- by QueerDoc
Running out of gender affirming medications, like leuprolide acetate, can lead to severe dysphoria, depression, and anxiety. It can put the physical safety of gender diverse people at risk. QueerDoc believes the supply of gender affirming medications should be consistently stable and accessible to all. We believe healthcare is a right not a privilege. Unfortunately, access issues and supply issues do occur. Here are some strategies you can try when this happens. We also recognize that navigating healthcare and pharmacies requires emotional energy and time which not all of us have. We encourage you to ask for help from your clinic, case manager, provider, or support people.
- Stay informed about shortages at the ASHP website and the FDA website
- Keep an extra vial on hand
- This can be tough because insurance often times only covers a 28 day or 90 day supply
- Attempt a prior authorization with your provider for an extra one-three month supply
- Consider paying cash for an extra one-three month supply when it is not in shortage (thus prices are low)
- Use GoodRx app or website for cash pay coupons (this is not always accessible with leuprolide)
- Consider ordering from a compounding pharmacy which may have better pricing for back up vial
- This can be tough because insurance often times only covers a 28 day or 90 day supply
- Check around at different pharmacies
- Each local pharmacy will run low at different times based on their pre-existing stock
- Have your provider send your prescription to that verified pharmacy or have the pharmacist transfer an existing prescription for you
- Consider national mail-order pharmacy like CVS Caremark
- Consider vetted international pharmacies*
- Each local pharmacy will run low at different times based on their pre-existing stock
- Consider different formulations of leuprolide acetate or getting a puberty blocking implant
- Lupron Peds Depot 3 month: comes in 11.25mg and 30mg
- Lupron Peds Depot 1 month: comes in 7.5mg, 11.25mg, and 15mg (weight based dosing)
- Lupron Depot 1 and 3 month formulations (adult fomulation can be used in youth)
- Adult Formulation Eligard: 7.5 mg: 1 month of therapy, 22.5 mg: 3 months of therapy, 30 mg: 4 months of therapy, 45 mg: 6 months of therapy (can be used in youth)
- Histrelin or Vantiss implant- 18 months of therapy
- Most insurances will require a new prior authrization for a change in formulation
- Work with your provider to change formulations during shortages
- Patient assistance programs are available usually at the pharmaceutical manufactueres website of a product that may not be covered by your insurance
*International pharmacies
Ordering prescriptions online can be both illegal and unsafe. Before ordering online, research and vet the pharmacy and be aware that your order could be confiscated.
Legality:
The FDA has issued “Coverage of Personal Importations” guidance for consumers and enforcers. You can import a 90-day supply of some prescription drugs and medical devices if you meet the following conditions:
- It is to be used to treat a serious condition and no effective treatment is available in the United States.
- You won’t be selling it or promoting it to others in the United States.
- The medication doesn’t represent an unreasonable risk.
- You affirm in writing that the drug is for your personal use.
- The quantity is no more than a three-month supply and you provide the name and address of the doctor licensed in the United States responsible for your treatment with the medication; or, you provide evidence that the medication is for continued treatment begun in a foreign country.
Safety:
Use these resources to vet your Canadian (recommended) or other foreign pharmacies:
