How Much Does Prometrium Cost in Maine in 2026?

Maine Retail Pricing: Brand vs. Generic vs. Compounded

The gap between list price and what Maine residents actually pay is significant. AbbVie's wholesale acquisition cost for brand Prometrium sits around $180 per month for a 30-capsule supply of 200 mg capsules. Retail pharmacies across Maine, however, price the generic (micronized progesterone) at approximately $45 per month cash-pay without insurance.

Micronized progesterone has been available generically since the mid-2000s, and competition among generic manufacturers has pushed retail prices well below the brand ceiling. Large-chain pharmacies such as CVS, Walgreens, and Hannaford (which operates pharmacy counters throughout Maine) tend to cluster around the $40 to $55 range for a 30-day supply. Independent pharmacies may vary by $5 to $10 in either direction.

For patients willing to use a compounding pharmacy, licensed 503A facilities in Maine can prepare micronized progesterone capsules for roughly $25 per month. The FDA permits 503A pharmacies to compound patient-specific prescriptions under section 503A of the Federal Food, Drug, and Cosmetic Act, provided they hold valid state licensure and compound pursuant to a valid prescription. Maine's Board of Pharmacy licenses these facilities, so compounded micronized progesterone is legal and accessible in the state.

One consideration: compounded products do not undergo FDA bioequivalence testing. The PEPI trial (N=875) established that oral micronized progesterone at 200 mg/day effectively opposed estrogen-induced endometrial hyperplasia 1, but that trial used the FDA-approved formulation. Patients switching to a compounded version should confirm with their prescriber that the compounding pharmacy follows USP standards for potency and dissolution.

Maine Medicaid Coverage for Prometrium

Maine Medicaid (MaineCare) covers Prometrium and its generic equivalents, but coverage requires prior authorization. The PA process typically involves documentation that the patient needs progesterone for endometrial protection as part of hormone replacement therapy or for another FDA-approved indication such as secondary amenorrhea.

Prescribers submit a PA request to MaineCare's pharmacy benefit manager. Approval timelines generally range from 24 to 72 hours. The Endocrine Society's 2022 clinical practice guidelines recommend progesterone co-administration for any patient with an intact uterus receiving systemic estrogen, which provides strong clinical justification for PA approval.

Once authorized, patients pay the standard MaineCare copay. For most MaineCare enrollees, prescription copays are nominal (often $1 to $3.40 per fill). Patients who are pregnant or have incomes below certain thresholds may qualify for zero-copay fills.

If the PA is denied, prescribers can file an appeal. Denials are uncommon when the clinical rationale is documented clearly, because opposing endometrial hyperplasia is a well-established, guideline-supported indication. The American College of Obstetricians and Gynecologists (ACOG) reinforces this recommendation in its 2021 practice bulletin on menopausal symptom management.

Commercial Insurance Coverage in Maine

Most commercial health plans sold in Maine include micronized progesterone on their formularies. Plans offered through the Health Insurance Marketplace (CoverME.gov, Maine's state-based exchange) and employer-sponsored plans typically place generic micronized progesterone on Tier 1 or Tier 2 of their drug formularies.

Tier 1 copays in Maine commercial plans commonly fall between $5 and $15 per 30-day fill. Tier 2 copays range from $20 to $40. Brand-name Prometrium, when specifically requested, may sit on Tier 3 with copays of $50 or more. For this reason, most prescribers write for generic micronized progesterone unless the patient has documented intolerance to a specific generic manufacturer's inactive ingredients.

Patients with high-deductible health plans (HDHPs) may pay cash price until meeting their deductible. In this scenario, using a discount card or GoodRx-type coupon can reduce the out-of-pocket cost to the $30 to $50 range at many Maine pharmacies. The AbbVie/Solvay savings card (discussed below) may also apply for commercially insured patients filling the brand product.

Anthem, Aetna, Cigna, and Harvard Pilgrim (now Point32Health), which collectively cover a large share of Maine's commercially insured population, all list generic micronized progesterone on formulary. Community Health Options, a Maine-based co-op insurer, similarly covers it at the generic tier.

The AbbVie/Solvay Savings Card

AbbVie (which acquired Solvay's pharmaceutical portfolio) offers a manufacturer copay card for brand Prometrium. Eligible patients can reduce their out-of-pocket cost to as low as $25 per fill, depending on the card's current terms.

Eligibility requirements are standard for pharma copay programs. Patients must have commercial insurance (not Medicare, Medicaid, Tricare, or other government-funded plans). The card typically covers the difference between the patient's copay and a set floor, up to a per-fill or annual maximum.

To activate the card, patients visit the Prometrium savings section on AbbVie's website or ask their prescriber's office for a physical card. The pharmacist processes it as a secondary payer at the point of sale.

For uninsured patients, AbbVie may offer a separate patient assistance program (PAP). These programs typically require proof of income below a certain threshold (often 300% to 400% of the federal poverty level). Application involves submitting tax documents and a prescriber attestation.

Compounded Micronized Progesterone: Legality and Access in Maine

Compounded micronized progesterone is legal in Maine when dispensed by a state-licensed 503A pharmacy pursuant to a valid prescription. The FDA's compounding framework distinguishes between 503A pharmacies (patient-specific compounding) and 503B outsourcing facilities (larger-scale compounding without patient-specific prescriptions).

Maine has several 503A compounding pharmacies, particularly in the Portland, Bangor, and Lewiston-Auburn metropolitan areas. Some operate mail-order services that reach rural parts of the state. Pricing for compounded micronized progesterone capsules in Maine averages $25 per month, though this can vary based on dose, capsule count, and whether the pharmacy uses peanut oil or an alternative suspension medium.

