Reusable vs Disposable Pessary — Which Saves More in 2026?
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Reusable vs Disposable Pessary — Which Saves More in 2026?
Pessary shoppers in 2026 have a new decision to make. Fem Therapeutics, a single-use disposable pessary brand, launched wider US availability this year with a subscription model that runs roughly $400 per year. That sits next to the decades-old alternative: a traditional reusable silicone ring pessary, which typically costs around $50 up front and lasts a year or more with routine cleaning.
On the surface, the two products solve the same clinical problem — supporting pelvic organ prolapse or stress urinary incontinence without surgery. But the cost structures could not be more different, and cost is only part of the story. This article walks through the 5-year math, the situations where disposables genuinely make sense, what the clinical research says about outcomes for each approach, and a simple framework for choosing between them.
We are not going to tell you disposables are bad or that reusable is always right. Both have a place. What follows is a factual comparison so you can make the call for your own situation, budget, and lifestyle — with real numbers, real citations, and no hype.
The 5-year cost math
The clearest way to compare a disposable subscription against a reusable device is to run the numbers out over five years, since that is roughly the usable lifespan of a well-maintained silicone pessary. Below is a side-by-side breakdown of four common paths US patients take, including provider-fitted reusable options and a direct-to-consumer silicone pessary.
| Product | Upfront | Per year | 5-year total |
|---|---|---|---|
| Fem Therapeutics disposable | $400 | $400 | $2,000 |
| Milex reusable (via provider) | $100 + $150 fitting = $250 | $50 replacement | $500 |
| Uresta reusable (Canada import) | $329 + $30 fitting | $50 replacement | $580 |
| SciMed silicone reusable direct | $49.99 | ~$20–25 replacement every 12–24 mo | ~$150 |
A few things drive this gap. First, disposables are, by design, a recurring purchase — every unit is used once and thrown away, so the per-year cost never drops. Second, provider-fitted reusable pessaries (Milex, Uresta) carry a fitting fee that a direct-to-consumer model like SciMed's does not, since sizing guides and support materials replace an in-office visit for many patients. Third, medical-grade silicone is durable: a ring pessary that is cleaned and inspected on a normal schedule commonly lasts 12–24 months before it needs replacing, not a single use.
Over five years, the disposable path runs roughly $2,000, the provider-fitted reusable paths land between $500 and $580, and a direct-to-consumer silicone reusable comes in around $150 — about 13x cheaper than the disposable subscription and 3–4x cheaper than a provider-fitted reusable. None of this accounts for the office-visit time or co-pays some provider fittings require, which would widen the gap further for patients without easy clinic access.
When disposable makes sense
Cost isn't the only variable, and disposable pessaries solve real problems for specific situations. Travel is the clearest case: a single-use pessary means no cleaning routine, no case to pack, and no concern about water quality or hygiene access on the road — useful for a two-week trip even if it isn't the everyday solution.
First-trimester pregnancy is another scenario where some clinicians prefer a disposable approach, since pessary use during early pregnancy may be shorter-term and tied to a specific monitoring window, making a reusable device's longer lifespan less relevant.
Hospital stays and short-term post-procedure use also favor disposables for straightforward infection-control reasons — a single-use device avoids any question about sterilization between uses in a clinical setting.
Finally, patients with a history of recurrent bacterial issues traced to cleaning failures — for example, difficulty following a cleaning routine due to dexterity limitations, memory issues, or lack of private washing facilities — may be better served by a disposable product, since it removes the maintenance step entirely. This is a legitimate clinical reason to choose disposable even at higher cost, and it should be discussed with a provider rather than decided on price alone.
When reusable wins
For the majority of long-term pessary users, reusable silicone remains the more practical choice. Daily wear is the biggest factor: someone using a pessary continuously, day after day, accumulates the disposable subscription cost quickly, while a reusable device amortizes its low upfront price over many months of use.
HSA/FSA optimization also favors reusable purchases — a single, well-documented upfront cost is simpler to submit against a health savings or flexible spending account than a recurring subscription charge, and it uses less of a limited annual HSA/FSA balance.
Medicare reimbursement is a further advantage: pessaries are billed under HCPCS code A4562, and Medicare Part B and many supplemental plans reimburse a portion of the device cost when billed correctly by a provider. See our Medicare reimbursement guide for code A4562 for how this works in practice. Reimbursement pathways are generally built around a discrete device purchase, not a recurring disposable subscription, which makes reusable pessaries easier to bill.
For long-term prolapse management, where a pessary may be part of a patient's routine for years, the cumulative savings of a reusable device are substantial, as shown in the cost table above.
There is also an environmental consideration: a patient using a daily disposable pessary for five years goes through roughly 1,800–2,000 individual units, compared with 3–5 reusable devices replaced on a normal 12–24-month cycle over the same period. For patients weighing medical waste alongside cost, that difference is worth knowing.
