Contents
Introduction
Premarin® (conjugated estrogens) vaginal cream is a brand-name vaginal estrogen cream that the FDA initially approved to treat vaginal atrophy in 1946. Since then, it’s also been approved to treat painful sex due to menopause, which is a symptom of vaginal atrophy.
Because insurance companies typically classify drugs to treat sexual health as a Tier 2 or Tier 3 drug, the cost of Premarin vaginal cream can be high even with insurance. You may find that you pay up to half of the retail price out of pocket.
Premarin vaginal cream is a conjugated estrogen that is applied twice weekly (or as directed by your doctor). Premarin vaginal cream is popular because it can be effective at treating vaginal atrophy and can be safer than oral estrogens. Along with other topical estrogen treatments, Premarin vaginal cream is not shown to raise the risk of cancer or heart disease.
Unfortunately, even if you have insurance, the cost of Premarin vaginal cream can amount to thousands of dollars per year.
How much does Premarin cost?
Pfizer, the manufacturer of Premarin, does not list the retail price of Premarin on their website. However, according to GoodRx, the retail price of Premarin at Walmart is listed as $523 per tube.
$523 is the price of one fill of Premarin if you don’t have insurance. However, if you have insurance, you could pay between $523 and $0 per fill of Premarin vaginal cream.
Each fill of Premarin vaginal cream is one tube that contains 30 grams of cream. If you apply 0.5 grams of cream twice a week, the tube will last about three months. So, the yearly cost of Premarin can be more than $2,000.
Is there a Premarin coupon?
To lower Premarin’s cost for patients, Pfizer has created a discount card called the MHT by Pfizer Savings Card program.
| Insurance type | Estimated price per fill without Premarin coupon | Estimated savings with Pfizer MHT Co-pay Card |
|---|---|---|
| Medicare, Medicaid, TRICARE, VA, or other state/federal insurance | $523–$262 | Not eligible for savings |
| Cash-paying (no insurance) | $523 | Not eligible for savings |
| Private insurance with high out-of-pocket costs | $262 (or higher) | Pay as little as $25. Save up to $250 per fill. Limitations apply, including $1,440 max annual benefit and 1 fill per 30 days. |
| Private insurance with $30 copay | $262 | Likely ineligible: Offer does not apply if insurance already covers entire cost. Check with your pharmacy. |
| Private insurance with $0 copay | $262 | Not eligible: Coupon cannot be used when full cost is covered by insurance. |
The Pfizer MHT savings card is essentially a manufacturer coupon for medications like Premarin, Premarin Vaginal Cream, Estring, and Duavee. It’s free and easy to access through Pfizer’s website—just download it or request to receive it via text or email.
The most important eligibility rule: you must have private (commercial) insurance. The card cannot be used if you’re paying cash or if you are enrolled in any state or federally funded insurance program, including Medicare, Medicaid, TRICARE, or VA health care. If you're uninsured, there are other ways to save—but this card won't be one of them.
For eligible patients with private insurance and some out-of-pocket costs, the card can lower your copay to as little as $25 per fill. For Premarin Vaginal Cream, you can save up to $250 per fill, with a maximum savings of $1,440 per calendar year. The savings amount is based on your actual out-of-pocket cost, and you cannot use the card if your insurance already covers the full amount.
The card is limited to 1 fill every 30 days, and only accepted at participating pharmacies. If your pharmacy doesn’t participate, you may still be able to use the offer by mailing in a reimbursement request with your receipt and card details to Pfizer.
Be sure to check your eligibility and whether your pharmacy participates. The offer expires December 31, 2026. This savings card is not health insurance, and certain restrictions apply.
Are there other Premarin savings?
Yes. Currently, there are savings available to help lower the cost of Premarin. Here’s what we found:
- goodrx.com: This company offers Premarin for as low as $426, but the price could be higher depending on your eligibility. You’ll also need to pay a $9.99 monthly membership fee to access any savings.
- Pfizer’s Patient Assistance Program: The manufacturer of Premarin offers assistance programs that provide eligible patients with their medications for free. You can apply online.
Are there more cost-effective Premarin alternatives?
There are Premarin alternatives if the cost is too high for your budget. As we reviewed earlier, Premarin is a conjugated estrogen cream that’s prescribed in low doses and applied directly to the vagina. When estrogen levels decline in menopause, Premarin can add estrogen back to the vaginal tissues, which helps prevent common concerns like vaginal atrophy and painful sex.
If you’re looking for an alternative to Premarin, a few other low-dose vaginal estrogen treatments are available, including Estrace, Vagifem, Imvexxy, and Estring. Each medication contains the same active ingredient, estradiol, which is a bioidentical estrogen hormone that’s FDA-approved to treat vaginal atrophy.
Estrace is a vaginal estrogen cream that’s applied directly to the vaginal tissues. Vagifem and Imvexxy are vaginal estrogen suppositories that are inserted into the vagina. Estring is a vaginal ring that’s replaced once a month.
At Interlude, we offer several formulations of vaginal estrogen cream, including the generic of Estrace and generic of Vagifem, both of which are cheaper than Premarin. No generic versions of Imvexxy or Estring are available anywhere on the market.
Additionally, systemic hormone therapy can treat vaginal atrophy from menopause, but it’s prescribed in higher doses as an estrogen patch or pill.
Remember, you should always work with a trusted healthcare provider who can prescribe medications that suit your preferences, concerns, and health history.
Premarin coupon FAQs
You likely still have a few questions about the Premarin coupon. Here are a few of the most common questions with answers.
Can I use the Premarin savings card without insurance?
No. You must have private (commercial) insurance to use the Premarin savings card. It is not valid for cash-paying patients without insurance.
Can I use my Medicare plan with the Premarin savings card?
No. Pfizer clearly states that you’re not eligible for the savings card if you’re enrolled in any state or federally funded insurance program. This includes Medicare, Medicaid, TRICARE, Veterans Affairs health care, state prescription drug assistance programs, or the Government Health Insurance Plan in Puerto Rico (formerly known as “La Reforma de Salud”).
Can I get Premarin for free with the savings card?
No. The savings card reduces your out-of-pocket cost but does not make it free. For eligible patients, it can bring your copay down to as little as $25 per fill, depending on your insurance coverage. The maximum savings per fill for Premarin Vaginal Cream is $250, and the total savings are capped at $1,440 per calendar year.
Is there a generic for Premarin?
Currently, there isn’t a generic for Premarin. You’ll have to get conjugated estrogen vaginal cream through Pfizer for the foreseeable future. However, there are generics of estradiol available. Take our quiz to learn more.
If you’re in menopause (or close to it) and experiencing vaginal or urinary symptoms, take our quiz or browse our treatments to learn more about how Interlude can help you.
