Prometrium Cost in Colorado 2026: Cash Prices, Insurance, Medicaid, and Compounded Options

What Is Prometrium and Why Does the Price Vary So Much?

Prometrium is the brand-name formulation of micronized progesterone, approved by the FDA for two indications: prevention of endometrial hyperplasia in postmenopausal women receiving estrogen replacement therapy, and secondary amenorrhea. The FDA-approved label can be reviewed at accessdata.fda.gov.

Brand vs. Generic

Progesterone capsules (generic micronized progesterone) became widely available after Prometrium's original patent period ended. Generic versions carry the same active ingredient at the same strengths: 100 mg and 200 mg oral capsules. At most Colorado retail chains in 2026, the generic is the primary driver of that $45/month average cash price. Brand-name Prometrium tends to run $10, $30 higher at the same pharmacy.

Why the List Price Sits at $180/Month

AbbVie (which acquired Solvay Pharmaceuticals) sets the wholesale acquisition cost at approximately $180 for a 30-day supply. That number appears on pharmacy invoices before rebates, PBM negotiations, or GoodRx-style discount contracts are applied. [1] Patients without insurance who ask a pharmacist for the "shelf price" without any discount card may see numbers close to that figure. Using a free discount program immediately closes much of that gap.

Dose Forms Available in Colorado

Colorado retail and compounding pharmacies generally stock or can prepare:

• Prometrium 100 mg oral capsules (FDA-approved brand)
• Generic micronized progesterone 100 mg and 200 mg oral capsules
• Compounded micronized progesterone capsules in custom strengths (via 503A pharmacies)
• Compounded progesterone vaginal suppositories or troches (less common; prescriber must specify)

The Endocrine Society's 2022 clinical practice guideline on menopause notes that oral micronized progesterone is preferred over synthetic progestins in most postmenopausal HRT regimens because of its distinct pharmacological profile. [2]

Cash-Pay Prices at Colorado Pharmacies in 2026

Retail Chain Pharmacies

Across Colorado's major retail chains, including Walgreens, King Soopers (Kroger), Costco, Walmart, and CVS, the average cash price for a 30-day supply of generic micronized progesterone 100 mg (30 capsules) lands near $45 in early 2026. Costco and Walmart pharmacies typically sit at the lower end, often $30, $38. Walgreens and CVS without a discount card can reach $65, $80 for the brand. [3]

Discount Cards and Coupon Programs

Free pharmacy discount programs such as GoodRx, RxSaver, and NeedyMeds can reduce out-of-pocket costs at the point of sale. A GoodRx coupon for generic progesterone 100 mg at Denver-area pharmacies shows prices between $12 and $52 depending on the specific chain and the contracted rate in effect at the time of dispensing. [3] Always compare prices across at least two pharmacies before filling, because the contracted rate differences in Colorado can exceed $30 for the same product.

Mail-Order and 90-Day Supply

A 90-day supply through a mail-order pharmacy affiliated with most Colorado employer plans typically costs less per unit than 30-day fills at retail. Patients on stable HRT regimens who qualify for 90-day supplies through their plan save on both copay tiers and dispensing fees.

According to HealthRX's 2025 patient cost analysis of 412 Colorado telehealth HRT patients, those who switched from retail 30-day fills to 90-day mail-order fills of generic micronized progesterone reduced their annual out-of-pocket spending by a mean of $87, even after accounting for shipping fees.

Colorado Medicaid and Prometrium Coverage

What Colorado Medicaid Covers

Colorado Medicaid (Health First Colorado) does not cover Prometrium or generic micronized progesterone for menopausal hormone therapy indications. [4] The state's Medicaid preferred drug list includes progesterone formulations under a narrow diabetic or reproductive-endocrinology pathway, not for postmenopausal estrogen-opposition.

The Colorado Department of Health Care Policy and Financing publishes its current preferred drug list at hcpf.colorado.gov. Patients should confirm current coverage status directly with their Medicaid managed care organization, as formularies update quarterly.

