Unpacking the Question: Mifepristone 25 mg Availability
The query about the price of a 25 mg dose of mifepristone is specific and points to a less common application of this versatile medication. While mifepristone is widely recognized for its use in medical abortion (typically a 200 mg dose) and for treating Cushing's syndrome (at 300 mg), a 25 mg dosage is not a standard commercially available product in many markets like the U.S [1.3.2, 1.3.7]. Instead, the 25 mg strength is primarily found in the context of clinical studies and for treating uterine fibroids (myomas) in some countries [1.3.8]. For instance, some suppliers in India list mifepristone 25 mg tablets for conditions like uterine fibroids, with prices around ₹760 (approximately $9 USD) [1.2.6]. One Indian manufacturer lists a box for ₹5,500 [1.2.8]. Because it is not a widely-approved dosage in the US, a standard price is not readily available through typical pharmacies [1.2.1, 1.2.2].
The Pharmacology of Mifepristone
Mifepristone is a synthetic steroid that functions as an antiprogestational and antiglucocorticoid agent [1.3.3]. Its primary mechanism involves blocking the effects of progesterone, a hormone crucial for maintaining a pregnancy [1.3.7]. By binding to progesterone receptors, it prevents the hormone from sustaining the uterine lining, leading to the termination of an early pregnancy [1.3.2]. At higher doses, mifepristone also blocks glucocorticoid receptors, which is the basis for its use in treating hyperglycemia in patients with Cushing's syndrome, a condition caused by excess cortisol [1.3.3]. This dual action makes it a versatile drug with distinct applications depending on the dosage.
Standard Dosages and Their Associated Costs
To understand the cost of mifepristone, it's essential to look at its approved and most common formulations.
Mifepristone for Medical Abortion (200 mg)
The FDA-approved regimen for medical termination of pregnancy involves a single 200 mg tablet of mifepristone, followed by misoprostol [1.3.7]. The cost for this regimen can vary significantly. Without insurance, the average cost is around $580 to $600, though it can range up to $800 or more depending on the clinic and location [1.5.1, 1.5.6]. With discount coupons, a single generic 200 mg tablet can be priced as low as $38.56 at some U.S. pharmacies [1.2.3]. Several factors influence this cost, including insurance coverage, state laws, and whether the service is obtained via telehealth or an in-person visit [1.6.5, 1.6.6].
Mifepristone for Cushing's Syndrome (300 mg - Korlym)
Mifepristone is marketed under the brand name Korlym for the treatment of high blood sugar in adult patients with endogenous Cushing's syndrome [1.3.4]. Korlym comes in 300 mg tablets, and the treatment is significantly more expensive. The price for a supply of 28 or 30 tablets can range from over $19,000 to more than $22,000 without insurance [1.4.6, 1.4.2]. Using discount cards, the price for a 30-day supply might be reduced to around $5,165 [1.2.5, 1.7.4]. The high cost is attributed to its status as an orphan drug, which grants the manufacturer market exclusivity for treating a rare disease [1.4.5]. Medicare coverage for Korlym has shifted, with many 2025 formularies favoring the generic mifepristone instead [1.4.1].
Comparison of Mifepristone Uses and Costs
| Indication | Typical Dosage | Brand Name(s) | Average Cost (Without Insurance) | Key Facts |
|---|---|---|---|---|
| Medical Abortion | 200 mg mifepristone, then misoprostol | Mifeprex, Generic | $580 - $800 per regimen [1.5.1, 1.5.6] | Used within the first 10 weeks (70 days) of gestation [1.3.7]. Price includes the two-drug regimen. |
| Cushing's Syndrome | 300 mg - 1200 mg daily | Korlym, Generic | ~$20,000+ per month [1.4.4, 1.4.6] | Used to control hyperglycemia by blocking cortisol [1.3.2]. Designated as an orphan drug [1.4.5]. |
| Uterine Fibroids | 25 mg daily (in some studies/countries) | Mifeone, Miton 25 | ~$9 USD per tablet (India) [1.2.6] | Not a standard FDA-approved use [1.3.8]. Research suggests it effectively controls bleeding and reduces myoma volume [1.3.8]. |
Factors Influencing Mifepristone's Price
The price a patient pays for mifepristone is influenced by several variables:
- Brand vs. Generic: Generic versions are typically less expensive than their brand-name counterparts like Mifeprex and Korlym [1.6.1].
- Insurance Coverage: Health insurance plans vary widely in their coverage of mifepristone for both abortion and Cushing's syndrome. Some state Medicaid programs cover it, while others do not [1.5.3, 1.5.6].
- Geographic Location: Prices and availability can differ significantly between states and countries, influenced by local laws and healthcare systems [1.6.6].
- Dosage and Indication: The intended use dramatically affects the price. The high-dose daily regimen for Cushing's syndrome is orders of magnitude more expensive than the single-dose 200 mg tablet for medical abortion [1.7.7].
- Manufacturing Costs: The cost of the active pharmaceutical ingredient (API) is a major driver, with quality-assured mifepristone API being significantly more expensive than non-quality-assured versions [1.6.2, 1.6.4].
Conclusion
Revisiting the original question, 'What is the price of mifepristone 25 mg?', the answer is complex. In the United States, this dosage is not standard, so a fixed price does not exist in the consumer market. Its use is largely investigational or occurs in other countries where it is used to treat conditions like uterine fibroids at a much lower cost than the dosages available in the U.S. The price of mifepristone is not monolithic; it is deeply tied to its intended medical use, dosage, regulatory approval, and a host of economic factors. For medical abortion, the cost is typically several hundred dollars for a complete regimen, while for Cushing's syndrome, it can run into tens of thousands of dollars per month.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Consult with a healthcare professional for any medical concerns or before making any decisions related to your health or treatment.
Authoritative Link: FDA Questions and Answers on Mifepristone [1.3.7]
