Your Patients Need Intrarosa — But Many Can't Afford It

You've diagnosed vulvar and vaginal atrophy (VVA), discussed treatment options, and determined that Intrarosa (Prasterone) is the right fit. Then your patient checks the price — and calls back saying they can't fill the prescription.

This is a common scenario. Intrarosa is an effective, well-tolerated treatment for moderate to severe dyspareunia due to menopause, but its cost can be a significant barrier to adherence. As a provider, you're in a unique position to help patients navigate the financial landscape and find programs that make this medication accessible.

This guide covers what your patients are actually paying, available savings programs, alternative cost strategies, and how to incorporate cost conversations into your clinical workflow.

What Patients Are Actually Paying

Understanding the cost picture helps you anticipate patient concerns and proactively offer solutions:

• Cash price (no insurance): $288 to $402 for a 28-count supply (one month)
• With commercial insurance: Varies widely. Some plans cover Intrarosa with a specialty-tier copay ($50-$150+). Others require prior authorization or step therapy through vaginal estrogen products first.
• Medicare Part D: Coverage varies by plan. Patients in the coverage gap ("donut hole") may face significantly higher costs.
• With manufacturer savings card: As low as $35/month for eligible commercially insured patients

The gap between "as low as $35" and "up to $402" is enormous — and which price a patient pays often depends on whether anyone tells them about the savings options. That's where you come in.

Manufacturer Savings Program

The Intrarosa Savings Program is the single most impactful cost-reduction tool for commercially insured patients.

Key Details

• Eligible patients: Commercially insured (private insurance, employer-sponsored plans)
• Savings: Patients may pay as little as $35 per 28-day supply
• How to enroll: Patients can sign up at intrarosasavingscard.com or receive a card from your office
• Not eligible: Patients on Medicare, Medicaid, TRICARE, VA, or other government-funded insurance programs. Also not valid for uninsured patients.

Clinical Workflow Recommendation

Consider keeping Intrarosa savings cards in your office and handing them to patients at the time of prescribing. This small step dramatically improves the chance that a patient will actually fill the prescription. You can also have your staff mention the savings program when calling in or e-prescribing.

Coupon and Discount Card Options

For patients who don't qualify for the manufacturer savings program — or who want to compare prices — third-party prescription discount cards can help:

• GoodRx, SingleCare, RxSaver: These platforms aggregate pharmacy pricing and often offer coupons that reduce the cash price. Savings vary by pharmacy but can be significant.
• Pharmacy-specific programs: Some chains (Walgreens, CVS) have their own prescription savings programs that may apply to Intrarosa.
• MedFinder: MedFinder for Providers helps clinicians check real-time pharmacy stock and pricing, so you can direct patients to pharmacies where Intrarosa is available and affordable.

Important caveat: Discount cards cannot be combined with insurance copay cards in most cases. Patients should compare the discount card price versus their insurance copay to determine which is lower.

Patient Assistance Programs

For patients who are uninsured or on government insurance (and therefore ineligible for the manufacturer savings card), other options exist:

• NeedyMeds (needymeds.org): A comprehensive database of patient assistance programs, including manufacturer and third-party options
• RxAssist (rxassist.org): Another resource for finding assistance programs by drug name
• Cosette Pharmaceuticals: Patients can contact the manufacturer directly to inquire about patient assistance. Contact information is available on the prescribing information or through NeedyMeds.

Encourage patients who are struggling financially to explore these resources. Your office staff can help patients get started with applications if time permits.

When to Consider Therapeutic Alternatives

If cost remains prohibitive despite savings programs, it may be appropriate to discuss therapeutic alternatives with your patient. Several options exist for treating VVA-related dyspareunia:

• Vaginal estradiol tablets (Vagifem/Yuvafem): Generic estradiol vaginal tablets are significantly less expensive and are often the first-line treatment for VVA. If the patient hasn't tried vaginal estrogen, this may be a reasonable starting point.
• Vaginal estradiol cream (Estrace): Generic vaginal estrogen cream is another cost-effective option, though some patients find creams less convenient than inserts.
• Conjugated estrogens vaginal cream (Premarin): Brand-name but widely covered by insurance. May be more accessible for some patients.
• Ospemifene (Osphena): The only oral option for dyspareunia. May be preferred by patients who dislike vaginal application. Has its own cost considerations.

For a comprehensive comparison, see our clinical overview of Intrarosa alternatives.

The decision to switch should be collaborative. Some patients prefer Intrarosa's DHEA-based mechanism over direct estrogen delivery, particularly those concerned about estrogen exposure. Cost is one factor among many in the shared decision-making process.

Insurance Navigation Tips

Several strategies can help patients access Intrarosa through their insurance:

Prior Authorization

Many plans require PA for Intrarosa. To improve approval rates:

• Document the diagnosis of moderate to severe dyspareunia due to VVA clearly
• Note any failed trials of lower-cost alternatives (step therapy documentation)
• Include relevant exam findings (vaginal pH, tissue appearance)
• Reference the FDA-approved indication

Step Therapy Appeals

If a plan requires trying vaginal estrogen first, document the trial and any reasons it was inadequate (side effects, patient preference for non-estrogen option, contraindications to estrogen). A well-documented appeal can often overturn a step therapy requirement.

Formulary Exceptions

For patients whose plans don't cover Intrarosa at all, a formulary exception request — supported by clinical documentation of medical necessity — may result in coverage.

Having the Cost Conversation

Many providers hesitate to discuss medication costs, but patients consistently report that they want their doctor to bring it up. Here are some practical approaches:

At the Time of Prescribing

• "Intrarosa can be expensive without a savings card. Let me give you this — it can bring your cost down to about $35 a month if you have commercial insurance."
• "If cost is a concern, let's talk about it. There are several programs that might help, and there are also alternative treatments we can consider."

At Follow-Up

• "Were you able to get the Intrarosa filled? Sometimes it's hard to find or expensive — I want to make sure you have what you need."
• "If the cost isn't working, let's look at other options. The most important thing is that we're treating your symptoms."

Systemic Approaches

• Train front desk and nursing staff to mention savings programs when Intrarosa is prescribed
• Keep a reference sheet of savings card URLs and patient assistance contacts
• Use tools like MedFinder for Providers to check pharmacy availability and pricing before the patient leaves

Quick Reference: Savings Options at a Glance

Here's a summary table for your office:

• Commercially insured: Intrarosa Savings Program → as low as $35/month (intrarosasavingscard.com)
• Uninsured: Discount cards (GoodRx, SingleCare) + contact Cosette for patient assistance
• Medicare/Medicaid: NeedyMeds, RxAssist, contact Cosette directly
• All patients: MedFinder for Providers to find stock + compare pricing

Final Thoughts

Intrarosa is a uniquely effective treatment that many patients abandon not because of side effects, but because of cost. As prescribers, we can close this gap by proactively discussing financial options, keeping savings cards in the office, and helping patients navigate insurance barriers.

The goal isn't just to prescribe the right medication — it's to make sure patients can actually access it. Tools like MedFinder for Providers and manufacturer savings programs make that easier than ever.

For more provider-focused resources on Intrarosa, see our guides on helping patients find Intrarosa in stock and the Intrarosa shortage update for providers.