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

As a provider who prescribes Novarel (human chorionic gonadotropin), you've likely fielded countless calls from frustrated patients who can't find their medication. The hCG shortage has been ongoing since 2020, and while supply has improved, it remains inconsistent enough to disrupt treatment cycles and cause significant patient distress.

This guide provides a practical, step-by-step framework for helping your patients navigate Novarel availability in 2026. Whether you're in reproductive endocrinology, urology, endocrinology, or OB/GYN, these strategies can be integrated into your clinical workflow.

Current Availability Overview

As of early 2026, the hCG product landscape looks like this:

• Novarel (Ferring Pharmaceuticals): Available in 5,000 and 10,000 USP Unit vials. Intermittent supply through standard distribution. More reliably stocked at specialty fertility pharmacies.
• Pregnyl (Organon): Available in 10,000 USP Unit vials. Similar availability pattern to Novarel.
• Generic hCG (Fresenius Kabi and others): Improving availability. Often the most accessible option.
• Ovidrel (EMD Serono): Recombinant hCG, 250 mcg pre-filled syringe. Generally more available but at higher cost ($250–$500+).

For the latest real-time data, direct your team to Medfinder for Providers.

Why Patients Can't Find Novarel

Understanding the root causes helps you counsel patients effectively:

1. Regulatory change: The FDA's 2020 reclassification of hCG as a biologic eliminated most compounding pharmacy supply.
2. Few manufacturers: Novarel (Ferring), Pregnyl (Organon), generic hCG (Fresenius Kabi), and Ovidrel (EMD Serono) are essentially the entire market.
3. Distribution gaps: Chain pharmacies often can't source hCG through standard wholesale channels. Specialty pharmacy distribution networks are more reliable but less accessible to patients who don't know about them.
4. Demand growth: Rising utilization of ART procedures and increasing recognition of male hypogonadism have expanded the patient population.

For the full shortage background, see our provider shortage briefing.

What Providers Can Do: 5 Steps

Step 1: Build Specialty Pharmacy Relationships

This is the single most impactful step you can take. Identify 2–3 specialty pharmacies that consistently stock hCG products and establish referral relationships.

What to look for in a specialty pharmacy partner:

• Dedicated fertility medication inventory
• Direct relationships with Ferring and other hCG manufacturers
• Ability to ship to patients (useful for rural or underserved areas)
• Insurance verification and prior authorization support
• Patient financial assistance coordination

Many fertility clinics already work with specialty pharmacies like Freedom Fertility, Encompass, or Village Fertility. If you don't have established relationships, now is the time to build them.

Step 2: Prescribe for Maximum Flexibility

Simple prescribing adjustments can significantly improve fill rates:

• Write for generic chorionic gonadotropin rather than Novarel by name when possible. This allows pharmacies to fill with whatever hCG product they have in stock.
• Include "brand medically necessary" only when there's a documented clinical reason — patient allergy to a specific formulation, insurance requirement, etc.
• Consider both strength options — if 10,000 Units isn't available, two 5,000 Unit vials may be.
• Note on the prescription that Ovidrel is an acceptable alternative, if clinically appropriate, to give the pharmacy another option.

Step 3: Equip Your Staff with Availability Tools

Your front desk, nursing staff, and care coordinators are often the first point of contact when patients can't find their medication. Equip them with:

• Medfinder for Providers — a real-time pharmacy availability tool your staff can use to direct patients to pharmacies with stock.
• A list of your preferred specialty pharmacies with contact information and ordering instructions.
• A patient handout explaining what to do if their pharmacy doesn't have hCG, including alternative medications and resources.

Step 4: Proactively Discuss Alternatives

Don't wait for patients to call in a panic. During treatment planning, proactively discuss:

• Pregnyl as a direct substitute (same active ingredient, same administration)
• Ovidrel as a convenient alternative (pre-filled syringe, subcutaneous injection) — note: only for fertility indications
• Generic hCG as a potentially lower-cost option
• Protocol adjustments for specific clinical scenarios (e.g., GnRH agonist trigger in appropriate IVF patients)

For a patient-facing comparison, share our guide on alternatives to Novarel.

Step 5: Address Cost Barriers

Cost is often intertwined with access. When patients can't afford brand-name hCG, they may delay treatment or skip doses. Help by:

• Checking insurance coverage — ensure prior authorization is submitted early in the cycle planning process
• Recommending discount cards — GoodRx and SingleCare can reduce generic hCG costs to $150–$300 per vial
• Connecting patients with manufacturer programs — Ferring's HeartTomorrow and OneHeart programs offer discounted pricing
• Referring to patient assistance programs — NeedyMeds and RxAssist for income-qualified patients

For comprehensive cost-saving strategies, see our provider's guide to helping patients save money on Novarel.

Alternative Medications to Consider

When hCG is completely unavailable, consider these clinical alternatives based on indication:

For ovulation trigger (fertility):

• Ovidrel (choriogonadotropin alfa) — recombinant hCG, subcutaneous
• GnRH agonist trigger (e.g., Leuprolide) — for patients at high risk of OHSS in IVF protocols using GnRH antagonist

For male hypogonadism:

• Clomiphene Citrate — off-label; stimulates endogenous LH and FSH production
• Enclomiphene — selective estrogen receptor modulator; under investigation
• Anastrozole — off-label aromatase inhibitor to increase testosterone

Note that none of these alternatives are exact substitutes for hCG. Clinical judgment and patient counseling are essential.

Workflow Tips for Your Practice

Integrating shortage management into your workflow reduces reactive firefighting:

• Check hCG availability at the start of each treatment cycle — don't assume it will be available at trigger time.
• Submit prior authorizations early — PA processing can take 3–7 business days. Build this into your cycle timeline.
• Designate a medication access coordinator — if volume warrants, assign a staff member to manage specialty pharmacy relationships and patient medication issues.
• Create a standard operating procedure for hCG unavailability scenarios, including decision trees for alternative medications and escalation pathways.
• Keep patients informed — a brief note in your patient portal about hCG availability and what to expect can prevent calls and reduce anxiety.

Final Thoughts

The hCG shortage requires providers to be more proactive about medication access than ever before. By building specialty pharmacy relationships, prescribing flexibly, equipping your staff with real-time tools, and addressing cost barriers, you can minimize the impact on your patients' care.

For real-time Novarel availability data and provider-specific tools, visit Medfinder for Providers. For the latest shortage status, see our provider shortage briefing.