Clickable Table
Generic Name | Brand Name | Strength | Dosing | 90 Day Cost | Coverage | Comments | Category 1 | Category 2 |
---|---|---|---|---|---|---|---|---|
Estradiol-17β | Estrace | 1 mg | QD | $35 | BC / NIHB - Covered | I Hormone Replacement Therapy | Oral | |
Conjugated Estrogens | Premarin | 0.625 mg | QD | $55 | BC / NIHB - Covered | I Hormone Replacement Therapy | Oral | |
Micronized Progesterone | Prometrium | 100 mg | HS | $50 | BC / NIHB - Covered | I Hormone Replacement Therapy | Oral | |
Medroxyprogesterone | Provera | 5 mg | QD | $40 | BC / NIHB - Covered | I Hormone Replacement Therapy | Oral | |
Estradiol-17β Patch | Estradot/Oesclim | 50 mcg | Twice weekly | $85 | BC / NIHB - Covered | I Hormone Replacement Therapy | Transdermal | |
Estradiol-17β Gel | Estrogel | 2.5 g gel = 1.5 mg estradiol | QD | $105 | BC / NIHB - Covered | I Hormone Replacement Therapy | Transdermal | |
Conjugated Estrogens | Premarin Vaginal Cr | 0.625 mg | QD | $95 | BC / NIHB - Covered | I Hormone Replacement Therapy | Vaginal | |
Estradiol-17β Vaginal Tablet | Vagifem-10 | 10 mcg | Twice weekly | $140 | BC / NIHB - Covered | I Hormone Replacement Therapy | Vaginal |