How Much Sermorelin Costs Per Month, and Why There Is No Insurance Price

This is the fact that sets sermorelin's price and decides its insurance status, and most pages that quote a price leave it out.

There was a branded sermorelin, and its maker stopped selling it. Sermorelin acetate was sold in the United States as Geref, an injection made by EMD Serono. One version was approved in 1990 to test whether the pituitary could release growth hormone; the other was approved in 1997 to treat growth hormone deficiency in children with growth failure. In 2008 the company told the FDA it was discontinuing both, and the FDA withdrew their approvals effective June 18, 2009 [1].

The FDA found the withdrawal was not for safety or effectiveness reasons. On March 4, 2013, in response to a citizen petition, the FDA published a determination in the Federal Register that both Geref products "were not withdrawn from sale for reasons of safety or effectiveness." After reviewing its own records and the postmarketing literature, it kept Geref on the discontinued list rather than removing it [1]. The FDA's drug database still lists Geref as discontinued, with that determination noted [2].

No approved replacement has arrived. The 2013 determination made it legally possible for a company to seek approval of a generic that referred back to Geref [1]. None has been approved: the FDA's drug-approval data lists only the two Geref applications for sermorelin, both discontinued [3].

So what is prescribed today is compounded. A pharmacy prepares it for an individual patient under a prescription. Compounded drugs are not FDA-approved, which means the FDA does not verify their safety, effectiveness or quality before they reach you [4]. The sermorelin prescribed through ACT 2 is a compounded oral dissolving tablet; it is not Geref, and Geref was only ever an injection.

What that means for the price

• There is no list price to anchor to. With no branded product on sale, there is no manufacturer price, no manufacturer savings card and no generic to look up at a retail pharmacy.
• Prices vary between providers for real reasons. What you pay elsewhere depends on the route (tablet or injection), whether lab work and clinician visits are bundled or billed separately, and how often you are reviewed. Compare the all-in monthly cost, not the headline.
• At ACT 2 the medication and the care are one price, $199 a month, with labs added separately.

What that means for insurance

• There is no branded version for a plan to cover. Insurance formularies list approved drugs, and no approved sermorelin product is on the market.
• Medicare does not cover it as a drug. Medicare's drug benefit does not treat a compounded product as a whole as a covered Part D drug, and bulk ingredients used for compounding are not covered at all [5].
• Geref's approved use was narrow. Even when it was sold, its treatment approval was for children with growth hormone deficiency [1], not adults in midlife.
• ACT 2 is direct-pay and does not bill insurance, Medicare or Medicare Advantage for any treatment or lab panel.

For HSA and FSA money, the IRS excludes expenses that are merely beneficial to general health [6], and eligibility is decided by your plan administrator, not by ACT 2. The pricing and insurance FAQ covers how to ask.

$2,786 for twelve months, assuming a monthly supply every month for a year, one comprehensive lab panel at baseline and one at review, and no welcome discount. Your clinician decides which labs you need and how often, so the lab share can be higher or lower.

A realistic first budget is shorter. Sermorelin is monitored against your baseline, and if nothing is moving at review, the plan is to stop. Three months of supply plus a baseline panel costs $796, assuming three monthly supplies and a single panel before starting.

New patients receive 10% off their first order, which applies to a sermorelin order but not to lab panels. The code is at the welcome offer page; the figures above do not include it.

If your symptoms suggest a pituitary problem, such as a known pituitary condition or changes that point to more than one hormone, that is an in-person endocrinology workup, not a direct-pay telehealth prescription. And if your IGF-1 is already at the upper end of the range for your age, you are not a sermorelin candidate, and the baseline panel will have been the only thing worth paying for. The cancer risk page sets out the other situations where sermorelin is ruled out.