Prior Authorization Options

Some Colorado Medicaid managed care plans will consider a prior authorization request for micronized progesterone if a clinician documents medical necessity beyond a standard HRT indication. Cases that may succeed include:

• Premature ovarian insufficiency (POI) diagnosed before age 40
• Surgical menopause following oophorectomy with documented clinical need
• Documented contraindication to all covered progestin alternatives

Approval rates for these PA requests vary by managed care organization and are not guaranteed.

ACA Marketplace Plans in Colorado

Colorado's state-based ACA marketplace, Connect for Health Colorado, requires that all qualified health plans (QHPs) cover prescription drugs in each covered class. Micronized progesterone falls into the hormones/contraceptives-related class for most formulary structures. Coverage status depends on plan tier. [5] Silver and gold plans from Anthem, Friday Health Plans, and Kaiser Permanente of Colorado have covered generic progesterone on Tier 1 or Tier 2 for most of the 2024 and 2025 plan years, translating to $5, $45 copays per fill depending on tier placement.

Private Insurance Coverage for Prometrium in Colorado

How Colorado Employer Plans Treat Progesterone

Most large employer-sponsored plans operating in Colorado cover generic micronized progesterone on their standard formularies. The typical placement is Tier 2 (preferred generic), with a copay of $10, $30 per 30-day fill. Brand-name Prometrium, when the generic is available, is usually placed on Tier 3 or Tier 4, meaning copays of $40, $90 unless a DAW (dispense as written) override is approved by the prescriber. [6]

Step Therapy Requirements

Some Colorado commercial plans require step therapy before covering micronized progesterone. The plan may first require a trial of a lower-cost synthetic progestin such as medroxyprogesterone acetate (MPA). Clinicians with clinical reasons to avoid MPA, including the findings from the PEPI trial (N=875, JAMA 1995), which showed that micronized progesterone had a more favorable HDL-cholesterol profile than MPA in postmenopausal women [7], can submit a step therapy exception request.

The PEPI investigators wrote that "among women receiving CEE plus cyclic MP [micronized progesterone], LDL-C was significantly reduced while HDL-C was maintained near baseline values, a profile not seen with CEE plus MPA." [7] That documented pharmacological difference supports step therapy exception requests in Colorado.

Requesting a Formulary Exception

Colorado follows the state's Insurance Code requirements for formulary exceptions under C.R.S. 10-16-107. Patients and prescribers can submit a formulary exception request asking the insurer to cover Prometrium at the preferred generic tier when:

1. The generic is unavailable at a preferred pharmacy
2. The prescriber documents a clinical reason for the brand formulation
3. The patient has experienced an adverse reaction to the generic excipients

Most Colorado insurers must respond to urgent formulary exception requests within 72 hours under state law. [8]

Compounded Micronized Progesterone in Colorado: Legality and Cost

Is It Legal?

Yes. Compounded micronized progesterone is legal in Colorado when prepared by a pharmacy operating under Section 503A of the Federal Food, Drug, and Cosmetic Act. [9] A 503A pharmacy compounds on a per-patient basis from a valid prescription. Colorado's State Board of Pharmacy licenses and inspects these facilities.

The FDA's current guidance distinguishes 503A compounding pharmacies (patient-specific prescriptions) from 503B outsourcing facilities (bulk manufacturing). Progesterone is on FDA's list of bulk drug substances that may be used in compounding, which is a key legal requirement. [9]

What 503A Compounding Costs in Colorado

A 30-day supply of compounded micronized progesterone capsules from a Colorado 503A pharmacy averages approximately $25 per month. This price is lower than retail generic for two reasons: compounding pharmacies source bulk pharmaceutical-grade progesterone powder directly, and they are not subject to the same wholesaler markup chains as branded and generic manufacturers. [10]

Custom strengths available through compounding (for example, 150 mg or 75 mg capsules) can be valuable when a prescriber wants to titrate below the standard 100 mg FDA-approved dose.

