormone Replacement Therapy Transdermal
Conjugated Estrogens Premarin Vaginal Cr 0.625 mg QD $85 BC / IA - Covered Hormone Replacement Therapy Vaginal
Estradiol-17β Vaginal Tablet Vagifem-10 10 mcg Twice weekly $125 BC / IA - Covered Hormone Replacement Therapy Vaginal
Estradiol-17β Estrace 1 mg QD $35 BC / IA - Covered Hormone Replacement Therapy Oral
Conjugated Estrogens Premarin 0.625 mg QD $50 BC / IA - Covered Hormone Replacement Therapy Oral
Micronized progesterone Prometrium 100 mg HS $125 BC - Covered / IA - SA Hormone Replacement Therapy Oral
Medroxyprogesterone Provera 5 mg QD $20 BC / IA - Covered Hormone Replacement Therapy Oral
Estradiol-17β Patch Estradot/Oesclim 50 mcg Twice weekly $80 BC / IA - Covered Hormone Replacement Therapy Transdermal
Legend:
BC = Alberta Blue Cross, IA = Indian Affairs, NC = Not covered, SA = special authorization, SR = sustained release, OTC = over the counter, SQ = subcutaneous injection, SS=Social Services