Abstract
Abstract Introduction Clomiphene, known by the brand-name Clomid, is used off-label as empiric medical therapy to improve testosterone and sperm parameters in men. Despite its role in the medical management of male infertility and hypogonadism, this selective estrogen receptor modulator (SERM) is rarely covered by insurance for these indications. Typically taken daily or every other day for 3-6 months, this lack of coverage makes the high and variable prices a barrier to fertility care for many patients. Objective This study sought to analyze the price variability of compounded clomiphene and brand name Clomid across the United States and identify regions where patients might face potential undue financial burden based on their geographical location. Methods Prices for compounded clomiphene 25 mg-50 mg and brand-name Clomid (50 mg) for 30-day and 90-day supplies were collected from 136 compounding pharmacies nationwide via phone; national retail pharmacy prices were recorded via GoodRx. The weighted average price per pill, minimum, and maximum values for each dosage were calculated. States were categorized into four regions (Northeast, Midwest, West, South) for regional analysis. Results The weighted mean price per pill for clomiphene 25 mg, clomiphene 50 mg, and Clomid were $2.21 ± 1.24; $2.60 ± 1.49; and $8.41 ± 1.53, respectively, from compounding pharmacies. In comparison, the national Clomid retail pharmacy average with GoodRx discount was $4.30 ± 0.29. The weighted per-pill averages in each region are presented in Table 1. Compounded clomiphene is a significantly more affordable alternative to the brand-name Clomid given the limited insurance coverage (p < 0.001). Additionally, patients face significantly varying average prices across different regions (p = 0.0441), with particularly higher average prices in the West and Northeast. The least and most expensive prices per pill of brand-name Clomid (without GoodRx) were $7.51 and $10.83 in the Northeast, $4.50 and $13.21 in the Midwest, $6.34 and $11.67 in the South, and $5.16 and $13.44 in the West. The greatest variation was in the Midwest, at $8.71 per pill ($784 for 90 pills). This was followed by the West with a difference of $8.28, the South with $5.33, and the Northeast with $3.32 (Fig. 1). Conclusions There are significant differences in the pricing of clomiphene (Clomid) across regions, with some regions experiencing more notable internal variations. These pricing trends could potentially hinder access to treatment and pose substantial obstacles for patients. Disclosure No.
Published Version
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