The peanut oil question matters clinically. Brand Prometrium uses peanut oil as a suspension agent. Patients with peanut allergies are labeled as contraindicated for the brand product per the FDA-approved prescribing information. Compounding pharmacies can substitute olive oil or another medium, making compounded progesterone the only oral option for peanut-allergic patients who need micronized progesterone specifically.

Prescribers should specify "micronized progesterone" (not synthetic progestins like medroxyprogesterone acetate) on the prescription. The distinction matters: the PEPI trial demonstrated that micronized progesterone produced fewer adverse effects on HDL cholesterol compared to medroxyprogesterone acetate 1. The Women's Health Initiative used medroxyprogesterone acetate, not micronized progesterone, which limits direct extrapolation of WHI risk data to Prometrium users [2].

Telehealth Prescribing in Maine

Maine permits telehealth prescribing of Prometrium and generic micronized progesterone. The state enacted permanent telehealth parity legislation, ensuring that clinicians licensed in Maine can prescribe medications via audio-video visits without requiring an in-person encounter first.

This access pathway is particularly relevant for patients in Maine's rural counties. Aroostook, Piscataquis, and Washington counties have limited endocrinology and gynecology practices. Telehealth allows these patients to consult with hormone therapy specialists in Portland, Bangor, or even out-of-state providers (if the provider holds a Maine license or practices under an interstate compact).

HealthRX and similar telehealth platforms can prescribe micronized progesterone to Maine residents after a clinical evaluation. The prescription can be sent electronically to any Maine pharmacy, including mail-order and compounding pharmacies. Patients should confirm that their chosen pharmacy stocks the generic or can compound it before the prescription is transmitted.

Maine also participates in the Psychology Interjurisdictional Compact (PSYPACT) and similar licensure compacts, though prescriptive authority compacts for physicians are still evolving. For now, the prescriber must hold an active Maine medical license or be authorized under Maine's telemedicine statutes.

How to Get the Lowest Price in Maine

A practical hierarchy for minimizing out-of-pocket cost:

Step 1: Check insurance formulary. If the plan covers generic micronized progesterone at Tier 1, the copay ($5 to $15) will likely beat any discount card.

Step 2: Use manufacturer or third-party coupons. The AbbVie savings card (for brand) or GoodRx/RxSaver coupons (for generic) can reduce cash prices to $25 to $40 at chain pharmacies.

Step 3: Compare compounding pharmacies. At $25 per month, a 503A compounding pharmacy may offer the lowest price, especially for uninsured patients. Call at least two pharmacies for quotes, as pricing is not standardized.

Step 4: Apply for patient assistance. Uninsured patients with low income should explore AbbVie's PAP and NeedyMeds (needymeds.org) databases.

Step 5: Consider 90-day fills. Many insurers and pharmacies offer a per-unit discount for 90-day supplies. A 90-day fill of generic micronized progesterone may cost $100 to $120 cash, effectively reducing the monthly rate to $33 to $40.

Dr. JoAnn Manson, professor of medicine at Harvard Medical School and a principal investigator of the Women's Health Initiative, has noted: "Micronized progesterone has a more favorable side-effect profile than synthetic progestins, and cost should not be a barrier to its use when clinically indicated" 3.

Clinical Context: Why Progesterone Matters on HRT

Prometrium exists to solve a specific problem. Unopposed estrogen therapy in patients with a uterus increases the risk of endometrial hyperplasia and endometrial cancer. The PEPI trial (N=875) quantified this: after three years, 62% of women on unopposed conjugated equine estrogen developed simple, complex, or atypical endometrial hyperplasia, compared to less than 1% of those receiving estrogen plus micronized progesterone 1.

The standard dosing protocol for endometrial protection is 200 mg orally at bedtime for 12 to 14 days per month (cyclic regimen) or 100 mg nightly (continuous regimen). Bedtime dosing is preferred because micronized progesterone has a mild sedative effect mediated through its allopregnanolone metabolite, which acts on GABA-A receptors 4.

The North American Menopause Society (NAMS) 2022 position statement recommends micronized progesterone as the preferred progestogen for most women on menopausal hormone therapy, citing its favorable cardiovascular and breast safety profile relative to synthetic alternatives [5]. The E3N cohort study (N=80,377 postmenopausal women) found that estrogen combined with micronized progesterone was not associated with increased breast cancer risk over a mean follow-up of 8.1 years, while estrogen combined with synthetic progestins was associated with a statistically significant increase 6.

These data shape prescribing patterns in Maine and nationally. When cost is a factor, generic or compounded micronized progesterone remains the evidence-based choice over cheaper synthetic progestins.

Prometrium Supply and Pharmacy Availability in Maine

Generic micronized progesterone is widely stocked at Maine pharmacies. The three major chain pharmacies (CVS, Walgreens, Rite Aid) and grocery store pharmacies (Hannaford, Shaw's) carry it as a routine formulary item. Independent pharmacies may need one to two business days to order it if not in stock.

Mail-order pharmacies, including those affiliated with Express Scripts, CVS Caremark, and OptumRx, deliver to all Maine ZIP codes. Patients in remote areas (northern Aroostook County, for example) may find mail-order the most convenient option. Shipping is typically free for maintenance medications under most insurance plans.

Brand Prometrium availability can be spottier. Some pharmacies stock only the generic, since the brand is rarely requested. Patients who specifically need brand Prometrium (due to inactive-ingredient sensitivities, for instance) should call ahead or use the pharmacy's special-order process.