CombiPatch doesn’t have a generic version currently. That may explain your high copay, especially if it’s on a non-preferred formulary tier.

The estrogen (estradiol) in CombiPatch is bioidentical, but the progestin part (norethindrone acetate) is synthetic. You can get the same estrogen from a much cheaper generic estradiol patch, and pair it with micronized progesterone (generic for Prometrium) which is bioidentical.

It’s worth discussing with your prescribing physician to see if switching is appropriate for you. My obgyn prescribed Vivelle-Dot (patch) and Prometrium (oral pill) - both have generics, and my 3mo supply costs $20 each (with commercial insurance). A nice bonus: Prometrium often helps with sleep when taken at bedtime.