Your Patients Need Intrarosa — Here's How to Help Them Get It

You've prescribed Intrarosa (Prasterone) because it's the right treatment for your patient's moderate to severe dyspareunia. But then the call comes: "My pharmacy doesn't have it." Or worse — the patient simply gives up and goes without treatment.

As a prescriber, you're uniquely positioned to help patients overcome the access barriers that come with specialty medications. This guide provides a practical, step-by-step approach to helping your patients find and fill their Intrarosa prescriptions.

Current Availability: What's Really Going On

Intrarosa is not in a formal FDA-listed shortage. The manufacturer, Cosette Pharmaceuticals, continues to produce and distribute the product. The challenge is at the pharmacy level:

• Intrarosa is a brand-name-only product (no generic available)
• It serves a relatively niche patient population
• The cash price of $288-$402/month discourages speculative stocking
• Large chain pharmacies often don't maintain standing inventory

The result: patients frequently encounter "not in stock" responses, which they may interpret as a shortage. Most pharmacies can order Intrarosa through standard channels within one to two business days — the key is making sure patients know this.

For a broader overview of the situation, see: Intrarosa shortage: What providers need to know in 2026.

Why Patients Can't Find Intrarosa

Understanding the patient experience helps you address barriers proactively:

1. First-fill surprise: Patients don't expect availability issues until they're at the pharmacy counter. By then, they're frustrated and may not know their options.
2. Phone fatigue: Calling multiple pharmacies is time-consuming and discouraging. Many patients give up after two or three attempts.
3. Insurance confusion: Prior authorization denials or step therapy requirements add another layer of complexity that patients may not understand how to navigate.
4. Cost shock: Patients who learn the cash price is $288-$402 may abandon the prescription entirely.
5. Lack of alternatives awareness: Patients may not know that other treatment options exist if Intrarosa can't be found.

What Providers Can Do: 5 Actionable Steps

Step 1: Set Expectations at the Time of Prescribing

The most impactful thing you can do is prepare patients before they leave your office. When prescribing Intrarosa, inform them that:

• Not every pharmacy stocks it — this is normal for specialty medications
• Their pharmacy may need to order it, which usually takes one to two business days
• They should request refills 5-7 days before running out

This simple conversation can prevent frustration and treatment gaps.

Step 2: Direct Patients to Medfinder

Recommend that patients use Medfinder to search for pharmacies with Intrarosa in stock. Medfinder allows patients to check real-time availability at pharmacies in their area, eliminating the need to call around.

Consider adding Medfinder to your patient handouts or post-visit instructions for any specialty medication.

Step 3: Recommend Independent Pharmacies

Independent pharmacies tend to be more responsive to specialty medication orders. They can often:

• Order Intrarosa within one to two business days
• Maintain ongoing stock once they know they have a regular patient
• Provide more personalized service and follow-up

If you have relationships with local independent pharmacies, share those recommendations with patients.

Step 4: Initiate Prior Authorization Proactively

If you know the patient's insurance plan requires prior authorization for Intrarosa, start the process immediately — don't wait for the pharmacy to trigger a rejection. Early PA initiation can save days of delay.

Key tips:

• Document the clinical rationale clearly: moderate to severe dyspareunia, vulvar and vaginal atrophy, menopause-related
• Note any prior therapies tried (relevant for step therapy requirements)
• Use the Intrarosa HCP portal (hcpintrarosa.com) for additional payer support resources

Step 5: Provide Savings Card Information

Hand patients the Intrarosa Savings Program information before they leave your office. Eligible commercially insured patients can pay as little as $35/month. Direct them to intrarosasavingscard.com.

For patients on Medicare, Medicaid, or other government insurance who are not eligible for the savings card, provide information about NeedyMeds (needymeds.org) and RxAssist (rxassist.org) as potential assistance resources.

For a comprehensive cost guide to share with patients, see: How to save money on Intrarosa.

Alternatives to Have Ready

When Intrarosa is unavailable or a patient can't afford it, have a backup plan:

• Estradiol vaginal inserts (Vagifem / Yuvafem): Most similar in form factor; generic available; $50-$120/month
• Estradiol vaginal cream (Estrace): Well-established; generic available; $20-$80/month
• Conjugated estrogens vaginal cream (Premarin): Widely stocked; brand-only; $200-$280/month
• Ospemifene (Osphena): Oral option for patients who prefer not to use vaginal products; carries boxed warning; $200-$300/month

A patient-facing comparison is available at: Alternatives to Intrarosa.

Workflow Tips for Your Practice

Integrating these steps into your existing workflow doesn't have to be complicated:

• Create a handout: Include Medfinder link, savings card URL, refill timing advice, and your office contact for PA support
• Add a note in your EHR template: For Intrarosa prescriptions, include a standard patient instruction about pharmacy ordering and early refills
• Designate a PA point person: Have a staff member who handles prior authorizations for specialty medications — this speeds up the process significantly
• Follow up: A brief check-in call or portal message one week after prescribing can catch access problems early, before the patient runs out of hope (or medication)

Final Thoughts

Intrarosa access challenges are frustrating for both patients and providers, but they're manageable with proactive planning. By setting expectations, providing tools like Medfinder, and streamlining your prior authorization process, you can help ensure your patients get the treatment they need without unnecessary delays.

For more provider-focused resources, visit Medfinder for Providers. For a broader overview of the Intrarosa landscape, see: Intrarosa shortage: What providers need to know in 2026.