Maximize all available discounts when purchasing contraceptive drugs and devices.

Strategy

Action Step(s)

Use the 340B Drug Pricing Program to purchase contraceptive drugs and devices for all patients (as defined by the Health Resources and Services Administration).
Plan LARC orders to realize the benefits of volume discounts, which can result in 4-12% reductions in cost with purchases of as few as five devices.
Contact LARC manufacturers about 90-day net terms and lines of credit.

Tools & Resources

Fact Sheet: Supply Chain for Stocking and Ordering LARC: This NFPRHA document outlines the supply chain for ordering buy-and-bill LARC methods, including the claims adjudication process.
PDF available
Buy-and-Bill of LARC: Health centers may order LARC devices directly from the manufacturer or through a third-party distributor. Each LARC device manufacturer’s website provides information on how to order and pay for devices, including current NDC codes, wholesale acquisition costs (including quantity discounts), specialty pharmacies, and distributors.

Manufacturer	Product	Description	Website link
Actavis	Liletta	52mg LNG IUD	https://www.lilettahcp.com/resources#purchasing-options
Bayer	Kyleena	19.5mg LNG IUD	https://hcp.kyleena-us.com/ordering-reimbursement/
Bayer	Mirena	52mg LNG IUD	https://hcp.mirena-us.com/ordering-and-reimbursement/
Bayer	Skyla	13.5mg LNG IUD	https://www.skyla-us.com/index.php
Cooper Surgical	Paragard	Copper IUD	https://hcp.paragard.com/ordering-paragard/paragard-access-center/
Merck	Nexplanon	68mg ENG implant	https://www.merckconnect.com/nexplanon/coverage/ordering-nexplanon/

Stellar RX Family Planning Program: “Buy and bill” refers to the process where health centers stock contraceptive methods, including LARC, at their expense; they subsequently recoup costs when billing third-party payers. It is well documented that this approach to stocking creates a financial challenge for health centers, which are required to purchase contraceptive methods that may go unused. It also can create a barrier to access for patients who cannot access same-day services because their chosen contraceptive method is not in stock. StellarRX produced the XpeDose unit to help address this challenge. XpeDose is a secure electronic dispensing unit that allows clinician dispensing of contraceptive methods and sexually transmitted infection treatment medications at the point of service. The XpeDose unit typically includes a three-month supply of various contraceptive methods.
LARC Modeling Tool: CAI's LARC Modeling Tool resource is intended to support healthcare service providers to examine assumptions about the affordability of stocking and providing LARC methods. Specifically, it calculates whether the costs associated with the provision of LARC will be covered (break-even), whether a profit can be realized, or if losses are projected based on a health center’s current payer mix (i.e., the proportion of clients insured by each third-party payer) and the reimbursement rates paid by each third-party payer.