How Much Does AndroGel Cost in North Dakota in 2026?

North Dakota Cash Price for AndroGel in 2026

The average cash price for brand-name AndroGel 1.62% across North Dakota retail pharmacies sits at approximately $510 per month in 2026. This figure mirrors AbbVie's national list price and has remained stable since mid-2025.

Prices do fluctuate between pharmacies. Walmart and Costco locations in Fargo and Bismarck tend to run $15, $40 below independent pharmacies, though stock availability varies. A 30-day supply of AndroGel 1.62% (two pump bottles of 75 g each at the standard 40.5 mg/day dose) is the most commonly dispensed configuration. The FDA-approved labeling for AndroGel specifies a starting dose of 40.5 mg applied once daily, with titration to 81 mg based on serum testosterone levels drawn 14 days after initiation.

Generic testosterone gel 1% (by Perrigo and Teva) typically costs $150, $250 per month cash in North Dakota. The generic is bioequivalent but uses a slightly different concentration (1% vs. 1.62%), meaning a larger volume per application. For patients paying out of pocket, the generic represents a 50 to 70% savings over the brand. GoodRx and SingleCare coupons can push the generic price below $100 at select ND pharmacies.

Insurance Coverage for AndroGel in North Dakota

Most commercial insurance plans in North Dakota cover testosterone replacement therapy, but brand-name AndroGel almost always sits behind a prior authorization wall and sometimes on a non-preferred formulary tier.

Blue Cross Blue Shield of North Dakota (BCBSND), the state's largest commercial carrier, covers generic testosterone gel on its preferred brand tier with a $50, $75 copay. Brand-name AndroGel requires prior authorization and a documented trial-and-failure of generic testosterone gel or injectable testosterone cypionate. Sanford Health Plan follows a similar step-therapy protocol. Medica, which covers state employees, lists generic testosterone gel on Tier 3.

Prior authorization criteria across ND carriers generally require: (1) a confirmed diagnosis of male hypogonadism with two morning serum testosterone levels below 300 ng/dL (Endocrine Society 2018 guidelines), (2) documented signs or symptoms such as reduced libido, fatigue, or decreased bone mineral density, and (3) failure of or contraindication to at least one lower-cost formulation.

The T-Trials, a coordinated set of seven randomized placebo-controlled trials enrolling 790 men aged 65 and older with testosterone levels below 275 ng/dL, showed that one year of testosterone gel treatment improved sexual function, walking distance, and mood compared to placebo (Snyder et al., NEJM 2016). These findings informed many insurers' medical policies on testosterone replacement coverage.

North Dakota Medicaid and AndroGel

North Dakota Medicaid does not cover AndroGel. The state's fee-for-service Medicaid formulary excludes brand-name testosterone gels entirely.

North Dakota is one of several states where Medicaid covers injectable testosterone cypionate (approximately $30, $50 per month) but not topical testosterone products. Patients on ND Medicaid who need a topical formulation due to needle phobia or injection-site reactions may request a formulary exception, but approval rates are low based on published state pharmacy reports. The Endocrine Society's clinical practice guideline recommends testosterone replacement for men with symptomatic hypogonadism regardless of formulation, noting that route of administration should be guided by patient preference, cost, and insurance coverage.

For Medicaid enrollees, injectable testosterone cypionate (200 mg/mL, administered intramuscularly every 1 to 2 weeks) remains the most accessible option. Compounded testosterone gel, discussed below, may serve as a middle-ground alternative for Medicaid patients willing to pay out of pocket.

Compounded Testosterone Gel in North Dakota

Compounded testosterone gel is legal in North Dakota through licensed 503A compounding pharmacies and costs approximately $120 per month. This is 76% less than brand-name AndroGel.

North Dakota's Board of Pharmacy permits 503A compounding pharmacies to prepare patient-specific testosterone gel formulations with a valid prescription. The state does not impose additional restrictions beyond federal FDA guidance on 503A compounding. Several compounding pharmacies in the state, including locations in Bismarck and Fargo, prepare testosterone gel in concentrations matching 1% or 1.62% formulations.

Key considerations for compounded testosterone gel: (1) it is not FDA-approved, meaning batch-to-batch consistency depends on the compounding pharmacy's quality controls, (2) insurance plans rarely cover compounded products, so patients should expect to pay cash, and (3) the FDA's 2023 advisory emphasizes that compounded drugs should be used only when a commercially available FDA-approved product is not medically appropriate. Patients should verify that their compounding pharmacy holds current North Dakota Board of Pharmacy licensure and follows USP 795 standards for non-sterile compounding.

Telehealth Prescribing of AndroGel in North Dakota

North Dakota permits testosterone gel prescribing via telehealth. Patients can obtain an AndroGel or generic testosterone gel prescription from a licensed provider through a video consultation without an in-person visit.

The state's telehealth parity law (NDCC 26.1-36-09.15) requires insurers to cover telehealth visits at the same rate as in-person visits. This means the consultation itself is typically covered by insurance, even if the medication requires separate authorization. HealthRX and other telehealth platforms operating in North Dakota can prescribe testosterone gel after reviewing lab work confirming hypogonadism.

