Estradiol Valerate - Injectable

[Angela49]

I live in New England and it took 2 weeks to fill my 20mg script at CVS.
Just picked it up today.

[Jessica Lynne]

I live in New England and it took 2 weeks to fill my 20mg script at CVS.
Just picked it up today.

Well if this thread serves no other purpose, I suppose it's a heads up to lay in supplies so you don't find yourself hung out to dry.

[LexiDreamer]

I just messaged my Primary and now they're saying it's not available.
I'll check with my pharmacy again and if they can't get it, I'm gonna have to see if my insurance will authorize the brand name version.

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[Jessica Lynne]

I just messaged my Primary and now they're saying it's not available.
I'll check with my pharmacy again and if they can't get it, I'm gonna have to see if my insurance will authorize the brand name version.

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the brand name is ridiculously priced. And by ridiculously, I mean 4 times the cost. See if your Dr. will switch you to cypionate. So far I've had zero issues with availability. Also, try these folks and see if they cant fill your present prescription:

Civic Center Pharmacy
https://www.civiccenterpharmacy.com/contact.html
Address. 7331 E. Osborn Drive Suite 208. Scottsdale, AZ 85251. Phone / Fax. 480-945-9519 Phone 480-945-9854 Fax 480-949-6033 Fax

[antia212]

My insurance only covers injectable estradiol valerate through a mail order pharmacy called Accredo/Express Scripts. It's 100% covered as part of my medical benefits. They send a 3-month supply at a time  and it comes with syringes/alcohol pads. They can mail it to your PCP or to your home.

It's a pretty sweet deal and I'm grateful that my insurance covers it completely, BUT it was actually quite a headache to finally get the order shipped. My insurance would tell me I needed approval from the mail order pharmacy and the mail order pharmacy would tell me I needed approval from my insurance, so I went back and forth many times explaining that the other had redirected me their way. At the end of the day, it was my insurance that was making the process difficult. I actually didn't need need an approval from anyone! A kind woman named Stephanie at the mail order pharmacy noticed how upset this was making me and called my insurance on my behalf and took it up to escalation. That was four weeks after going back and forth and spending over 20 hours on the phone. It was humiliating and I kept getting misgendered. I've always had a feminine voice and would get called mam at the beginning of a call, I'd say my legal name and the person would excuse themselves and call me sir, and then after I told them I was trans, they would awkwardly excuse themselves AGAIN and call me mam.

I often wondered if i should just have stuck with the pills, and I'm a week into my first shot now and don't know how worth it it's going to be, to be honest. I am happy that I'm finally on estrogen though

If possible, try calling your pharmacy and ask if they have a mail order pharmacy that they work. Ask about the cost and if an approval from your PCP would be necessary. It may take a while, but at least you'll be on pills in the meantime.


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[antia212]

try calling your insurance and ask if they have a mail order pharmacy that they work with***

sorry, was typing on my phone!


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[KarynMcD]

Saw my doctor the other day. We switched to the 40mg strength. It came in the next day.

[LexiDreamer]

I just messaged my Primary and now they're saying it's not available.
I'll check with my pharmacy again and if they can't get it, I'm gonna have to see if my insurance will authorize the brand name version.

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I contacted my Primary and they called it into my regular pharmacy (Rite Aid). I got a text message from my pharmacy yesterday stating it was out of stock. So I called the pharmacy to inquire about the 40mg vial's availability.
They told me that they ordered my regular (20mg) and that it would be ready the next day.
I went to pick it up and the pharmacist informed me that the generic was in shortage due to "production issues" so they ordered the brand name Delestrogen.
I asked about my insurance and they told me my insurance covered it and my copay was the same!
Phew! Calamity averted!

I hope my sisters on here have similar luck in getting their EV prescriptions filled.

I must say, aside from loathing the cold weather, I'm very fortunate to live in the great state of New York.


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[mako9802]

Doc just changed my script after the 20mg/ml was in shortage.  Now  the 40mg/ml vial is delayad as well.  I just can't not win for losing.

[LexiDreamer]

Has anyone filled their EV script lately?

Just wondering what the status of the shortage is.

[AshleyP]

Has anyone filled their EV script lately? Just wondering what the status of the shortage is.

I just got my prescription and turned it in to the pharmacy yesterday. They had it filled today. The script is for the 40mg/mL concentration.

I used the GoodRX website for their discount coupon, and it noted that there's been shortages for both the 20mg and 40mg versions.  I did see a website that claimed the shortage has been resolved, but I don't remember the site.

I'll add that the packaging said the product was manufactured for Perrigo by PharmaForce, Hilliard, OH.

--AshleyP

[Barb99]

I normally use the 20mg/ml. Went to get it refilled 10 days ago and was told by Walgreen's and CVS that the generic supplier is no longer making it and none is available. the My doctor wrote me a new prescription for the 40mg/ml which was in stock at both places.

The brand name was available in both concentrations (at 7 times the cost). This is in the Chicago area.

[SadieBlake]

I filled mine about 3 weeks ago, I'll let y'all know when it comes up next week whether I get it ok. Perrigo 40mg/ml.

[Shadowsister]

I was just switched to injections from pills but was able to thankfully get the injectable estrogen. I am really worried about these shortages though. I wonder how long they'll last. I'm in big trouble without my estrogen.

[Susan]

From the company making the generic which is totally unavailable as far as I can determine (name brand is available but at over 3x the price)

From the email I sent to them.

I am contacting you for more information about the shortage of your generic Estradiol Valerate product. Please provide as much detail as you are able about the cause of this shortage, what precipitated it, what the solution entails, when the product will be available on the market again, as well as any steps Perrigo is putting in place to prevent a recurrence the shortage in the future.

Perrigo's official response...

Susan,

Thank you for reaching out.  We do not have a comment to provide at this time, thanks.


-Brad

Bradley Joseph
VP, Global Investor Relations and Corporate Communications
Perrigo Company plc

20mg/ml 5ml vial (Name Brand) $200 monthly supply. ($198 with GoodRX Coupon at Walmart)
20mg/ml 5ml vial (Generic) $120 monthly supply ($48 with GoodRX coupon at Walmart)

[SadieBlake]

Susan, I noted in another recent thread, may as well add it here ...

I spoke with customer service at Perrigo a couple of weeks ago when my local CVS said they couldn't source it. the response was that it had gone into backorder. I think they also said there was no particular manufacturing problem and in any case I knew there wasn't anything FDA reportable because I'd already checked the FDA website.

The cs rep also advised me that the backorder problem had started late January/early February and that it was expected to be back into normal supply by mid March.

Having worked in corporate medical / pharma for over 20 years I can assure you at least nobody I've ever worked for would answer questions about the details you requested.

[Susan]

Susan, I noted in another recent thread, may as well add it here ...

I spoke with customer service at Perrigo a couple of weeks ago when my local CVS said they couldn't source it. the response was that it had gone into backorder. I think they also said there was no particular manufacturing problem and in any case I knew there wasn't anything FDA reportable because I'd already checked the FDA website.

The cs rep also advised me that the backorder problem had started late January/early February and that it was expected to be back into normal supply by mid March.

Having worked in corporate medical / pharma for over 20 years I can assure you at least nobody I've ever worked for would answer questions about the details you requested.

The company that manufactures it for Perrigo states long term backorder, and referred all questions back to Perrigo. I am half tempted to start a funding campaign to create a low cost alternative supplier of the medication.

Each 20mg/5ml vial has 100mg of Estradiol Valerate  ($10,388.00 per kg which is 1,000,000mg)
1,120mg of Benzyl Benzoate (200 LT for $6383.85)
100mg of Benzyl Alcohol (200 LT for  $6235.70)
and the rest is made up of Caster Oil (200LT for $2516.80, 200,000 ML)

I would estimate their actual costs per vial is under $2 Add in manufacturing and packaging and we are still probably less than $5.00-$20.00. Yet it is being sold for $120-$220 per vial... This is obscene.

All of these ingredient prices are USP/medical grade from FDA approved manufacturers.

So the raw materials are not that expensive.

Manufacturing would have to be negotiated but you can get FDA Certified companies to handle the manufacture and packaging. Approval is the question mark, but if you keep the formulation identical then it should be manageable.

[Devlyn]

I see the parts cost, but the manufacturing expenses and liability are where the real money kicks in.

[Susan]

Unavoidably unsafe products

Some prescription drugs are considered "unavoidably unsafe" products. This means that no matter how well or carefully they are manufactured, they can never be made 100 percent safe. For example, these drugs may come with potentially harmful side effects, but are still prescribed because of their overall benefit to the user. If drugs in this category are found to have been manufactured properly and carry appropriate safety warnings then they cannot typically be used in a successful products liability lawsuit.

Unknown/known side effects

While drug manufacturers have a duty to warn about known side effects, they are not obligated to warn about unknown side effects or dangers. There is no duty to warn about possible reactions in unusually vulnerable users either but the fact that a possible known reaction is rare does not absolve the manufacturer of its duty to warn nor does it mean the patient experiencing the reaction is unusually vulnerable. Manufacturers typically work to eliminate their legal liability for the duty to warn by providing all relevant information to the patient's prescribing physician or to the pharmacist. Manufacturers are expected to stay on top of new studies or information about their products and take reasonable steps to update medical professionals on newly discovered side effects or possible adverse reactions.

[Colleen_definitely]

I see the parts cost, but the manufacturing expenses and liability are where the real money kicks in.

Yep, the machinery is not cheap.  Then you have record keeping, quality control, shipping, etc...

Could you do a small scale startup for under a mil?  I'm sure you could, staffing could be kept relatively low by using automation, but you better believe I'd want a full NMR and LC-MS workup on every single batch of EV and other materials coming in and going out.  The instrumental analysis could likely be farmed out and cut costs further, but I am not 100% sure where the FDA stands on that.