Susan's Place Transgender Resources

I'm still pre HRT but just got a RX for propecia and still waiting for it to be filled so i haven't gotten it yet but while waiting ive been looking up the prices for it since I don't think my insurance will cover "cosmetic prescriptions" and everything I've been finding online says its around $100 for a 30 day bottle! is this really how much it costs per month and is it really necessary since ill probably start spiro in 2-4 months? I really cant afford $100 a month and I haven't lost too much hair and probably wont for another few years or more. does spiro alone stop DHT or do i really need finasteride as well? also are there any ways to legally buy prescriptions online? everything i find online is from some sketchy website which i don't trust one bit.

When I was taking Finastertide (generic Propecia Strength specifically for MPB, hence cosmetic) at Costco it costs me $28 for a 90 day supply without insurance but with a prescription discount card I got for free at Costco. My HRT doctor switched me the higher strength version (generic Proscar that's 5 times the dosage of Propecia, but is for shrinking the prostate.) It is cheaper at $12 for a 90 day supply at Costco. (I believe Wal-Mart is a few dollars more, but not by much.)

Shop around if you can or ask doctor for the higher strength version because it's a lot cheaper and if your already going to be taking HRT, it's not going to cause any side effects that Spiro is going to already give you.

Now is it necessary, well I think it maximizes your chance to have a full head of hair. It made a huge difference for me.

The prices Sydney_NYC qoutes from Costco are far better than I can do locally.  I have no Costco in reasonable distance out here in the sticks.  I can get a coupon from GoodRx.com that gets me a 30 day supply of the 1 mg Finisteride for $40.05 - for the 5 mg strength it would be $44.83.  That still beats paying full price.

X1 on shopping around.


Erin

My local Walmart offers 5mgs 30 tablets of Finastertide for 9 bucks.

I am not sure why main brands continue to gouge their costumers when their are generics out there that are the same thing for less cost.

Also check out goodrx.com it is a site that offers coupons and discounts on "ALOT" of different types of medications.

I don't know much about how prescriptions work but I was prescribed the brand name propecia can I just ask the pharmacist to switch it to the generic or do I have to call my Dr to switch it?

I pay $8.50 for two months of finasteride in Canada.

I also use goodrx and paid $35 for a month supply. You just print out the coupon and it dropped my cost down from $71. I feel that spiro either greatly slowed down my rate of hair loss or stopped it altogether. I just started taking finasteride too, and while I don't like what it costs I really don't want to risk losing hair. You should read up on propecia versus proscar as they are (nearly) the same exact thing (not mentioning doses because of site's tos). I requested avodart (dutasteride) but my endo wasn't comfortable with that. I also asked for proscar but she didn't like that either (but from what I've read many docs are ok with it and you can save a ton of money). Good luck!

All good info.  Finasteride is exactly the same as Propecia.  Don't buy the brand;the generic is dirt cheap.  Also (and I hope this doesn't breach any dosage rules) the Finasteride comes in 5mg tablets that are easily split into smaller doses, and a 30 day supply often lasts twice as long.  It's pennies per month under my insurance, and $9 for a month of 5mg tablets without.  Not sure why anyone is paying more than that in the US.

But yeah, if you're committed to retaining all your hair, it's a no-brainer.  Cheap, proven effective.

Quote from: QuestioningEverything on August 18, 2014, 04:00:13 PM
I don't know much about how prescriptions work but I was prescribed the brand name propecia can I just ask the pharmacist to switch it to the generic or do I have to call my Dr to switch it?

Ask the pharmacist.  Unless the prescription has the "brand medically necessary" box checked, the generic should be no problem.  Your doc also should have no problem rewriting the script for a generic 5mg/day.  If the doc doesn't want to, I'd be surprised and suspicious.

Ask your doctor to write you a prescription for the larger pill which is not considered cosmetic and with the instruction to cut it into smaller pieces as needed according to his dosage for you. Exact same drug. That's what I've been doing for years. I've had several doctors who were all okay with it over the years. No harm in asking. They understand the drug biz nonsense and that people are on budgets. Like someone said, $9 at Walmart and all I'll say is it lasts more than a month at the particular dose I've been prescribed (for completely different non-trans-related issues and the dosage of which I will not be disclosing. I've gotten a hand-slap for mentioning it before). Even if your prescription is for a larger dose, that's pretty cheap!

Quote from: QuestioningEverything on August 18, 2014, 04:00:13 PM
I don't know much about how prescriptions work but I was prescribed the brand name propecia can I just ask the pharmacist to switch it to the generic or do I have to call my Dr to switch it?

