How Much Does Prometrium Cost in Nevada in 2026?

Nevada Retail Cash Prices for Prometrium in 2026

The average cash-pay price for a 30-day supply of brand-name Prometrium 200 mg in Nevada is roughly $45 per month at retail pharmacies, well below the $180 list price set by the manufacturer. Pricing varies by pharmacy chain and location.

Large retailers like CVS, Walgreens, and Walmart in the Las Vegas and Reno metro areas tend to cluster near that $45 average, though independent pharmacies sometimes price a few dollars higher. Costco and similar membership pharmacies occasionally dip below $40. These prices reflect the broader national trend: generic micronized progesterone capsules became widely available after Prometrium's patent expiration, and competition has driven the retail cost down substantially from the branded list price 1.

GoodRx, RxSaver, and similar pharmacy benefit aggregators can sometimes find prices between $8 and $25 for generic micronized progesterone at specific Nevada locations. The spread is real. A patient who checks only one pharmacy and pays sticker price might spend three to five times more than a patient who shops around or uses a free discount card.

Worth noting: the $45 figure is for the generic. If a prescriber writes "brand medically necessary" and the pharmacy dispenses actual Prometrium capsules, expect to pay closer to $120 to $180 without insurance.

Why Nevada Medicaid Does Not Cover Prometrium for HRT

Nevada Medicaid does not include Prometrium on its preferred drug list for endometrial protection during hormone replacement therapy. This gap affects thousands of postmenopausal Medicaid enrollees statewide.

The exclusion is not clinical. The Postmenopausal Estrogen/Progestin Interventions trial (PEPI, N=875) demonstrated that micronized progesterone at 200 mg per day opposed estrogen-driven endometrial hyperplasia as effectively as medroxyprogesterone acetate (MPA) while producing a more favorable lipid profile 2. The Endocrine Society's 2015 clinical practice guideline on menopausal hormone therapy specifically lists micronized progesterone as an appropriate progestogen for women with an intact uterus.

The coverage exclusion is financial. Nevada Medicaid's pharmacy benefit manager classifies micronized progesterone as a higher-tier agent relative to synthetic progestins like MPA, which costs pennies per capsule. Patients and prescribers can file a prior authorization request if clinical documentation supports medical necessity, such as documented adverse effects on MPA or a contraindication to synthetic progestins. Approval rates for these PAs vary, but a well-documented request citing the PEPI lipid data and patient-specific side-effect history improves the odds.

For Medicaid patients denied coverage, the compounded route (discussed below) or manufacturer assistance may fill the gap.

Compounded Micronized Progesterone in Nevada: Legal, Accessible, and Cheaper

Compounded micronized progesterone is legal in Nevada through licensed 503A pharmacies, and the cost averages around $25 per month.

A 503A pharmacy compounds medications pursuant to an individual patient prescription under the federal Drug Quality and Security Act (DQSA). Nevada's Board of Pharmacy licenses and inspects these facilities. Patients in Las Vegas, Reno, Henderson, and Sparks have access to multiple 503A compounding pharmacies, and several offer mail-order service to reach rural parts of the state.

Compounded progesterone is not identical to brand Prometrium. Prometrium uses a peanut-oil suspension to improve oral bioavailability of micronized progesterone. Compounding pharmacies may use alternative oil bases (olive oil, sunflower oil) which matters clinically for patients with peanut allergies but can also slightly alter absorption kinetics 3. The FDA-approved label for Prometrium specifies its particular formulation; compounded versions are not FDA-approved but are FDA-regulated under section 503A of the Federal Food, Drug, and Cosmetic Act.

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 better safety profile than synthetic progestins, particularly regarding breast cancer risk and cardiovascular markers" 4.

The $25 per month average for compounded micronized progesterone in Nevada represents a 44% savings over the $45 generic retail price and an 86% savings over the $180 brand list price. For uninsured patients or those on fixed incomes, this difference is meaningful across a multi-year HRT regimen.

Insurance Coverage for Prometrium Across Nevada Plans

Commercial insurance coverage for Prometrium and generic micronized progesterone varies by plan, but most major Nevada insurers cover the generic on a mid-tier formulary position.

Anthem Blue Cross Blue Shield of Nevada typically places generic micronized progesterone on Tier 2, with copays ranging from $15 to $35 per month depending on the specific plan. Brand Prometrium, if dispensed, usually falls on Tier 3 or requires step therapy showing generic failure.

Health Plan of Nevada (HPN) and Sierra Health Services, both UnitedHealthcare affiliates operating in the state, generally cover generic micronized progesterone after standard formulary rules. Copays align with their generic or preferred-brand tiers.

Silver State Health Insurance Exchange plans (Nevada's ACA marketplace) are required to cover FDA-approved contraceptives without cost-sharing under the ACA preventive care mandate, but this mandate does not extend to progesterone prescribed for HRT or endometrial protection. HRT prescriptions go through standard formulary adjudication.

Medicare Part D plans available in Nevada generally cover generic micronized progesterone. The 2026 Part D redesign caps annual out-of-pocket drug spending at $2,000, which benefits patients on multiple medications but rarely comes into play for a single $45-per-month generic.

Patients unsure of their plan's formulary should call the number on the back of their insurance card and ask two specific questions: "Is generic micronized progesterone 200 mg capsule covered?" and "What tier is it on?"

AbbVie Savings Card and Other Discount Programs

AbbVie (which acquired Solvay's Prometrium franchise) offers a copay savings card for commercially insured patients. The card typically reduces the brand-name copay to $25 or less per 30-day fill.

Limitations apply. The card does not work for patients covered by Medicare, Medicaid, Tricare, or other government-funded insurance. It is restricted to commercially insured patients with a valid prescription for brand Prometrium. Nevada pharmacies accept the card at point of sale.

Beyond the manufacturer card, several other programs reduce cost:

NeedyMeds maintains a database of patient assistance programs (PAPs) and state-level assistance for Nevada residents. Low-income, uninsured patients may qualify for free or reduced-cost medication through AbbVie's own PAP.

Mark Cuban Cost Plus Drugs sells generic micronized progesterone at a transparent markup over manufacturing cost, and ships to Nevada addresses. Prices at the time of writing are competitive with or below GoodRx coupon pricing.

Pharmacy discount cards from GoodRx, RxSaver, SingleCare, and others are accepted at most Nevada chain pharmacies and can pull the generic price below $15 at selected locations. These are free, require no insurance, and work at the pharmacy counter.

A 2022 JAMA Internal Medicine analysis found that pharmacy discount cards produced lower prices than insurance copays for 40% of generic prescriptions studied 5. This means insured patients should compare their copay with the discount-card cash price before assuming insurance is the cheaper route.

Telehealth Prescribing of Prometrium in Nevada

Telehealth prescribing of Prometrium is fully legal in Nevada. The state's telehealth parity law (NRS 629.515) requires insurers to cover telehealth visits on the same terms as in-person visits, and prescribers can issue prescriptions for Schedule IV and non-scheduled medications, including micronized progesterone, after a telehealth evaluation.

This matters for patients in rural Nevada. Clark County and Washoe County concentrate most of the state's OB-GYN and endocrinology practices. Women in Elko, Nye, Humboldt, or White Pine counties can access HRT prescribing through telehealth platforms without driving hours to a specialist.

HealthRX and similar telehealth platforms licensed in Nevada can evaluate patients, order labs, prescribe micronized progesterone, and monitor therapy remotely. The typical workflow: an initial video consultation (15 to 30 minutes), lab review, prescription sent electronically to the patient's preferred Nevada pharmacy, and follow-up visits at 3- to 6-month intervals.

The E-Prescribing mandate in Nevada (NRS 639.2353) requires electronic transmission of prescriptions, which all major telehealth platforms already support. Paper prescriptions are no longer standard practice for non-controlled substances in the state.

Clinical Context: Why Micronized Progesterone Over Synthetic Progestins

The question of cost only matters if the drug is clinically appropriate. For micronized progesterone, the evidence favoring it over synthetic alternatives is substantial.

The PEPI trial randomized 875 postmenopausal women to five arms: placebo, conjugated equine estrogens (CEE) alone, CEE plus MPA (cyclic), CEE plus MPA (continuous), and CEE plus micronized progesterone (cyclic). The micronized progesterone arm matched MPA for endometrial protection while preserving the HDL cholesterol benefit of estrogen, an advantage MPA partially blunted 2.

The French E3N cohort study (N=80,377) 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 (RR 1.69 to 95% CI 1.50 to 1.91) 6. This finding aligned with the Fournier et al. analysis published in Breast Cancer Research and Treatment.

The 2022 North American Menopause Society (NAMS) position statement identifies micronized progesterone as an appropriate progestogen for endometrial protection and notes its potentially favorable breast and cardiovascular profile relative to synthetic progestins 7.

For Nevada patients and prescribers weighing cost against clinical evidence, micronized progesterone offers a clear value proposition: strong trial data, guideline endorsement, and a retail price under $50 per month for the generic formulation.

How to Get the Lowest Price in Nevada: A Step-by-Step Approach

1. Ask your prescriber to write for generic micronized progesterone, not brand Prometrium. Nevada law allows pharmacists to substitute generics automatically unless the prescriber writes "dispense as written."
2. Check discount card prices at GoodRx.com or RxSaver.com for your specific zip code. Prices vary by pharmacy, sometimes by $20 or more within the same city.
3. Compare your insurance copay against the discount card price. Use whichever is lower. You are not required to use your insurance for every prescription.
4. Ask about 90-day fills. Many Nevada pharmacies and mail-order services offer a lower per-unit price for a 90-day supply.
5. Consider a 503A compounding pharmacy if the $25 per month price point matters to your budget, especially if you are uninsured or on Medicaid without coverage.
6. Apply for the AbbVie savings card if you have commercial insurance and your prescriber specifically requires brand Prometrium.
7. Use telehealth if travel to a prescriber is a barrier. Nevada law supports it, and insurers must cover it at parity.

The standard prescribed dose for endometrial protection is 200 mg orally at bedtime for 12 consecutive days per 28-day cycle (cyclic regimen) or 100 to 200 mg daily (continuous regimen) 1. Taking micronized progesterone at bedtime reduces the sedative side effect that some women experience, a property related to its allopregnanolone metabolite acting on GABA-A receptors 8.