Finasteride Cost in Nevada 2026

What Does Finasteride Cost in Nevada Right Now?

Generic finasteride 1 mg costs approximately $12 per month at Nevada retail pharmacies when paying cash in 2026. The brand-name product Propecia carries a list price near $85 per month, but virtually no prescriber or patient in Nevada pays that figure because multiple generic manufacturers have competed the price down sharply since patent expiration. Compounded finasteride sits between those two points at roughly $45 per month from licensed 503A pharmacies in the state.

Finasteride is a type II 5-alpha-reductase inhibitor that blocks the conversion of testosterone to dihydrotestosterone (DHT). The FDA approved the 5 mg tablet (Proscar) for benign prostatic hyperplasia in 1992 and the 1 mg tablet (Propecia) for androgenetic alopecia in 1997 [1]. Both indications require a prescription.

The landmark Kaufman et al. trial published in the Journal of the American Academy of Dermatology (1998, N=1,553) showed that finasteride 1 mg daily for 2 years increased hair count by a mean of 107 hairs in a 1-inch circle versus a loss of 50 hairs with placebo (P<0.001) [2]. That clinical data formed the foundation for finasteride's dominance in androgenetic alopecia treatment, which in turn drove the enormous generic market that keeps Nevada retail prices low today.

GoodRx and pharmacy benefit aggregators consistently show 30-tablet supplies of generic finasteride 1 mg available for $10 to $15 at Walgreens, CVS, Smith's (Kroger), and Walmart locations across Las Vegas, Reno, Henderson, and Carson City [3]. The exact figure shifts by pharmacy and week. Calling ahead or using a discount card almost always beats the shelf sticker price.

How Nevada Retail Pharmacies Price Generic Finasteride

Pharmacy cash pricing reflects wholesale acquisition cost plus a dispensing fee, and generic finasteride's wholesale cost has dropped below $0.30 per tablet in most supply chains [4]. That is why the sticker price at a Nevada Walmart or Costco pharmacy can be as low as $9 for a 30-day supply. Warehouse-club pharmacies (Costco in Las Vegas and Reno) frequently undercut chain drug stores by 20 to 35 percent on generic finasteride because they use a flat membership-based dispensing-fee model rather than percentage markup.

Mail-order pharmacies licensed in Nevada, including those attached to major pharmacy benefit managers, often dispense 90-day supplies of generic finasteride 1 mg for $25 to $36, which works out to roughly $8.50 to $12 per month [5]. A 90-day supply from a telehealth-affiliated pharmacy may cost slightly more, typically $30 to $50 for a 90-day quantity, because the platform incorporates provider fees separately or bundles them into a subscription.

The FDA's Orange Book lists 11 approved generic finasteride 1 mg manufacturers as of early 2026, meaning supply competition is intense and price deflation is likely to continue [6]. Patients in Nevada should not assume the price they paid in 2024 still applies; the direction of travel is almost always down for a commodity generic with this many manufacturers.

Compounded Finasteride in Nevada: Legality and Cost

Compounded finasteride is legal in Nevada when a licensed 503A compounding pharmacy prepares it pursuant to a valid patient-specific prescription. Nevada's pharmacy practice is governed by the Nevada State Board of Pharmacy, which enforces compliance with USP Chapter 795 for non-sterile compounding and aligns with federal 503A requirements under the Drug Quality and Security Act [7]. A 503B outsourcing facility can also supply compounded finasteride to Nevada prescribers under different regulatory conditions, primarily for office use rather than individual prescriptions.

Compounded finasteride in Nevada costs approximately $45 per month in 2026. Compounding pharmacies charge more than retail generics because they are preparing individualized formulations, which requires pharmacist labor, quality testing, and specialty packaging. Common reasons a prescriber might write for compounded rather than commercial finasteride include custom-dose combinations (for example, finasteride plus minoxidil in a single topical or oral preparation), tablet-size adjustments for pediatric or unusual BPH dosing, or allergen avoidance (some commercial tablet fillers contain lactose).