I think it's not just about the generic. It's about the dosage size. The smaller dose cosmetic version is more expensive, ironically, and probably not covered by insurance. You DO have to ask your doctor if (s)he will write you a prescription for the larger dose with instructions to cut it into smaller pieces. If they approve, and I think they will, then just buy a pill splitter for about 2 bucks.

Quote from: dalebert on August 18, 2014, 06:07:07 PM
I think it's not just about the generic. It's about the dosage size. The smaller dose cosmetic version is more expensive, ironically, and probably not covered by insurance. You DO have to ask your doctor if (s)he will write you a prescription for the larger dose with instructions to cut it into smaller pieces. If they approve, and I think they will, then just buy a pill splitter for about 2 bucks.

I'll have to try that, i just don't understand how the higher dose is about 10x cheaper then the lower one! The drug industry is messed up!

Quote from: QuestioningEverything on August 18, 2014, 06:12:42 PM
I'll have to try that, i just don't understand how the higher dose is about 10x cheaper then the lower one! The drug industry is messed up!

Because it's considered cosmetic and because marketing. I think it's a sign that most people care more about their looks than their health in first world countries. FWIW, I used to go to the gym 3 or 4 times a week to get all buff and hot. I eventually lost that motivation as my sex drive finally went down a little bit. Now I do yoga to battle pain from aging, so my joints won't hurt and such, and I find that feeling better is actually a more powerful motivator to do my exercise.

Interesting read on the cost of Propecia vs Proscar:

http://blogs.law.harvard.edu/billofhealth/2013/02/15/the-high-cost-of-health-care-why-some-pay-240-for-a-9-bottle-of-pills/ (http://blogs.law.harvard.edu/billofhealth/2013/02/15/the-high-cost-of-health-care-why-some-pay-240-for-a-9-bottle-of-pills/)

To answer your question on whether Spiro is enough. There isn't really a lot of scientific evidence because we are not a well studied group. But the wisdom I've been taught is that Spiro isnt enough. What Sprio does is it blocks T from the receptors. Which is fantastic! But that T can still be converted to DHT, which can still cause hairloss and other masculinizations. So is a DHT blocker necessary? Consult your doctor but a lot of doctors will add it to the regimen.

I noticed that most of the girls around here take dutasteride instead of finasteride, and so I did some research.  It turns out dutasteride is more effective because it blocks both kinds of DHT.  So I got my doctor to switch my prescription, but apparently there isn't yet a generic version of avodart (dutasteride), so it was going to cost me $170 per month.  And since my insurance doesn't do avodart at all, I'm back to finasteride. 

And apparently I've been overpaying for finasteride...$30 per month or so. :(

I'll be switching insurance companies after moving to Seattle in a few weeks, so I'll take a crack at switching again then.

Quote from: katiej on August 18, 2014, 11:01:58 PM
I noticed that most of the girls around here take dutasteride instead of finasteride, and so I did some research.  It turns out dutasteride is more effective because it blocks both kinds of DHT.  So I got my doctor to switch my prescription, but apparently there isn't yet a generic version of avodart (dutasteride), so it was going to cost me $170 per month.  And since my insurance doesn't do avodart at all, I'm back to finasteride. 

And apparently I've been overpaying for finasteride...$30 per month or so. :(

I'll be switching insurance companies after moving to Seattle in a few weeks, so I'll take a crack at switching again then.

Katie -

So for the DHT that Finasteride doesn't block, what does this do?

Here's a good article by a hair restoration doctor comparing the two:  http://californiahairsurgeon.com/news/dutasteride-vs-finasteride/

Just putting this here from another related thread.

https://www.susans.org/forums/index.php/topic,164001.msg1414580.html#msg1414580

arg my dr wont let me switch to the higher dose pill since its not actually meant to be split and isn't technically approved for hair loss. that leave me either paying $90 a month or ill probably just wait till october when i meet with in endocrinologist about transitioning and see what they say.  >:(

Quote from: QuestioningEverything on August 20, 2014, 03:54:18 PM
arg my dr wont let me switch to the higher dose pill since its not actually meant to be split and isn't technically approved for hair loss. that leave me either paying $90 a month or ill probably just wait till october when i meet with in endocrinologist about transitioning and see what they say.  >:(

Those are BS reasons.  Not meant to be split?  Isn't technically approved for hair loss?  Switch docs: he or she is either serving the insurance companies and not you, or just plain misinformed.  Splitting 5mg Finasteride tablets is commonly done, and the drug itself acts in the same manner whether it comes from a quarter of a 5mg tablet or an entire 1mg tablet (assuming there are no time-release characteristics that are being defeated by splitting the tablet, which is not the case for Finasteride.)

