cost of NEXPLANON

can you get NEXPLANON for free?

The cost of NEXPLANON depends on your insurance plan. You may be able to get  NEXPLANON for free, as a result of the Affordable Care Act.

Once you and your doctor have decided that NEXPLANON is right for you, check with your insurance  plan for cost and coverage information. You may need to pay a co-pay, deductible, or other charges.

how much will you have to pay for NEXPLANON?

Figuring out what you might pay out-of-pocket for a prescription medicine can be confusing. What you pay will depend on many factors, including your insurance situation. At Merck, we believe that you should be better able to understand what you can expect to pay out of your own pocket for your prescription medicine.

The Affordable Care Act (ACA) covers one type of birth control from each of 18 FDA-approved categories of birth control for women without charging a co-payment or co-insurance even if you haven’t met your deductible. This coverage includes the arm implant, NEXPLANON. Some patients may still be responsible for other costs associated with the product. This could include fees associated with insertion and/or removal procedures.

The list price for one rod (for up to 3 years of continuous pregnancy prevention) of NEXPLANON is $934.82.*

Most women will not pay the list price, although it may have an impact on your out-of-pocket costs.** The amount you pay will depend on many factors including your insurance situation. The information below will help you better estimate what you may pay for your prescription medicine based on your insurance situation. For the actual out-of-pocket cost, talk to your insurance provider who knows the details of your plan if you have insurance, or contact your health care provider’s office.

*The list price is current as of October 2019. The list price does not include other treatment-related costs, such as insertion and/or removal procedure fees.

**The out-of-pocket costs include the price patients paid for NEXPLANON.

Choose an option below that best describes your insurance situation:

I have commercial insurance through an employer or private policy that covers NEXPLANON

For patients with commercial insurance, 96% of patients paid no out-of-pocket costs for NEXPLANON. For those patients who did have out-of-pocket costs, 80% of patients paid between $5 and $899 for NEXPLANON.1

1IQVIA Nexplanon OOP Costs, October 2019. Based on an analysis of 2018 commercial, Medicare and Medicaid claims. Commissioned by Merck, Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. IQVIA’s analysis is based on remittance data that provides claim payment information after medical claims have been processed by the patient’s medical insurer and assigned to primary payer channel. The data is limited to remittance transactions on medical claims collected by IQVIA and may not constitute a nationally representative sample. Please note that a patient’s cost may differ from the amounts depicted above.

I have coverage for NEXPLANON through Medicare

For patients with Medicare, 99.4% of patients paid no out-of-pocket costs for NEXPLANON. For those patients who did have out-of-pocket costs, 80% of patients paid between $25 and $887 for NEXPLANON.1

1IQVIA Nexplanon OOP Costs, October 2019. Based on an analysis of 2018 commercial, Medicare and Medicaid claims. Commissioned by Merck, Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. IQVIA’s analysis is based on remittance data that provides claim payment information after medical claims have been processed by the patient’s medical insurer and assigned to primary payer channel. The data is limited to remittance transactions on medical claims collected by IQVIA and may not constitute a nationally representative sample. Please note that a patient’s cost may differ from the amounts depicted above.

I have coverage for NEXPLANON through Medicaid

For patients with Medicaid, 99.7% of patients paid no out-of-pocket costs for NEXPLANON. For those patients who did have out-of-pocket costs, 80% of patients paid between $1 and $899 for NEXPLANON.1

To learn more about Medicaid in your state and find out if you’re eligible, visit www.medicaid.gov/medicaid-and-you/index.html

1IQVIA Nexplanon OOP Costs, October 2019. Based on an analysis of 2018 commercial, Medicare and Medicaid claims. Commissioned by Merck, Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. IQVIA’s analysis is based on remittance data that provides claim payment information after medical claims have been processed by the patient’s medical insurer and assigned to primary payer channel. The data is limited to remittance transactions on medical claims collected by IQVIA and may not constitute a nationally representative sample. Please note that a patient’s cost may differ from the amounts depicted above.

I don’t have insurance, or NEXPLANON is not covered by my insurance.