Topical finasteride compounded in a gel or solution base has gained attention as a potentially lower-systemic-exposure alternative to oral tablets [8]. A 2021 trial published in JAMA Dermatology (N=101) found that topical finasteride 0.25% solution applied once daily produced scalp DHT suppression comparable to oral finasteride 1 mg while reducing serum DHT by only 25% versus 65% with the oral route [8]. Nevada compounding pharmacies that offer topical finasteride typically charge $50 to $70 per month, somewhat above the oral compounded price, because the base formulation requires additional raw materials.

Patients should verify that any Nevada compounding pharmacy they use holds an active state license by searching the Nevada State Board of Pharmacy's public license lookup tool. Compounded finasteride is not FDA-approved as a finished product, which means no FDA bioequivalence data exists for the specific compounded preparation [9].

Does Nevada Medicaid Cover Finasteride?

Nevada Medicaid does not cover finasteride for androgenetic alopecia. The Nevada Division of Health Care Financing and Policy classifies hair-loss treatment as cosmetic and excludes it from the Medicaid formulary [10]. This matches the exclusion policy in most state Medicaid programs across the country, where coverage is typically limited to conditions with a clear medical necessity classification.

Finasteride 5 mg for BPH presents a more nuanced picture. Medicaid programs sometimes cover finasteride for BPH under prior authorization, but Nevada's published formulary data as of 2026 lists finasteride 5 mg as non-preferred or not covered without documented medical necessity and prescriber justification [10]. Patients on Nevada Medicaid who need finasteride for BPH should ask their urologist or primary care provider to submit a prior authorization with supporting clinical notes, including prostate volume measurements and symptom scores from the American Urological Association Symptom Index.

Nevada's Check Up program (CHIP) follows similar exclusion rules for hair-loss indications. Enrollees in Nevada's Medicaid managed-care plans, which include Anthem Blue Cross Blue Shield of Nevada Medicaid and Molina Healthcare of Nevada, can call member services to request the most current formulary tier for NDC codes associated with finasteride 5 mg if BPH is the diagnosis.

Private Insurance Coverage for Finasteride in Nevada

Private insurance coverage for finasteride in Nevada depends on three factors: the insurer, the plan tier, and the diagnosis code on the prescription [11]. Most commercial plans in Nevada cover finasteride 5 mg for BPH on Tier 1 or Tier 2, meaning copays of $5 to $20 per 30-day fill. Finasteride 1 mg for androgenetic alopecia is treated differently.

Many Nevada commercial insurers categorize finasteride 1 mg as cosmetic and exclude it from medical benefit coverage, mirroring the Medicaid exclusion [11]. When a prescriber codes the prescription as androgenetic alopecia (ICD-10 L64.9), insurers may deny coverage. Some plans will cover finasteride 1 mg if it is prescribed for BPH because the dose used clinically for BPH is 5 mg, not 1 mg, so coverage decisions can become administratively complex.

The Nevada Division of Insurance oversees commercial plan compliance. Patients who receive a coverage denial for finasteride have a right to appeal under Nevada Revised Statutes Chapter 695B, which governs health insurer practices. The appeal process requires a written denial letter from the insurer, and the prescriber's office can submit a letter of medical necessity [12]. Telehealth prescribers licensed in Nevada can write these letters the same way an in-office provider can.

Major Nevada commercial carriers including Anthem, UnitedHealthcare, Aetna, and Nevada Health CO-OP publish formularies annually through the Nevada Health Link marketplace. Checking the 2026 formulary document for the specific plan before enrolling or before switching pharmacies can prevent billing surprises.

Telehealth Prescribing of Finasteride in Nevada

Nevada law allows telehealth prescribing of finasteride. Providers must hold an active Nevada medical license and comply with Nevada Revised Statutes 629.515 through 629.527, which govern telemedicine practice standards [13]. A prescriber-patient relationship can be established via synchronous video visit or, in some circumstances, asynchronous photo-based evaluation for dermatologic conditions including androgenetic alopecia.

Several telehealth platforms operating in Nevada, including national services with Nevada-licensed physicians, offer finasteride 1 mg prescriptions with delivery to the patient's Nevada address. Platform pricing for the medication itself typically aligns with retail generic prices ($10 to $20 per month for the drug), and some platforms roll provider fees into a monthly subscription of $15 to $30 that covers both the consultation and the prescription.

The Nevada State Board of Medical Examiners has not issued telehealth-specific restrictions on finasteride prescribing beyond the standard controlled-substance rules (finasteride is not a controlled substance, so those rules do not apply here). Prescribers must still conduct an adequate clinical evaluation before prescribing, which for AGA typically includes a review of medical history, current medications, and documented presentation of hair loss [14].

The HealthRX clinical team uses a three-step telehealth prescribing framework for Nevada finasteride patients: (1) async photo assessment to confirm androgenetic alopecia pattern versus other alopecia types, (2) synchronous follow-up at 6 months to evaluate response using the 7-point Investigator Global Assessment scale from the Kaufman et al. protocol, and (3) annual labs including serum PSA if the patient is over age 40, consistent with FDA label guidance on PSA interpretation in finasteride users [1][2].

Cheapest Ways to Get Finasteride in Nevada

The cheapest route to finasteride in Nevada is cash-pay generic at a discount-club pharmacy combined with a GoodRx or manufacturer discount card. Walmart pharmacy in Nevada frequently prices 30 tablets of generic finasteride 1 mg at $9 to $11 without any coupon. Adding a GoodRx coupon at Costco or Kroger (Smith's) can bring 90-day supplies to $20 to $27 [3].

Mark Cuban's Cost Plus Drugs (costplusdrugs.com) sells generic finasteride 1 mg for $6.40 for 30 tablets plus a $5 pharmacy dispensing fee per order as of early 2026, which may be shipped to Nevada residents with a valid prescription [15]. That puts total monthly cost at approximately $11.40 with shipping, competitive with local retail but convenient for patients who prefer delivery.

The Merck Patient Assistance Program (PAP) covers brand-name Propecia for patients who meet income criteria, generally at or below 400% of the federal poverty level and without qualifying insurance coverage [16]. Nevada residents can apply through Merck's MerckHelps program online or by calling 1-800-727-5400. Because generic finasteride already costs under $15 per month for most Nevada patients, the PAP is most relevant for patients specifically requiring the brand-name product or for those with unusual insurance situations.

State pharmaceutical assistance programs in Nevada are limited. The Nevada Senior Rx program, which existed as a stop-gap drug benefit, was discontinued after Medicare Part D expansion. Nevada seniors on Medicare Part D should check their specific plan's formulary because most Part D plans include generic finasteride 5 mg for BPH on Tier 1, making copays as low as $0 to $5 per month depending on the plan [17].

Finasteride Dosing, Efficacy, and What to Expect

For androgenetic alopecia, the FDA-approved dose is finasteride 1 mg once daily orally. For BPH, the approved dose is 5 mg once daily. These are distinct formulations sold under different brand names (Propecia for 1 mg, Proscar for 5 mg) but both are available as generics [1].

Clinical response for hair loss is slow. The Kaufman et al. 2-year data showed statistically significant hair count improvement beginning at month 3 and peaking around month 12 to 24 [2]. The FDA label states that treatment for at least 12 months is needed to assess whether the drug is working, and continued use is required to maintain benefit. Stopping finasteride results in loss of any hair gained within 12 months in most patients [1].

The McConnell et al. PLESS trial (N=3,040, published in the New England Journal of Medicine) demonstrated that finasteride 5 mg reduced the risk of acute urinary retention by 57% and the need for BPH-related surgery by 55% over 4 years compared to placebo in men with symptomatic BPH [18]. This trial is the primary evidence base for finasteride's BPH indication and underpins insurer coverage decisions for the 5 mg dose.

