Implanon® (etonogestrel implant) 68 mg

FAQs

Questions about ordering and billing

How can I order IMPLANON?
Currently IMPLANON is offered through two distributors, CuraScript and CVS Caremark. Please note that only healthcare providers who have attended a Merck Training Program and are listed in the trained clinician database are authorized to purchase IMPLANON.
Who is the distributor?
Merck has contracted with two specialty distributors: CuraScript and CVS Caremark.
How do I choose who I order from? Do you recommend CuraScript or CVS Caremark?
Every customer has different requirements. Visit the CuraScript and CVS Caremark pages to review the ordering process for both. This can help you make the best decision for your practice.
Will the product be available to additional distribution outlets in the future?
At this time Merck has chosen to use only CuraScript and CVS Caremark.  Additional distributors may be available in the future.
How much does IMPLANON cost?

As with any medication, the cost to the patient will depend on the patient’s health coverage.  Most patients have public or private medical coverage which may cover the cost of IMPLANON.  For complete details, please contact the patient’s insurer.

If you are a clinician ordering IMPLANON on behalf of a patient, complete details on the cost of IMPLANON can be obtained from either of our distributors. You can contact the CuraScript Call Center at 1.866.844.0148 or the CVS Caremark Call Center at 1.866.318.3492 for more information.

What is the NDC Code for IMPLANON?
The NDC code for IMPLANON is 00052-0272-01.
What is the Product code or J-code for IMPLANON?
The J code for IMPLANON is J7307.
What procedure codes should I use to bill for IMPLANON?
The procedure code is 11975 or 11981 for insertion, and 11976 or 11982 for removal.  If the procedure performed is a combination of removal and reinsertion, then 11977 or 11983 can be used.

Questions about CuraScript

Who is CuraScript?

CuraScript, Inc., a subsidiary of Express Scripts (ESRX), is one of the largest, independent specialty pharmaceutical services companies in the United States.  CuraScript offers wholesale distribution and specialty pharmacy services, including Freedom Fertility Pharmacy.  With this combined offering, CuraScript has become an established provider of women’s health products.

Physicians who choose to purchase IMPLANON directly may do so through CuraScript’s wholesale distribution channel. CuraScript’s physician customers enjoy an easy ordering experience, complementary express shipping, and personalized customer service to meet the individual needs of their practice.  

Complementing its distribution service, CuraScript also offers patient-specific specialty pharmacy services.

What are CuraScript’s hours of operation?
At CuraScript, you will have access to customer service and clinical staff from 8:00 am to 8:00 pm EST.
Is there a fee for using CuraScript?
No, there is no fee for using CuraScript; however, the patient will be responsible for any co-payment, co-insurance and/or deductible as determined by her insurance plan.
How do I set up an account with CuraScript?

CuraScript offers physicians the option of opening an account to purchase IMPLANON.  With a CuraScript account, you can access a 90-day line of credit and place your order by paying with a credit card.

To open an account with CuraScript, simply complete the one-time Account Application form.  To expedite the account set-up process, return the completed application along with a copy of your State Medical License, DEA license and a list of trained clinicians authorized to place orders on the account.  Applications can be submitted to our dedicated IMPLANON fax number at 1.866.389.7928.

Account setup is complete within 48 hours in most cases.  Someone from CuraScript’s IMPLANON customer support team will contact you within 24 hours to confirm receipt of your application and again once account setup is complete. 

To order IMPLANON you must first establish an account with CuraScript. To set up an account, you must complete a credit application and attach the applicable supporting documentation. The credit application must be fully completed and signed by the principle owner of the liable party.

Key areas to be completed in the application:

  • Type of organization and federal tax ID number – This allows CuraScript to use an external reporting agency to verify credit worthiness and in most cases enables the account to be opened within 24 hours.

  • Contact person (A/P and Purchasing) – This information is necessary for CuraScript to manage your account.

  • Financial statements (not listed) – This is not a requirement, but will expedite the turnaround time. If the information received from the credit investigation is incomplete, CuraScript may require this information to support the credit limit required to make purchases on terms.

  • Average monthly purchases – This field is not required, but is helpful to determine credit line needed to support purchases.

  • Vendor references – Please provide references in which you purchase on a line of credit, preferably other drug and/or medical supply vendors. Leases and utilities are not suitable references.

  • Bank references – Please provide banking information for your primary account and line of credit (if applicable). Please verify that the account number appears completely and is legible. Also, providing the name of your relationship manager is helpful in assisting CuraScript in providing the information and speeds up the processing time.

  • Terms and conditions – Please read and have a business principal sign. Credit applications without signature cannot be processed.