If you don’t have insurance coverage, or if your insurance does not cover your treatment with NEXPLANON, you could pay an amount closer to the list price shown above, plus any additional charges depending on where you receive your medicine.

learn more

about insurance information

INSURANCE  

Important Safety Information
  • You should not use NEXPLANON if you are pregnant or think you may be pregnant; have or have had blood clots; have liver disease or a liver tumor; have unexplained vaginal bleeding; have breast cancer or any other cancer that is sensitive to progestin (a female hormone), now or in the past; or are allergic to anything in NEXPLANON.
  • Talk to your health care provider about using NEXPLANON if you have diabetes, high cholesterol or triglycerides, headaches, gallbladder or kidney problems, history of depressed mood, high blood pressure, allergy to numbing medicines (anesthetics) or medicines used to clean your skin (antiseptics). These medicines will be used when the implant is placed into or removed from your arm.
  • Immediately after the NEXPLANON implant has been placed, you and your health care provider should check that the implant is in your arm by feeling for it. If you cannot feel the NEXPLANON implant, contact your health care provider immediately and use a non-hormonal birth control method (such as condoms) until your health care provider confirms that the implant is in place. You may need special tests to check that the implant is in place or to help find the implant when it is time to take it out.
  • The implant may not be placed in your arm at all due to failed insertion. If this happens, you may become pregnant. Removal of the implant may be very difficult or impossible if the implant is not where it should be. Special procedures, including surgery in the hospital, may be needed to remove the implant. If the implant is not removed, then the effects of NEXPLANON will continue for a longer period of time. Other problems related to insertion and removal include pain, irritation, swelling, bruising, numbness and tingling, scarring, infection, injury to the nerves or blood vessels, and breaking of the implant. Additionally, the implant may come out by itself. You may become pregnant if the implant comes out by itself. Use a back-up birth control method and call your health care provider right away if the implant comes out.
  • The most common side effect of NEXPLANON is a change in your normal menstrual bleeding pattern. In studies, one out of ten women stopped using the implant because of an unfavorable change in their bleeding pattern. You may experience longer or shorter bleeding during your periods or have no bleeding at all. The time between periods may vary, and in between periods you may also have spotting.
  • If you become pregnant while using NEXPLANON, you have a slightly higher chance that the pregnancy will be ectopic (occurring outside the womb) than do women who do not use birth control. Ectopic pregnancies can cause serious internal bleeding, infertility, and even death. Call your health care provider right away if you think you are pregnant or have unexplained lower stomach (abdominal) pain.
  • The use of NEXPLANON may also increase your chance of serious blood clots, especially if you have other risk factors, such as smoking. If you smoke and want to use NEXPLANON, you should quit. Some examples of blood clots are deep vein thrombosis (legs), pulmonary embolism (lungs), retinal thrombosis (eyes), stroke (brain), and heart attack (heart). It is possible to die from a problem caused by a blood clot, such as a heart attack or stroke. Tell your doctor at least 4 weeks before if you are going to have surgery or will need to be on bed rest, because you have an increased chance of getting blood clots during surgery or bed rest.
  • Cysts may develop on the ovaries and usually go away without treatment, but sometimes surgery is needed to remove them.
  • Besides changes in menstrual bleeding patterns, other common side effects reported in women using NEXPLANON include: headaches; vaginitis (inflammation of the vagina); weight gain; acne; breast pain; viral infection such as sore throats or flu-like symptoms; stomach pain; painful periods; mood swings, nervousness, or depressed mood; back pain; nausea; dizziness; pain and pain at the site of insertion. Implants have been reported to be found in a blood vessel, including a blood vessel in the lung.
  • Call your health care provider right away if you have pain in your lower leg that does not go away; severe chest pain or heaviness in the chest; sudden shortness of breath, sharp chest pain, or coughing blood; symptoms of a severe allergic reaction, such as swollen face, tongue or throat, trouble breathing or swallowing; sudden severe headaches unlike your usual headaches; weakness or numbness in your arm, leg, or trouble speaking; sudden partial or complete blindness; yellowing of your skin or whites of your eyes, especially with fever, tiredness, loss of appetite, dark-colored urine, or light-colored bowel movements; severe pain, swelling, or tenderness in the lower stomach (abdomen); lump in your breast; problems sleeping, lack of energy, tiredness, or you feel very sad; heavy menstrual bleeding; or if you feel that the implant may have broken or bent while in your arm.
  • NEXPLANON does not protect against HIV or other STDs.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please read the accompanying Patient Information for NEXPLANON and discuss it with your health care provider. The physician Prescribing Information also is available.



 

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