Sexual side effects including decreased libido, erectile dysfunction, and ejaculatory disorders occur in 1.8% to 3.8% of men on finasteride 1 mg in placebo-controlled trials, compared to 1.3% to 2.2% with placebo [1]. These rates are low in absolute terms but patients should be counseled before starting. The FDA updated finasteride's label in 2012 to include post-marketing reports of persistent sexual dysfunction after discontinuation, sometimes called post-finasteride syndrome, though causality remains under active research [19].

Serum PSA values in men on finasteride 5 mg are suppressed approximately 50% after 6 months. Clinicians interpreting PSA in Nevada patients on finasteride should double the observed value to estimate the true PSA for prostate cancer screening purposes, per FDA label guidance [1]. This adjustment does not apply to the 1 mg dose in most clinical protocols.

Nevada-Specific Pricing Comparison Table

Prices reflect 2026 cash-pay estimates from publicly available pharmacy pricing aggregators and do not constitute a guarantee of the price any individual patient will pay.

| Source | Dose | 30-Day Cost (Est.) | Notes | |---|---|---|---| | Walmart (NV locations) | 1 mg generic | $9 to $11 | No coupon needed | | Costco (Las Vegas, Reno) | 1 mg generic | $8 to $10 | Membership required | | CVS / Walgreens | 1 mg generic | $14 to $22 | Lower with GoodRx | | Cost Plus Drugs (mail) | 1 mg generic | ~$11.40 incl. shipping | Rx required, ships to NV | | 503A Compounding (NV) | 1 mg or custom dose | ~$45 | Requires prescription | | Telehealth platform bundle | 1 mg generic | $25 to $50 | Includes provider fee | | Brand Propecia (Merck) | 1 mg | ~$85 | List price, rarely paid |

Side Effects Nevada Patients Ask About Most

Beyond sexual side effects, Nevada patients commonly ask about breast tenderness and gynecomastia, which the FDA label lists as occurring in less than 1% of finasteride 1 mg users [1]. A 2020 systematic review in the Journal of Clinical Endocrinology and Metabolism (N=data from 17 RCTs) found no statistically significant increase in gynecomastia with finasteride 1 mg versus placebo after correction for reporting bias [20].

Depression and mood changes have been reported post-marketing. A 2023 pharmacovigilance analysis of FDA FAERS data found disproportionality signals for depression and suicidal ideation in finasteride users, though observational confounding is difficult to exclude in voluntary adverse event databases [19]. Men starting finasteride should be told to contact their prescriber if they notice mood changes, particularly in the first 6 months.

Liver enzyme elevations are rare but documented. Baseline hepatic function testing is not required in the FDA label but some Nevada prescribers obtain it for patients with pre-existing liver disease. Finasteride is hepatically metabolized via CYP3A4, so drug interactions with strong CYP3A4 inhibitors (ketoconazole, ritonavir) may theoretically increase finasteride plasma levels, though no dose adjustment is formally recommended in the label [1].

Drug Interactions and Contraindications Relevant to Nevada Patients

Finasteride is contraindicated in women who are or may become pregnant due to risk of feminization of a male fetus [1]. Women of childbearing potential in Nevada should not handle crushed or broken finasteride tablets. This is the primary reason finasteride is classified as a Pregnancy Category X drug historically, though the FDA now uses the Pregnancy and Lactation Labeling Rule (PLLR) format [9].

Alpha-blockers used for BPH (tamsulosin, doxazosin) are commonly co-prescribed with finasteride 5 mg. The MTOPS trial (N=3,047, New England Journal of Medicine 2003) demonstrated that combination therapy with doxazosin plus finasteride reduced the risk of overall BPH clinical progression by 66% versus placebo, compared to 39% with doxazosin alone and 34% with finasteride alone [21]. Nevada urologists frequently use this combination. No dangerous pharmacokinetic interaction exists between finasteride and standard alpha-blockers.