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Why Is the Cost of Premarin So Outrageous?

Premarin is made from pregnant mare's urine and has been around for decades and decades. Why is the cost of Premarin so high? Where is generic Premarin?

Q. I take Premarin, but the drug is very expensive. Both my doctor and pharmacist say there is no generic version of this drug. How can this be true? It is my understanding that this hormone treatment has been on the market for decades.

A. Premarin (conjugated estrogens) was approved by the FDA in the early 1940s. According to the company, more than 30 billion doses have been dispensed over the last 70 years to treat menopausal symptoms.

The estrogens in Premarin are made from purified pregnant mare’s urine (we suspect the name Pre-Mar-In is some sort of combination of pregnant mare’s urine). This formulation has stimulated a lot of controversy from animal rights advocates. The uniqueness and complexity of this biological medicine has made it hard for the FDA to approve any generic substitutes.

The cost of Premarin (a month’s supply) in our area is over $140. Forty years ago, the cost of a three-month’s supply of Premarin was under $7.

Other Readers Angry About Cost of Premarin:

Judy relates her Canadian connection:

“I have been on Premarin since 1982 and feel great. I tried to get off it but I was tired the next day by noon.

“The Premarin makes me feel good and I am still working 25 hours a week. I am 71 years old, at a good weight and have no problems with heart, blood pressure and no mood swings.

“I tried that estradiol. Forget it! Not for me. I had a total hysterectomy in 1982 due to endometriosis. I am scared to get off Premarin because I got severe migraines before I started it.

“Medicare does not cover it anymore so I got in touch with a Canadian pharmacy in Winter Park, FL and I get 3 months for 54.00 delivered to the door from Canada. It is the same as I have taken all those years. I am not quitting this drug as I feel great and all my co-workers think I am in my 50’s; fine with me and yes I outwork those young girls. Just wanted to put in my two cents.”

Janet wonders about Canada:

“I cannot go without my Premarin.

“Please share your Canadian pharmacy with me as I cannot afford to buy Premarin any longer. My 0.62 mg is almost $4.00 a pill. The drug manufacturers in the US need to be hung up by their toes. No one can afford healthcare anymore, especially us aging women.”

Susie also wants more information:

“Judy, I would love to get in touch with that Canadian pharmacy in Winter Park because my Medicare drug insurance stopped their coverage of Premarin! I’ve been on this drug for 30+years and I’m not sure how to feel good about something that has helped for this many years. Premarin is a great drug but with all the controversy, I guess insurance companies caved in from the pressure. I’ll soon be desperate without Premarin.”

Pharmacy Checker for Better Cost of Premarin:

PharmacyChecker.com offers price comparisons on brand name Premarin. Here is a link to the website:

Another Option:

You might ask your physician about other options to the high cost of Premarin. There are a number of synthetic estrogen products as well as natural estrogens formulated by compounding pharmacists. Many visitors to our website have found such products cost effective. Some people also prefer non-equine estrogen on ethical grounds.

What Has Been Your Experience?

If you must rely on an estrogen product, what has worked for you? How have you dealt with the high cost of Premarin? Share your thoughts below in the comment section and please vote on this article at the top of the page.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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