Your endo can prescribe Finasteride.  Hopefully he or she is not as stubborn.

Seriously, switch docs.  Any physician who would rather you couldn't afford a brand name and have no access to treatment as a result, instead of offering you a common, safe alternative, is a genuinely ->-bleeped-<-ty medic.  Their loyalty should be to you, not Merck.

I'll be asking this same question to my Dr next week. Im just starting to get a little concerned about what I have read about left over T can transform into little grimlins that feed on hair.  (I was looking up the side effects and how spiro works)

  :icon_punch:   t is such a bully!! 


...revenge will be a dish best served under anesthetics   c:
:icon_chainsaw:

Get on dutasteride. You can take it twice a week and still suppress DHT more than fin daily. For me it was a headache cutting and actually taking it twice a day.

I don't think my current dr is really trying to screw me over as they have no idea that im thinking about transitioning and they are just trying to treat me like a typical guy who doen't want to loose their hair and by splitting the pill you might not get an equal dose every time so they would keep me on the lower dose to avoid the negative side effects. Even though i don't really care about a lot of the sexual side effects. Whatever I'll just wait, the endo im going to see deals with trans patients all the time and ill bring up finasteride/avodart. I'm just terrified that I wont be able to afford all the medication and if every pill is going to cost $100 a month I'm going to be running into some financial issues.

Quote from: QuestioningEverything on August 20, 2014, 07:20:53 PM
I don't think my current dr is really trying to screw me over as they have no idea that im thinking about transitioning and they are just trying to treat me like a typical guy who doen't want to loose their hair and by splitting the pill you might not get an equal dose every time so they would keep me on the lower dose to avoid the negative side effects. Even though i don't really care about a lot of the sexual side effects. Whatever I'll just wait, the endo im going to see deals with trans patients all the time and ill bring up finasteride/avodart. I'm just terrified that I wont be able to afford all the medication and if every pill is going to cost $100 a month I'm going to be running into some financial issues.

One reason your Dr doesn't want you to go to the higher dosage is that it will most definitely have a higher change of giving you ED (Erectile Dysfunction) than the smaller dosage.

As a side note, HRT prescriptions are much cheaper. Without insurance I pay $20/month for Spiro and about $22/month for Estrogen (injection). On the injectable Estrogen (Estradiol Valerate), it's a little cheaper than the pill form, but you pay more up front. A 5 month supply (I pay up front) costs about $108 and the pharmacy charges $2.50 for syringes and needles for the same 5 months.

Quote from: QuestioningEverything on August 20, 2014, 07:20:53 PM
I don't think my current dr is really trying to screw me over as they have no idea that im thinking about transitioning and they are just trying to treat me like a typical guy who doen't want to loose their hair

If you want to start circa October you should definitely let your doctor know. There is little to worry about.

Quote from: Sydney_NYC on August 20, 2014, 10:54:38 PM
One reason your Dr doesn't want you to go to the higher dosage is that it will most definitely have a higher change of giving you ED (Erectile Dysfunction) than the smaller dosage.

She wouldn't actually be taking the higher dosage. She would be cutting it to fit the smaller dosage. It would just be cheaper but do the same thing.

QuoteAs a side note, HRT prescriptions are much cheaper. Without insurance I pay $20/month for Spiro and about $22/month for Estrogen (injection). On the injectable Estrogen (Estradiol Valerate), it's a little cheaper than the pill form, but you pay more up front. A 5 month supply (I pay up front) costs about $108 and the pharmacy charges $2.50 for syringes and needles for the same 5 months.

Some have said in the thread that regular HRT alone doesn't always block DHT properly.

Dutasteride (Avodart) literally saved my hair. My genetics are somewhat unique, causing me to have very low T naturally, and having them most Doc's didn't think it was DHT causing my hair loss. I couldn't get my PC to even prescribe me Finasteride in low dose form. All he wanted to do is run test after test after test. However, upon beginning my hrt and finding my Endo, my hair loss stopped in it's tracks, and began reversing on the 3rd day in. Thus, it had to be DHT. Therefore I believe everything I've read about lingering low T levels causing DHT production and "feeding on hair," as someone else wrote.

Best wishes.

Ally :icon_flower: