Provider Briefing: Junel Fe 1.5/30 28 Day Supply Disruptions in 2026

Oral contraceptive shortages have been a persistent clinical challenge since 2023, and Junel Fe 1.5/30 28 Day (norethindrone acetate 1.5 mg/ethinyl estradiol 30 mcg with ferrous fumarate) remains among the affected products. If your patients are reporting difficulty filling prescriptions for this medication, here's what you need to know to guide clinical decisions and maintain continuity of care.

Shortage Timeline

The supply disruption for norethindrone acetate/ethinyl estradiol combination products has followed a recognizable pattern:

• 2022–2023: Demand for oral contraceptives surged following the Dobbs v. Jackson decision. Manufacturers reported difficulty keeping pace, particularly for norethindrone-based formulations.
• 2023–2024: The FDA added several norethindrone acetate/ethinyl estradiol products to its drug shortage list. Production slowdowns at key manufacturing facilities compounded the issue.
• 2025: Supply began to stabilize in some regions as manufacturers increased production capacity. However, distribution remained uneven, with rural and underserved areas disproportionately affected.
• 2026 (current): Availability is improving but remains inconsistent. Some pharmacy networks report adequate stock while others continue to experience intermittent shortages, particularly for specific NDC numbers.

Prescribing Implications

The ongoing supply variability has several practical implications for prescribers:

Generic Substitution

Junel Fe 1.5/30, Microgestin Fe 1.5/30, Blisovi Fe 1.5/30, Larin Fe 1.5/30, Gildess Fe 1.5/30, Hailey Fe 1.5/30, and Aurovela Fe 1.5/30 are all AB-rated generic equivalents of Loestrin Fe 1.5/30. All contain identical active ingredients (norethindrone acetate 1.5 mg/ethinyl estradiol 30 mcg + ferrous fumarate 75 mg).

Clinical recommendation: Unless there is a documented, patient-specific reason to require a particular manufacturer's product, prescribe using the generic name (norethindrone acetate/ethinyl estradiol 1.5/0.03 mg with iron) and avoid "dispense as written" to maximize pharmacy flexibility in filling the prescription.

Therapeutic Alternatives

If all norethindrone acetate 1.5/30 formulations are unavailable, consider these therapeutic alternatives:

• Norethindrone acetate/ethinyl estradiol 1/20 (Loestrin Fe 1/20 equivalents): Lower hormone dose; appropriate for patients who may benefit from reduced estrogen exposure.
• Norgestimate/ethinyl estradiol (Sprintec equivalents): Different progestin; widely available and well-tolerated. Appropriate for most patients without contraindications.
• Levonorgestrel/ethinyl estradiol (Levlen, Portia equivalents): Another well-established combination OC with broad availability.
• Etonogestrel/ethinyl estradiol vaginal ring (NuvaRing/generic): Non-oral option for patients open to alternative delivery methods.

When switching progestins, counsel patients about potential breakthrough bleeding during the first 1–3 cycles and the importance of consistent daily use during the transition.

Current Availability Picture

Availability varies significantly by region, pharmacy chain, and wholesaler. Key observations:

• Chain pharmacies (CVS, Walgreens, Rite Aid) may have limited stock at individual locations due to centralized inventory management.
• Independent pharmacies often access multiple wholesalers and may have better ability to source specific products.
• Mail-order pharmacies report more stable supply for 90-day fills.
• Real-time availability tracking through Medfinder for Providers allows clinicians and staff to check pharmacy stock before sending prescriptions.

Cost and Access Considerations

Under the ACA contraceptive mandate, most commercial insurance plans cover Junel Fe 1.5/30 and its generic equivalents at $0 cost-sharing. However, cost becomes relevant in several scenarios:

• Uninsured patients: Cash prices range from $30 to $90 per pack at retail. Discount cards (GoodRx, SingleCare) can reduce this to $15–$35.
• Out-of-network pharmacies: If a patient must fill at an out-of-network pharmacy due to availability, they may face unexpected costs.
• Brand vs. generic: If a patient's plan only covers a specific generic and it's unavailable, navigating coverage exceptions may be necessary.

Title X clinics, Planned Parenthood, and other safety-net providers may offer oral contraceptives at no cost to qualifying patients. For detailed patient-facing pricing information, see our savings guide for Junel Fe 1.5/30.

Tools and Resources for Your Practice

• Medfinder for Providers: Real-time pharmacy availability search. Integrate into your prescribing workflow to route prescriptions to pharmacies with confirmed stock.
• FDA Drug Shortage Database: Official shortage listings and estimated resolution dates for norethindrone products.
• ACOG Practice Advisory: The American College of Obstetricians and Gynecologists has published guidance on managing contraceptive access during drug shortages.

Consider having your clinical staff check availability via Medfinder before sending electronic prescriptions, particularly for patients who have previously reported difficulty filling their Junel Fe 1.5/30 prescriptions.

Looking Ahead

Industry analysts expect the oral contraceptive supply chain to continue improving through 2026 as additional manufacturing capacity comes online. However, the structural vulnerabilities that led to these shortages — manufacturer consolidation, just-in-time inventory models, and limited API suppliers — remain largely unaddressed.

Proactive prescribing practices, flexible generic substitution policies, and patient education about alternatives will remain important strategies for the foreseeable future.

Final Thoughts

The Junel Fe 1.5/30 shortage underscores the fragility of the oral contraceptive supply chain. As a prescriber, you can minimize disruptions for your patients by prescribing generically, discussing alternatives proactively, using availability tools like Medfinder for Providers, and maintaining open communication about the realities of the current market.

For a patient-facing version of this update, you can direct patients to our patient shortage update. For guidance on helping patients locate the medication, see our provider's guide to helping patients find Junel Fe 1.5/30.