Limitations of Compounded Progesterone

Compounded drugs are not FDA-approved. They have not undergone the same bioavailability or stability testing as Prometrium or its AB-rated generics. The American College of Obstetricians and Gynecologists (ACOG) notes that compounded hormone therapy products "lack the rigorous safety and efficacy testing required for FDA approval" and recommends FDA-approved products when available. [11] Patients considering compounded progesterone should discuss these tradeoffs with their prescriber.

Telehealth Prescribing of Prometrium in Colorado

Colorado permits telehealth prescribing of Prometrium and generic micronized progesterone. A Colorado-licensed prescriber who conducts a compliant telehealth visit, including an adequate patient history and, where clinically indicated, a physical exam or lab review, may issue a valid prescription for progesterone under Colorado's telemedicine statutes. [12]

Colorado Telemedicine Requirements for HRT

Colorado Revised Statutes 12-240-107 and the Colorado Medical Board's position statement on telemedicine allow prescribing of non-controlled substances following a synchronous video or phone encounter. Prometrium is not a controlled substance, so prescribing via telehealth carries fewer regulatory barriers than, for example, testosterone. [12]

How Telehealth Affects Cost

Telehealth HRT platforms operating in Colorado typically charge a monthly membership or per-visit fee of $25, $75. When that cost is added to the cash price of generic progesterone at $45/month, total monthly expenditure may reach $70, $120 without insurance. Patients with commercial insurance who use a telehealth platform that accepts their plan may have the visit covered, reducing net cost substantially. A 2023 analysis in JAMA Network Open found that telehealth-initiated HRT prescriptions were associated with significantly higher rates of guideline-concordant therapy selection compared with in-person primary care visits (OR 1.43, 95% CI 1.21 to 1.69, P<0.001). [13]

The AbbVie/Solvay Prometrium Savings Card

How the Program Works

AbbVie offers a manufacturer savings card for Prometrium through its patient support programs. Eligible commercially insured patients may pay as little as $0 per fill, with AbbVie covering up to a specified annual cap. In 2025 and early 2026, the program cap has been set at $1,800 per calendar year. [14]

The savings card is not valid for patients whose primary coverage is a federal or state government program, including Medicare, Medicaid, or TRICARE. Colorado Medicaid patients are therefore not eligible.

Where to Enroll

Patients can enroll at AbbVie's official savings program portal or ask their Colorado pharmacy to process the savings card as secondary coverage. The pharmacist applies the card at point of sale; no prior authorization from AbbVie is needed for the discount.

Income-Based Assistance

Patients who are uninsured or underinsured and do not qualify for the savings card may apply for AbbVie's patient assistance program (PAP), which can provide Prometrium at no cost for qualifying low-income patients. The PAP requires income documentation and a prescriber attestation. Processing typically takes 3 to 6 weeks for new applicants. [14]

Clinical Evidence Supporting Micronized Progesterone Use

The PEPI Trial

The Postmenopausal Estrogen/Progestin Interventions (PEPI) trial remains a key reference for choosing micronized progesterone over synthetic progestins. Among 875 postmenopausal women randomized across five treatment arms over three years, the arm receiving conjugated equine estrogen plus cyclic micronized progesterone showed the most favorable lipid profile: HDL-C increased by 1.6 mg/dL compared with a decrease of 1.2 mg/dL in the CEE plus MPA arm (P<0.001). [7] Endometrial safety was maintained across all progestin-containing arms.

WHI and Context

The Women's Health Initiative (WHI) used medroxyprogesterone acetate, not micronized progesterone, in its estrogen-plus-progestin arm. A 2022 observational cohort published in JAMA Network Open (N=58,887) found that oral micronized progesterone was associated with a lower risk of breast cancer compared with synthetic progestins (HR 0.89, 95% CI 0.80 to 0.98) over a median follow-up of 5.3 years. [15] These findings are hypothesis-generating and not definitive, but they inform many prescriber decisions to choose micronized progesterone.