Credit applications can be downloaded, obtained from CuraScript  by calling 1-877-IMPLANON and selecting option #1, or by United States Postal Service (USPS).

How do I order IMPLANON from CuraScript?
You can order IMPLANON in two ways:
  1. Access a 90-day line of credit or use a credit card payment through your CuraScript account.

  2. Order IMPLANON via prescription order.

CuraScript Account

If you do not already have a CuraScript account, you can open an account by following the steps outlined above. Once you have your account number, you can order by calling 1.866.844.0148.

Once you have your account number, you can order by calling 1.866.844.0148 or order online.

All orders received by 7:00 pm EST are processed the same day and shipped second day delivery via UPS or FedEx. Emergency shipping is also available upon request.

Prescription Order

When IMPLANON is covered as a pharmacy benefit, prescription orders may be placed for individual patients. To initiate a prescription order with CuraScript, complete a CuraScript Benefits Investigation Form or call CuraScript at 1.866.844.0148 to submit a prescription.

Once CuraScript receives your request, a representative will perform an in-depth benefit investigation.  Once the investigation is complete, CuraScript will contact the patient (via phone) and your office (via fax of an EOB) to review the referral.  The benefits investigation process is complete within 48 hours in most cases.

If IMPLANON is covered under the patient’s insurance plan, a CuraScript representative will contact the patient to discuss any financial responsibility (if any) and your office to coordinate the delivery of IMPLANON to your office.

How can I request a benefits investigation for IMPLANON?

To request a benefits investigation, compete the CuraScript Benefits Investigation Form or call CuraScript at 1.866.844.0148.  Once your request has been received, a CuraScript representative will perform an in-depth benefit investigation. Once the investigation is complete, CuraScript will contact the patient (via phone) and your office (via fax of an Explanation of Benefits) to review the referral. The benefits investigation process is complete within 48 hours in most cases.

Note: The coverage and payment information CuraScript provides is based on what is provided by the patient’s insurer. The insurer does not guarantee the information to CuraScript at the time of verification, nor can CuraScript guarantee the information to you. It is therefore recommended that your office investigate the patient's specific benefits and authorization requirements for IMPLANON prior to purchasing and seeking reimbursement.
Can CuraScript administer FSS and PHS (340b) and Apexus discounts?

Yes, CuraScript can administer FSS and PHS (340b) and Apexus discounts for covered entities. CuraScript’s contract team can set up your account to support this special pricing. 

Please check with the HRSA website or with your facility to determine if you are PHS or 340b eligible.

Questions about CVS Caremark

Who is CVS Caremark IMPLANON Direct?
CVS Caremark IMPLANON Direct provides specialty healthcare services to patients and prescribers to ensure patients will have access to IMPLANON.
What do they do? (What services do they provide?)

CVS Caremark IMPLANON Direct offers support services designed for physicians and their patients considering IMPLANON. CVS Caremark can provide a variety of services to both you and your patient. These services include benefits investigation as well as wholesale (Buy and Bill) and retail (Specialty Pharmacy) distribution.

First, once you complete the provided service request form or place a call to IMPLANON Direct, CVS Caremark will contact your patient’s insurance company and research your patient’s insurance benefit coverage for IMPLANON and the insertion and removal procedure. Their detailed benefits investigation entails researching all possible options for coverage for IMPLANON. These options will include verification of both the pharmacy benefit and medical benefit, including benefits applied to physician’s buy and bill. CVS Caremark’s goal through their benefits investigation is to identify the IMPLANON coverage option that offers the lowest out-of-pocket responsibility for your patient.

Second, depending on the results of the benefits investigation, CVS Caremark can ship IMPLANON directly to you if you wish to purchase the product and bill the cost directly to the IMPLANON patient’s insurance company. In some cases, CVS Caremark may also be able to dispense for your patient. In this case, CVS Caremark will bill the insurance company directly for the product costs. Either way, CVS Caremark will ship the product directly to the office or institution of your choice.

What are the CVS Caremark IMPLANON direct hours of operation?
CVS Caremark IMPLANON direct hours of operation are from 8:00 am to 8:00 pm EST.
How do I order IMPLANON?

IMPLANON orders are received via phone or fax by CVS Caremark IMPLANON Direct Team at 1.866.318.3492 (phone) or 1.866.769.3882 (fax), or order online.

Orders will be shipped second-day delivery unless there is an immediate need for product due to scheduled procedure date, in which case a one-day delivery can be requested.

Orders will be processed either through CVS Caremark's Specialty Pharmacy (single patient ordering) or through its Specialty Distribution (Buy and Bill or larger direct purchase quantity ordering).

