How Much Does Prometrium Cost in Mississippi in 2026?

Mississippi Retail Pricing: Brand vs. Generic vs. Compounded

The average cash-pay price for a 30-day supply of Prometrium (micronized progesterone 200 mg) at Mississippi retail pharmacies sits near $45 in 2026. That figure reflects generic micronized progesterone capsules, which account for the vast majority of dispensed prescriptions. Brand-name Prometrium from AbbVie lists at approximately $180 per month, though few patients pay sticker price.

Compounded micronized progesterone from 503A-licensed pharmacies in Mississippi averages around $25 per month. The price difference between retail generic and compounded versions reflects pharmacy markup structures, not differences in the active ingredient itself. Both contain USP-grade micronized progesterone 1.

Price variation across Mississippi pharmacies can be significant. A 2023 analysis by the FDA noted that cash-pay prescription prices may vary by 80% or more between pharmacies in the same metropolitan area 2. Jackson-area pharmacies tend to cluster near the state average, while rural pharmacies in the Delta region sometimes charge 15-20% more due to distribution costs. Checking prices at multiple pharmacies before filling is worth the effort.

Discount platforms like GoodRx, RxSaver, and SingleCare frequently bring the generic price below $30 for a 30-day supply at chains including Walmart, Kroger, and CVS locations throughout Mississippi. These coupons cannot be combined with insurance but often beat insured copays for patients on high-deductible plans.

Mississippi Medicaid and Prometrium Coverage

Mississippi Medicaid does not cover Prometrium or generic micronized progesterone for endometrial protection in hormone replacement therapy (HRT). This coverage gap affects a substantial population. According to the Kaiser Family Foundation, approximately 756,000 Mississippians were enrolled in Medicaid as of early 2026 3.

The Division of Medicaid's preferred drug list categorizes progesterone products primarily under fertility and pregnancy-related indications. Coverage for secondary amenorrhea exists, but the endometrial-protection indication tied to estrogen-based HRT is excluded. Patients who need micronized progesterone specifically for HRT endometrial protection face full out-of-pocket costs.

Prior authorization requests for off-formulary coverage have a low approval rate for this indication based on reports from Mississippi prescribers. The Endocrine Society's 2022 clinical practice guideline on menopausal hormone therapy recommends micronized progesterone as the preferred progestogen for endometrial protection in women with a uterus receiving estrogen therapy 4. Despite this guideline support, Mississippi Medicaid has not expanded coverage.

For Medicaid-enrolled patients, the compounded route at $25 per month or manufacturer assistance programs represent the most accessible alternatives. Some federally qualified health centers (FQHCs) in Mississippi also maintain 340B pricing arrangements that may reduce costs below typical retail.

Commercial Insurance Coverage in Mississippi

Most commercial insurance plans sold on the Mississippi Health Insurance Marketplace and through employer-sponsored coverage include generic micronized progesterone on their formularies. Typical copay tiers place generic micronized progesterone at Tier 1 or Tier 2, with copays ranging from $5 to $30 per month.

Blue Cross & Blue Shield of Mississippi, the state's largest insurer, covers generic micronized progesterone on its standard formulary. Ambetter (Centene), which covers a large share of Marketplace enrollees in Mississippi, similarly includes generic progesterone at preferred tier copays. UnitedHealthcare and Cigna employer plans operating in the state follow national formulary patterns that also cover the generic.

Brand-name Prometrium falls on higher tiers (Tier 3 or non-preferred brand) with most Mississippi insurers. Copays for brand Prometrium typically range from $50 to $75 per month. Step therapy requirements may apply, meaning the plan will only cover brand Prometrium after documentation that the generic was tried and caused issues such as allergic reaction to the peanut oil base.

The Affordable Care Act requires most plans to cover FDA-approved contraceptive methods without cost sharing, and progesterone prescribed for contraceptive purposes falls under this mandate 5. Patients whose prescribers document the contraceptive indication may receive $0 copay coverage even on plans that otherwise require cost sharing for the HRT indication.

Compounded Micronized Progesterone in Mississippi

Compounded micronized progesterone is legal and available through 503A-licensed compounding pharmacies in Mississippi. These pharmacies operate under individual patient prescriptions and must comply with both Mississippi Board of Pharmacy regulations and federal requirements under section 503A of the Federal Food, Drug, and Cosmetic Act 6.

The typical price for compounded micronized progesterone in Mississippi runs about $25 per month for a standard 200 mg oral capsule formulation. Some patients use compounded progesterone in alternative delivery forms (sublingual troches, topical creams, vaginal suppositories) that may cost between $30 and $50 per month depending on the formulation.

One distinction matters clinically. The landmark PEPI trial (Postmenopausal Estrogen/Progestin Interventions, N=875) demonstrated that oral micronized progesterone provided effective endometrial protection while preserving the favorable HDL cholesterol effects of estrogen therapy, an advantage not seen with medroxyprogesterone acetate 7. That trial used oral micronized progesterone capsules.

Compounded formulations, particularly topical creams, have not been studied with the same rigor for endometrial protection. The North American Menopause Society (NAMS) notes that "transdermal progesterone creams available without a prescription do not provide adequate endometrial protection" 8. Compounded oral capsules using USP-grade micronized progesterone are pharmacologically comparable to the FDA-approved product, but compounded topical formulations carry more uncertainty regarding absorption and endometrial protection adequacy.