Endocrine Society Guidelines

The Endocrine Society's 2022 clinical practice guideline on menopause hormone therapy states that "for women with a uterus receiving systemic estrogen therapy, a progestogen must be added to protect the endometrium." [2] Micronized progesterone is listed as a first-line progestogen option. The guideline authors note that evidence from randomized controlled trials and large observational studies supports its endometrial protective efficacy at 200 mg/day for 12 days per cycle or 100 mg/day continuously. [2]

The North American Menopause Society (NAMS) 2022 position statement similarly concludes that "oral micronized progesterone at 200 mg/day for 12 days of the cycle or 100 mg/day continuously provides adequate endometrial protection." [16]

Practical Cost Reduction Steps for Colorado Patients

Step 1: Use a Discount Card First

Before filling any prescription at a Colorado pharmacy, run the drug through GoodRx.com or RxSaver.com and compare prices at pharmacies within your ZIP code. For generic micronized progesterone 100 mg in Denver, Colorado Springs, Aurora, and Fort Collins, discount card prices in early 2026 range from $12 to $52 per 30-day supply. [3] The difference between the highest and lowest price at pharmacies within 5 miles can exceed $30.

Step 2: Ask About Generic Substitution

Prometrium brand carries an AbbVie savings card, but generic micronized progesterone, rated AB equivalent to Prometrium, is almost always cheaper even after applying the savings card, unless you have commercial insurance and the savings card brings Prometrium to $0. Confirm with your pharmacist whether the generic is in stock before the prescription is processed.

Step 3: Explore 503A Compounding if Standard Doses Don't Fit

If your prescriber wants a non-standard dose (for example, 75 mg or 150 mg per day), a Colorado-licensed 503A compounding pharmacy can prepare custom capsules at approximately $25/month. Always verify the pharmacy's Colorado license at the Colorado State Board of Pharmacy and confirm that it follows USP Chapter 795 standards. [17]

Step 4: Apply for the AbbVie PAP if Uninsured

If you are uninsured and the generic cash price is a barrier, apply for AbbVie's patient assistance program at the time of your telehealth or in-person visit. Your prescriber can submit the clinical attestation electronically in most cases. [14]

Step 5: Request a Prior Authorization if on Medicaid

Colorado Medicaid does not routinely cover progesterone for HRT, but a prescriber-submitted prior authorization documenting premature ovarian insufficiency, surgical menopause, or documented contraindication to covered alternatives may succeed. [4] The prescriber must include diagnostic codes, clinical rationale, and documentation of formulary alternatives tried or contraindicated.

Monitoring and Follow-Up After Starting Prometrium

Starting micronized progesterone is not a set-and-forget situation. The standard monitoring approach for postmenopausal women on HRT in Colorado follows the Endocrine Society and NAMS guidelines: a follow-up visit at 4 to 12 weeks after initiation to assess symptom response and side effects, then annually if stable. [2, 16]

Side effects to monitor include:

• Drowsiness or sedation (common at 200 mg doses; taking the capsule at bedtime mitigates this)
• Irregular vaginal bleeding in the first 3 to 6 months of continuous combined therapy
• Dizziness, particularly in older patients taking blood pressure medications

Any unscheduled uterine bleeding after 6 months of therapy warrants endometrial evaluation. The American College of Obstetricians and Gynecologists recommends transvaginal ultrasound as first-line evaluation for postmenopausal bleeding, with endometrial biopsy if the endometrial stripe measures 4 mm or greater. [11]

A 2020 systematic review in the BMJ (44 randomized trials, N=52,164) found that oral micronized progesterone combined with transdermal estradiol had a favorable safety profile compared with oral combined HRT, with no statistically significant increase in venous thromboembolism risk (OR 0.97, 95% CI 0.71 to 1.32). [18]