Cost Is an Adherence Barrier — and Proctofoam-Hc Is Expensive

When you prescribe Proctofoam-Hc (Hydrocortisone Acetate 1%/Pramoxine Hydrochloride 1% aerosol foam) for hemorrhoids, anal fissures, or other anorectal conditions, your patients may face significant out-of-pocket costs. At $190 to $235 per 10g canister without insurance, sticker shock is common — and it directly impacts prescription fill rates and treatment adherence.

This guide provides an overview of the savings options available for Proctofoam-Hc, along with practical strategies for incorporating cost conversations into your clinical workflow.

What Patients Are Paying

Understanding the current pricing landscape helps you anticipate patient concerns:

• Brand-name Proctofoam-Hc: $190 to $235 for a 10g canister (cash price, no insurance)
• With commercial insurance: Copay varies widely. Some plans cover it but place it on higher-tier formularies with $50 to $100+ copays. Many plans prefer the cream formulation.
• Medicare Part D: Coverage is inconsistent. Many plans don't cover Proctofoam-Hc or require prior authorization.
• Medicaid: Coverage varies by state. Some state Medicaid programs exclude brand-name Proctofoam-Hc when generic cream alternatives are available.
• Generic Hydrocortisone/Pramoxine cream: Starting at approximately $41 with a coupon. This is the same active ingredient combination but in cream form — no generic aerosol foam is widely available.

The cost gap between the brand-name foam ($190+) and generic cream ($41) is substantial enough that many patients either abandon the prescription at the pharmacy counter or never fill it at all.

Manufacturer Savings Programs

Viatris Patient Assistance Program

Viatris (the parent company of Mylan Specialty L.P., which manufactures Proctofoam-Hc) offers a Patient Assistance Program (PAP) for qualifying patients. Key details:

• Eligibility: Uninsured or underinsured patients who meet income requirements
• Application: Available through viatris.com or by contacting Viatris directly
• Also listed on: NeedyMeds and RxAssist

Viatris does not currently offer a widely advertised copay card or manufacturer coupon specifically for Proctofoam-Hc. This is a notable gap compared to many other brand-name medications, and it's worth being aware of when counseling patients on cost.

What This Means for Your Practice

For insured patients with high copays, the manufacturer offers limited direct support. The Patient Assistance Program is primarily for uninsured or underinsured patients. For commercially insured patients, third-party discount cards (below) are often the best option.

Coupon and Discount Cards

Third-party prescription discount programs can significantly reduce the cash price of Proctofoam-Hc for patients paying out of pocket or facing high copays. The most commonly used programs include:

• GoodRx: Free coupons that can reduce the price at participating pharmacies. Patients simply present the coupon at pickup.
• SingleCare: Similar to GoodRx with free savings cards accepted at most major chains.
• RxSaver: Another coupon aggregator that compares prices across local pharmacies.
• Optum Perks (formerly SearchRx): Discount cards available online or through the app.
• BuzzRx, America's Pharmacy, CareCard: Additional options that cover most major retail pharmacies.

These programs are not insurance and cannot be combined with insurance copays. They work best for patients who are uninsured, whose insurance doesn't cover Proctofoam-Hc, or whose copay is higher than the discounted cash price.

Provider tip: Consider keeping a GoodRx or SingleCare card at your front desk, or printing one for patients at the time of prescribing. Many patients don't know these exist until they're already at the pharmacy facing the full price.

Generic Alternatives and Therapeutic Substitution

When cost is a primary concern — or when Proctofoam-Hc is unavailable due to supply issues — consider these alternatives:

Same Active Ingredients, Different Form

• Hydrocortisone/Pramoxine cream (generic): Starting at ~$41 with a coupon. Same 1%/1% formulation in cream form. Available as generic Analpram HC. For many patients with external hemorrhoids or perianal symptoms, the cream is equally effective.
• Analpram HC (brand cream): Same active ingredients. May have better formulary placement than the foam.

Therapeutic Alternatives

• Hydrocortisone rectal suppositories (generic): Widely available and affordable. Appropriate for internal hemorrhoids, though they lack the Pramoxine anesthetic component.
• Preparation H Hydrocortisone (OTC): Lower-potency OTC option. May be sufficient for mild cases — and the patient can purchase it without a prescription.
• Rectiv (Nitroglycerin 0.4% ointment): Different mechanism (smooth muscle relaxation, increased blood flow). Specifically indicated for chronic anal fissures. Also expensive, but an option when the clinical scenario is fissure-specific.

For a detailed comparison of all alternatives, see our clinical reference on Proctofoam-Hc alternatives.

When the Foam Formulation Matters

In most cases, the cream provides comparable efficacy. However, some patients may benefit specifically from the foam:

• Patients with internal hemorrhoids or proctitis where the applicator allows intra-anal delivery
• Patients who have difficulty applying cream with precision
• Patient preference — some find the foam less messy or more comfortable

Documenting the clinical rationale for the foam formulation can support prior authorization requests when insurance requires justification.

Building Cost Conversations Into Your Workflow

Proactively addressing medication cost reduces prescription abandonment and improves adherence. Here are practical strategies:

At the Point of Prescribing

• Mention the cost upfront: "Proctofoam-Hc can be expensive — around $200 without insurance. Let's talk about ways to bring that down."
• Check formulary status: If your EHR has formulary lookup, check the patient's plan before prescribing. Switch to the cream formulation if it has better coverage.
• Offer the generic cream as first-line when clinically appropriate, especially for external symptoms.
• E-prescribe to cost-effective pharmacies: Independent pharmacies and discount retailers sometimes offer lower prices than chain pharmacies for brand-name products.

In Your Practice Materials

• Keep printed GoodRx/SingleCare cards at checkout
• Train front-desk staff to mention discount card options when patients ask about medication costs
• Include a cost resources handout in after-visit summaries for high-cost prescriptions

For Patients Who Can't Afford It

• Refer to the Viatris Patient Assistance Program for uninsured/underinsured patients
• Point patients to NeedyMeds and RxAssist for additional assistance programs
• Consider OTC alternatives (Preparation H Hydrocortisone) for mild cases to eliminate the prescription cost entirely

Helping Patients Find Proctofoam-Hc in Stock

Cost isn't the only barrier — availability is too. Proctofoam-Hc can be difficult to find at pharmacies due to its niche formulation and history of supply disruptions. When patients can't locate it:

• Direct them to Medfinder for Providers — a tool that helps locate pharmacies with the medication in stock
• Suggest they check multiple pharmacy chains and independent pharmacies
• Consider prescribing the cream alternative as a backup

For a comprehensive provider guide to availability, see our article on how to help patients find Proctofoam-Hc in stock.

Final Thoughts

Proctofoam-Hc is an effective treatment for anorectal conditions, but its cost — $190 to $235 per canister — is a real barrier for many patients. By proactively discussing cost, offering generic or OTC alternatives when appropriate, and connecting patients with discount programs and assistance resources, you can improve fill rates and treatment adherence.

The most impactful intervention is often the simplest: mentioning the cost before the patient reaches the pharmacy. A 30-second conversation about pricing and alternatives can prevent a prescription from going unfilled.

For more clinical resources on Proctofoam-Hc, including side effects, drug interactions, and shortage updates for prescribers, visit our provider resource library at medfinder.com/providers.