Mississippi has 22 accredited compounding pharmacies according to the Pharmacy Compounding Accreditation Board (PCAB) database. Patients should verify that any compounding pharmacy holds current Mississippi Board of Pharmacy licensure and, ideally, PCAB or equivalent accreditation.

Manufacturer Savings and Discount Programs

AbbVie (which acquired Solvay's Prometrium product line) offers a manufacturer savings card for brand-name Prometrium. Commercially insured patients may be eligible for copay reductions that bring the monthly cost to as low as $0 to $25 per month, depending on plan structure. The card is not valid for patients covered by government insurance programs (Medicare, Medicaid, Tricare, VA).

Eligibility requirements are straightforward. The patient must have commercial insurance, reside in the United States, and have a valid prescription. Cards can typically be activated online and presented at the pharmacy alongside insurance.

For uninsured patients, AbbVie's patient assistance program may provide brand Prometrium at no cost for qualifying individuals. Income thresholds generally sit at 300% of the federal poverty level or below. For a single-person household in 2026, that threshold is approximately $47,000 in annual income.

Additional discount avenues available to Mississippi residents include:

Generic manufacturer rebate programs occasionally offered by Teva, Mylan (Viatris), and other generic producers. State pharmaceutical assistance: Mississippi does not operate a state pharmaceutical assistance program (SPAP), unlike some northeastern states. NeedyMeds and RxAssist maintain searchable databases of patient assistance programs that Mississippi residents can access.

Dr. JoAnn V. Pinkerton, former Executive Director of NAMS, has noted that "cost should not be a barrier to appropriate menopausal hormone therapy, and clinicians should be aware of generic options and assistance programs to help patients access evidence-based treatments" 9.

Telehealth Access to Prometrium in Mississippi

Mississippi law permits telehealth prescribing of Prometrium and generic micronized progesterone. The Mississippi Telehealth Access Act, expanded during 2020 and made permanent, allows licensed prescribers to evaluate patients and write prescriptions via audio-video telehealth visits 10.

Telehealth access matters for Prometrium prescribing in Mississippi because of the state's provider distribution. Mississippi has the fewest physicians per capita of any U.S. state, with approximately 184 physicians per 100,000 population according to the Association of American Medical Colleges 11. Rural counties in the Delta, Pine Belt, and northeastern hill country often lack OB-GYN or endocrinology specialists entirely.

Several telehealth platforms operating in Mississippi can prescribe micronized progesterone after an appropriate clinical evaluation. HealthRX offers telehealth hormone therapy consultations with licensed Mississippi prescribers. Patients complete a health questionnaire, undergo a video consultation, and receive a prescription sent electronically to their preferred Mississippi pharmacy.

The cost of a telehealth consultation ranges from $50 to $150 depending on the platform and whether follow-up visits are included. Combined with generic pharmacy pricing of $45 per month or compounded pricing of $25 per month, the total annual cost of micronized progesterone therapy via telehealth in Mississippi can be as low as $350 to $600 per year, including prescriber visits.

Clinical Context: Why Micronized Progesterone Specifically

Not all progestogens are interchangeable. The PEPI trial (N=875, published in JAMA 1995) demonstrated that oral micronized progesterone, unlike medroxyprogesterone acetate (MPA), did not blunt the beneficial HDL-cholesterol increase produced by conjugated equine estrogen 7. Women randomized to the estrogen-plus-micronized-progesterone arm saw a 4.1 mg/dL increase in HDL, compared to a 1.6 mg/dL increase in the estrogen-plus-MPA arm.

The Women's Health Initiative (WHI) used MPA, not micronized progesterone, in its estrogen-plus-progestin arm. The increased breast cancer risk observed in that trial arm has not been replicated in observational studies of micronized progesterone. The E3N French cohort study (N=80,377) found no significant increase in breast cancer risk with estrogen plus micronized progesterone over a mean 8.1-year follow-up (RR 1.00, 95% CI 0.83-1.22) 12.

This clinical distinction drives many prescribers' preference for micronized progesterone over synthetic progestins. For Mississippi patients weighing cost considerations, knowing that the $45 generic and $25 compounded oral capsule contain the same micronized progesterone studied in PEPI and preferred in current NAMS guidelines is relevant to the value equation 8.

Comparing All Mississippi Options Side by Side

A quick cost breakdown for a 12-month supply of micronized progesterone 200 mg daily in Mississippi:

Brand Prometrium without insurance: approximately $2,160 per year ($180 per month). Brand Prometrium with AbbVie savings card (commercially insured): approximately $0 to $300 per year. Generic micronized progesterone, cash pay: approximately $540 per year ($45 per month). Generic micronized progesterone with insurance (Tier 1): approximately $60 to $360 per year ($5 to $30 per month). Generic with GoodRx or similar coupon: approximately $300 to $360 per year. Compounded micronized progesterone (503A): approximately $300 per year ($25 per month).

The lowest-cost option for most Mississippi patients is compounded oral micronized progesterone at $25 per month, provided they use an accredited 503A pharmacy and their prescriber confirms the compounded product meets clinical standards. For patients with commercial insurance, the generic at Tier 1 copay or brand with manufacturer savings card often yields comparable or lower out-of-pocket costs.

Mississippi patients filling a new prescription for micronized progesterone should ask their pharmacist to run both insurance and discount card pricing before choosing. The lower price is not always the insured price, particularly for patients on high-deductible health plans who have not yet met their annual deductible.