You will need to provide the following information on the Service Request Form (SRF):

  • Direct Purchase/Wholesale Order  (Buy and Bill)
    a. Prescriber’s name
    b. Prescriber’s demographics, including address and phone
    c. Billing address if different than shipping information
    d. Quantity requested
    e. Credit card information
    f. Requested delivery date
    g. Tax identification number
    h. Signature of the contact placing the order and the name of the trained clinician

  • Retail Order (Specialty Pharmacy)
    a. Complete patient name and address and insurance information
    b. Complete prescriber information and authorization
    c. Prescription information for IMPLANON
    All verbal orders will be taken by a registered pharmacist.

How do I order IMPLANON from CVS Caremark IMPLANON Direct?
Please submit the CVS Caremark IMPLANON Direct Service Request Form (SRF) with the required information to CVS Caremark IMPLANON Direct. Download this form or call the CVS Caremark direct line at 1.866.318.3492.
How do I determine if I should order IMPLANON from Specialty Pharmacy or Specialty Distribution/Wholesale?
The Service Request Form allows you to either request that a benefit investigation be performed or to simply place an order for IMPLANON.  Once the benefits have been investigated for your patient, CVS Caremark IMPLANON Direct will provide you with information related to your patient’s coverage for IMPLANON and if the insurance company will require that your office Buy and Bill the product or if CVS Caremark can dispense the product and bill the patient’s insurance company directly.  The ease of one toll-free number for placing your order will assist you in this decision.  Based on whether you are going to order IMPLANON on a patient-by-patient basis via Pharmacy or if you choose to order Buy and Bill wholesale and/or order product in volume, CVS Caremark will assist you in determining the process as indicated on the service request form.
How do I know if I am PHS or 340b eligible?
IMPLANON Direct will confirm your eligibility upon receipt of the service request form by checking your status utilizing the HRSA website.
Once I have placed my order, how will I receive IMPLANON?
Orders received by 7:00 pm EST will be processed that day. Orders are shipped via FedEx for two-day delivery unless there is a special request for next-day delivery due to scheduled procedure date.
What is the latest I can order to ensure I get it the next day?
The latest time to order for next-day delivery is 7:00 pm EST.

IMPLANON (etonogestrel implant) is indicated for use by women to prevent pregnancy.

