Provider Briefing: Prempro 0.3/1.5 28 Day Supply in 2026

If your patients on Prempro 0.3/1.5 28 Day have been reporting difficulty filling their prescriptions, you're hearing a consistent signal from across the country. While this medication is not formally listed on the FDA drug shortage database as of early 2026, real-world availability has been inconsistent—particularly for the 0.3/1.5 mg strength.

This briefing covers the current supply landscape, prescribing considerations, therapeutic alternatives, and tools to help your patients maintain access to their hormone replacement therapy (HRT).

Supply Timeline and Current Status

Prempro (conjugated estrogens/medroxyprogesterone acetate) is manufactured exclusively by Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer. The 0.3/1.5 mg formulation—the lowest available dose—has been subject to intermittent availability issues at the retail pharmacy level for several years.

Key supply factors:

• No generic equivalent exists. Pfizer remains the sole manufacturer, creating a single point of failure in the supply chain.
• The 0.3/1.5 mg strength has lower prescribing volume compared to the 0.625/2.5 mg and 0.625/5 mg formulations, leading to reduced stocking at many retail pharmacies.
• Wholesale distribution patterns have contributed to geographic variability—some regions may have adequate supply while others experience consistent stock-outs.
• No formal FDA shortage declaration has been made, meaning manufacturer reporting thresholds have not been triggered despite patient-reported access issues.

Overall HRT prescribing volumes remain below their pre-WHI peak (2002), though there has been a gradual rebound as updated guidelines from the North American Menopause Society (NAMS) and the Endocrine Society have supported the use of HRT in appropriate candidates, particularly within the first 10 years of menopause onset.

Prescribing Implications

For providers who have patients stabilized on Prempro 0.3/1.5, the availability challenges create several clinical considerations:

Continuity of Therapy

Abrupt discontinuation of combination HRT can lead to return of vasomotor symptoms, vaginal atrophy symptoms, and potential acceleration of bone loss in patients taking it for osteoporosis prevention. When patients cannot fill their Prempro prescription, continuity of therapy should be prioritized through one of the strategies outlined below.

Dose Equivalence Considerations

If switching patients to an alternative HRT regimen, consider the following dose equivalence principles:

• Conjugated estrogens 0.3 mg is approximately equivalent to estradiol 0.5 mg
• Medroxyprogesterone acetate 1.5 mg daily is a low-dose continuous progestin; equivalent progestin coverage may be achieved with norethindrone acetate 0.1–0.5 mg daily or micronized progesterone 100 mg daily
• Transdermal estradiol 0.025–0.0375 mg/day provides approximately equivalent systemic estrogen exposure to oral CE 0.3 mg

Boxed Warning Reminder

All combination estrogen-progestin therapies carry the same FDA boxed warning regarding increased risks of cardiovascular events (DVT, PE, stroke, MI), breast cancer, and probable dementia in women 65 and older. These warnings apply equally to Prempro and its alternatives. Prescribe at the lowest effective dose for the shortest duration consistent with treatment goals.

Current Availability Picture

Based on pharmacy-level data and patient reports:

• Large chain pharmacies (CVS, Walgreens, Rite Aid) frequently do not stock Prempro 0.3/1.5 unless they have active, recurring prescriptions for it
• Independent pharmacies may have better access through alternative wholesale channels
• Mail-order pharmacies generally maintain more consistent stock of brand-name products
• Specialty pharmacies focused on women's health may also be a reliable source

The Medfinder platform for providers offers real-time pharmacy stock data that can help you direct patients to pharmacies with confirmed availability in their area.

Cost and Access Considerations

As a brand-name-only product, Prempro 0.3/1.5 carries significant cost implications for patients:

• Average cash price: $330–$400 per 28-day supply
• Insurance coverage: Typically Tier 3 (non-preferred brand); some plans require prior authorization or step therapy through generic alternatives
• Discount card pricing: As low as $237 with SingleCare or similar programs
• Pfizer patient assistance: Eligible patients may receive the medication at no cost through Pfizer RxPathways

For patients facing cost barriers, generic alternatives like estradiol/norethindrone acetate (generic Activella) can reduce monthly costs to $30–$80. For a comprehensive overview, see our provider's guide to helping patients save money on Prempro.

Tools and Resources for Providers

Several resources can help you manage patients affected by Prempro 0.3/1.5 availability issues:

• Medfinder for Providers: Real-time pharmacy stock search to find Prempro 0.3/1.5 near your patients' locations
• FDA Drug Shortage Database: Monitor for formal shortage declarations at accessdata.fda.gov
• Pfizer Medical Information: Contact Pfizer's medical affairs team for current manufacturing and distribution updates
• Pfizer RxPathways: Patient assistance program for eligible uninsured or underinsured patients
• NAMS (North American Menopause Society): Clinical guidance on HRT prescribing and alternative regimens

Looking Ahead

The supply outlook for Prempro 0.3/1.5 is unlikely to change dramatically in the near term. Without generic competition or additional manufacturers entering the market, availability will continue to depend on Pfizer's production and distribution decisions.

Providers should consider establishing a proactive plan for patients on Prempro 0.3/1.5:

1. Identify a preferred alternative regimen in advance
2. Document the rationale for the current therapy to support insurance appeals if needed
3. Educate patients about using Medfinder to locate pharmacies with stock
4. Consider prescribing 90-day mail-order supplies when possible to reduce stock-out risk

Final Thoughts

While Prempro 0.3/1.5 28 Day remains a clinically valuable low-dose HRT option, its status as a brand-name-only product with inconsistent retail availability requires providers to be proactive. Having alternative regimens ready, understanding dose equivalencies, and leveraging tools like Medfinder for Providers can help ensure your patients maintain uninterrupted access to effective menopause management.

For patient-facing resources to share, see our guides on finding Prempro in stock and alternatives to Prempro.