A practical workflow for ND residents: (1) obtain morning fasting testosterone labs at any Quest or Labcorp draw site in the state (Fargo, Bismarck, Grand Forks, and Minot all have locations), (2) complete a telehealth consultation with a licensed prescriber, (3) receive an electronic prescription sent to the pharmacy of your choice.

Lab requirements are specific. The Endocrine Society guideline specifies that total testosterone should be measured between 7:00 and 10:00 AM on two separate mornings, using a reliable assay (LC-MS/MS preferred over immunoassay). Levels consistently below 300 ng/dL, combined with symptoms, meet the diagnostic threshold for testosterone replacement therapy.

AbbVie Savings Card and Discount Programs

AbbVie's AndroGel savings card can reduce patient copays to as low as $0 per month for commercially insured patients. The card covers up to $150 per prescription fill.

Eligibility requirements: the patient must have commercial insurance (not Medicare, Medicaid, Tricare, or any government-funded plan), be 18 years or older, and have a valid prescription for brand-name AndroGel. The card is reusable for up to 12 months and can be re-enrolled annually. Patients can enroll online or by calling AbbVie's patient support line.

For uninsured patients, AbbVie's myAbbVie Assist program offers free medication to qualifying individuals earning below 600% of the federal poverty level. In 2026, that threshold is approximately $94,000 annually for a single-person household. Application requires proof of income and a signed prescription.

Additional savings avenues for ND residents:

• GoodRx and RxSaver coupons: Generic testosterone gel 1% drops to $80, $130 at Walmart, Costco, and Walgreens locations in North Dakota with these free coupons
• Mark Cuban Cost Plus Drugs: Offers generic testosterone gel at cost-plus pricing, shipped directly to North Dakota addresses
• VA coverage: North Dakota veterans enrolled in VA healthcare receive testosterone gel at no copay through VA pharmacies in Fargo

According to IQVIA prescription data, approximately 68% of testosterone gel prescriptions filled in the U.S. in 2025 were for generic formulations, up from 41% in 2020. This shift reflects both increasing generic availability and insurer step-therapy requirements that push patients toward lower-cost options (IQVIA Institute report, 2025).

Clinical Considerations for Testosterone Gel Users in North Dakota

Testosterone gel therapy requires ongoing monitoring regardless of brand or formulation. The Endocrine Society recommends checking serum testosterone levels 2 to 4 hours after gel application, 14 days after starting or adjusting the dose (Bhasin et al., JCEM 2018).

Follow-up labs should include hematocrit (to screen for polycythemia), PSA (in men over 40), and a comprehensive metabolic panel. Hematocrit levels exceeding 54% require dose reduction or temporary discontinuation. The T-Trials found that testosterone treatment was associated with a small increase in coronary artery plaque volume on CT angiography, though cardiovascular event rates did not differ significantly between treatment and placebo groups over the 12-month study period (Budoff et al., JAMA 2017). The more recent TRAVERSE trial (N=5,246), a dedicated cardiovascular safety study, demonstrated that testosterone replacement in men aged 45, 80 with hypogonadism and established or high risk for cardiovascular disease did not increase the incidence of major adverse cardiovascular events compared to placebo over a median follow-up of 33 months (Lincoff et al., NEJM 2023).

Transference risk is a specific concern with topical testosterone. The FDA black box warning on AndroGel states that secondary exposure in women and children can cause virilization, including premature pubic hair development in children and acne or voice changes in women. Patients should wash hands immediately after application and cover the application site with clothing before contact with others.

Comparing AndroGel Costs: North Dakota vs. Neighboring States

North Dakota's AndroGel pricing aligns closely with neighboring states. Brand-name cash prices across the region in 2026:

• North Dakota: ~$510/month
• Minnesota: ~$505/month
• South Dakota: ~$510/month
• Montana: ~$515/month

The price consistency reflects AbbVie's uniform wholesale pricing. Meaningful savings differences appear only in compounded gel pricing and insurance formulary placement. Minnesota Medicaid, unlike North Dakota's, covers generic testosterone gel with prior authorization, giving Minnesota residents on Medicaid a coverage option that ND residents lack.

For North Dakota residents near the Minnesota border (Fargo-Moorhead area), filling prescriptions at Minnesota pharmacies is legal and may offer modest savings with certain discount programs, though insurance networks may restrict out-of-state fills.

What North Dakota Patients Should Do Next

Patients diagnosed with hypogonadism in North Dakota should request generic testosterone gel as a first-line topical option (saving $260, $360/month over brand AndroGel), verify their insurance formulary tier and prior authorization requirements before filling, and ask about 503A compounded gel at $120/month if cost remains prohibitive. Those with commercial insurance should enroll in AbbVie's savings card before filling a brand-name prescription, and Medicaid enrollees should discuss injectable testosterone cypionate with their prescriber as the covered alternative.