SELECTED SAFETY INFORMATION

  • IMPLANON should not be used in women who have known or suspected pregnancy; current or past history of thrombosis or thromboembolic disorders; liver tumors, benign or malignant, or active liver disease; undiagnosed abnormal genital bleeding; known or suspected breast cancer, personal history of breast cancer, or other progestin-sensitive cancer, now or in the past; or allergic reaction to any of the components of IMPLANON.
  • IMPLANON should be inserted subdermally so that it will be palpable after insertion, and this should be confirmed by palpation immediately after insertion. Failure to insert IMPLANON properly may go unnoticed unless it is palpated immediately after insertion. Undetected failure to insert the implant may lead to an unintended pregnancy. Failure to remove the implant may result in continued effects of etonogestrel, such as compromised fertility, ectopic pregnancy, or persistence or occurrence of a drug-related adverse event.
  • Complications related to insertion and removal procedures, such as pain, paresthesias, bleeding, hematoma, scarring, or infection, may occur. Occasionally in post-marketing use, implant insertions have failed because the implant fell out of the needle or remained in the needle during insertion. If IMPLANON is inserted too deeply (intramuscular or in the fascia), neural or vascular injury may occur. Implant removal may be difficult or impossible if the implant is not inserted correctly, inserted too deeply, not palpable, encased in fibrous tissue, or has migrated. Deep insertions may lead to difficult localization of the implant and may also result in the need for a surgical procedure in an operating room in order to remove the implant.
  • After starting IMPLANON, women are likely to have changes in their menstrual bleeding pattern. These may include changes in frequency, intensity, or duration. Abnormal bleeding should be evaluated as needed to exclude pathologic conditions or pregnancy. In clinical studies of IMPLANON, reports of changes in bleeding pattern were the most common reason for stopping treatment (11.1%). Women should be counseled regarding bleeding pattern changes that they may experience.
  • Be alert to the possibility of an ectopic pregnancy in women using IMPLANON who become pregnant or complain of lower abdominal pain.
  • The use of combination hormonal contraceptives increases the risk of vascular events, including arterial events (strokes and myocardial infarctions) or deep venous thrombotic events (venous thromboembolism, deep venous thrombosis, retinal vein thrombosis, and pulmonary embolism). It is recommended that women with risk factors known to increase the risk of venous and arterial thromboembolism be carefully assessed. There have been postmarketing reports of serious arterial and venous thromboembolic events, including cases of pulmonary emboli (some fatal), deep vein thrombosis, myocardial infarction, and stroke, in women using IMPLANON. IMPLANON should be removed in the event of a thrombosis. Due to the risk of thromboembolism associated with pregnancy and immediately following delivery, IMPLANON should not be used prior to 21 days postpartum. Women with a history of thromboembolic disorders should be made aware of the possibility of a recurrence. Consider removal of the IMPLANON implant in case of long-term immobilization due to surgery or illness.
  • If follicular development occurs, atresia of the follicle is sometimes delayed, and the follicle may continue to grow beyond the size it would attain in a normal cycle. Generally, these enlarged follicles disappear spontaneously. Rarely, surgery may be required.
  • Some studies suggest that the use of combination hormonal contraceptives might increase the incidence of breast cancer, and increase the risk of cervical cancer or intraepithelial neoplasia. Women with a family history of breast cancer or who develop breast nodules should be carefully monitored.
  • IMPLANON should be removed if jaundice occurs.
  • The IMPLANON implant should be removed if blood pressure rises significantly and becomes uncontrolled.
  • Studies suggest a small increased relative risk of developing gallbladder disease among combination hormonal contraceptive users. It is not known whether a similar risk exists with progestin-only methods like IMPLANON.
  • Prediabetic and diabetic women using IMPLANON should be carefully monitored.
  • Women with a history of depressed mood should be carefully observed. Consideration should be given to removing IMPLANON in patients who become significantly depressed.
  • In clinical trials, the etonogestrel levels in blood decreased below sensitivity of the assay by one week after removal of the implant. In addition, pregnancies were observed to occur as early as 7 to 14 days after removal. Therefore, a woman should re-start contraception immediately after removal of the implant if continued contraceptive protection is desired.
  • Hormonal contraceptives may cause some degree of fluid retention. They should be prescribed with caution, and only with careful monitoring, in patients with conditions which might be aggravated by fluid retention. It is unknown if IMPLANON causes fluid retention.
  • Contact lens wearers who develop visual changes or changes in lens tolerance should be assessed by an ophthalmologist.
  • The most common adverse reaction causing discontinuation of use of the implant in clinical trials was change in menstrual bleeding patterns, specifically irregular menses (11.1%).The most common adverse reactions (=10%) reported in clinical trials were headache (24.9%), vaginitis (14.5%), weight increase (13.7%), acne (13.5%), breast pain (12.8%), abdominal pain (10.9%), and pharyngitis (10.5%).
  • Drugs or herbal products that induce enzymes, including CYP3A4, that metabolize progestins may decrease the plasma concentrations of progestins and may decrease the effectiveness of IMPLANON. In women on long-term treatment with hepatic enzyme inducing drugs, it is recommended to remove the implant and to advise a contraceptive method that is unaffected by the interacting drug. Significant changes (increase or decrease) in the plasma levels of progestin have been noted in some cases of coadministration with HIV protease inhibitors or with non-nucleoside reverse transcriptase inhibitors.
  • CYP3A4 inhibitors, such as itraconzaole or ketoconazole, may increase plasma concentrations of etonogestrel.
  • Hormonal contraceptives may affect the metabolism of other drugs. Consequently, plasma concentrations may either increase (for example, cyclosporin) or decrease (for example, lamotrigine).
  • Rule out pregnancy before inserting IMPLANON.
  • Based on limited clinical data, IMPLANON may be used during breast-feeding after the fourth postpartum week. Use of IMPLANON before the fourth postpartum week has not been studied. Small amounts of etonogestrel are excreted in breast milk. The health of breast-fed infants whose mothers began using IMPLANON during the fourth to eighth week postpartum (n=38) was evaluated in a comparative study with infants of mothers using a non-hormonal IUD (n=33). They were breast-fed for a mean duration of 14 months and followed up to 36 months of age. No significant effects and no differences between the groups were observed on the physical and psychomotor development of these infants. No differences between groups in the production or quality of breast milk were detected.
  • Safety and efficacy of IMPLANON have been established in women of reproductive age and are expected to be the same for postpubertal adolescents. However, no studies have been conducted in women less than 18 years of age. Use of this product before menarche is not indicated.
  • The efficacy of IMPLANON in women who weighed more than 130% of their ideal body weight has not been defined because such women were not studied in clinical trials. Serum concentrations of etonogestrel are inversely related to body weight and decrease with time after implant insertion. Therefore, IMPLANON may be less effective in overweight women.
  • IMPLANON does not protect against HIV infection (AIDS) or other sexually transmitted diseases.

Before prescribing IMPLANON, please read the Prescribing Information.