Clinical outcomes — what the research shows
Cost and convenience matter, but outcome data should carry real weight in this decision, and here reusable silicone pessaries currently have the deeper evidence base. The TOPSY trial, a large UK randomized controlled trial registered on NCBI Bookshelf (NBK603994), evaluated pessary care for pelvic organ prolapse against a structured comparison arm and is among the most rigorously designed studies of pessary management to date. It focused on ring-style, provider-fitted reusable pessaries and provided outcome data on symptom improvement, quality of life, and continued use over a follow-up period — the kind of longitudinal evidence that is harder to generate for a product only recently available at scale.
A separate randomized controlled trial published in the International Urogynecology Journal in 2024 (DOI 10.1007/s00192-024-05933-x) compared silicone pessaries directly against PVC pessaries, examining material-specific outcomes such as comfort, discharge, and device-related complications. The trial's findings generally supported silicone as the better-tolerated material of the two, reinforcing why silicone has become the standard reusable pessary material over PVC in recent years.
Single-use disposable pessaries, including newer entrants like Fem Therapeutics, do not yet have a comparable body of published randomized trial data specific to their disposable format as of 2026. That does not mean they are ineffective — the underlying mechanical principle of pessary support is well established — but it does mean the specific claims made about disposable products rest more on manufacturer data and smaller studies than on the kind of large, independent RCT evidence available for reusable silicone. Patients who weight clinical evidence heavily in their decision-making should know this distinction going in, and it is worth raising directly with a provider rather than assuming equivalence.
How to choose
A simple decision framework can cut through most of the noise:
- Are you a daily wearer? Reusable silicone is very likely the more cost-effective and better-evidenced choice for continuous, long-term use.
- Are you an occasional traveler or short-term user? A mix can make sense — a reusable device for daily use at home, with disposables reserved for trips or situations where cleaning access is limited.
- Does your insurance cover pessary devices? Check whether your HSA or FSA can be used for the purchase, and ask your provider about billing under Medicare code A4562 — see the A4562 reimbursement guide for specifics on what's typically covered and how to request it.
- Do you have a history of cleaning-related infections or limited hand dexterity? This is a legitimate reason to discuss a disposable option with your provider, even though it costs more over time.
If you're still narrowing down which brand or style fits your situation, our guide to the top pessary brands in the USA compares the major reusable and provider-fitted options side by side.
Conclusion
For most US patients using a pessary as a long-term, non-surgical option for pelvic organ prolapse or stress urinary incontinence, a reusable silicone pessary is roughly 10–13x cheaper over five years than a disposable subscription model, while also being backed by more extensive randomized controlled trial evidence, including the TOPSY trial and the 2024 silicone-vs-PVC comparison cited above. Disposable pessaries remain a reasonable, medically justified choice for travel, certain pregnancy scenarios, hospital stays, and patients with specific cleaning-related infection histories — but they are not automatically the safer or more convenient default for everyday use.
If you're evaluating reusable silicone options, SciMed's full line of vaginal silicone ring pessaries — including versions with and without support — is outlined on our vaginal silicone ring pessary page, alongside sizing guidance and care instructions. You can also view the individual products directly: Silicone Ring Pessary Without Support and Silicone Ring Pessary With Support.
This article is for general information and does not replace individualized medical advice. Talk to your provider before starting or switching pessary types.
Frequently asked questions
Can I use disposable and reusable together?
Yes. Many patients keep a reusable silicone pessary for daily use at home and carry disposables for travel or short trips where cleaning access is limited. There's no clinical conflict in alternating between the two, as long as sizing is consistent and you follow the care instructions for whichever device you're using.
Does insurance cover disposable pessary?
Coverage varies by plan and is generally easier to secure for a discrete device purchase billed under HCPCS code A4562 than for a recurring subscription product. Some insurers and HSA/FSA administrators will reimburse disposable pessaries, but you should confirm with your specific plan before assuming coverage, since subscription billing structures aren't always handled the same way as a one-time device purchase.
How long does a silicone reusable actually last?
With regular cleaning and inspection, most medical-grade silicone ring pessaries last approximately 12–24 months before replacement is recommended. Actual lifespan depends on wear frequency, cleaning routine, and how the device is stored between uses.
Are disposables safer against infection?
Disposables remove the maintenance step, which can lower infection risk specifically for patients who struggle with a consistent cleaning routine due to dexterity, memory, or hygiene-access limitations. For patients who clean their reusable pessary correctly and consistently, published research — including the 2024 silicone-vs-PVC RCT — does not show reusable silicone carrying a materially higher infection risk. The right choice depends on the individual's ability to maintain a cleaning routine, not on disposables being universally safer.
Which do gynecologists prescribe more often?
Reusable silicone ring pessaries remain the more commonly prescribed option in routine gynecologic and urogynecologic practice, in part because of their longer track record, lower long-term cost for patients, and the larger evidence base — including trials like TOPSY — supporting their use in ongoing prolapse and incontinence management. Disposable options are typically recommended for specific situations rather than as a first-line default.