Long-acting Reversible Contraception Products

LARC Drugs

Name/Generic Name NDC Programs
NEXPLANON 68 MG IMPLANT
etonogestrel
00052433001 Medicaid-HTW
PARAGARD T 380-A IUD
copper
59365512801 Medicaid-HTW
KYLEENA 19.5 MG SYSTEM
levonorgestrel
50419042401 Medicaid-HTW
SKYLA 13.5 MG SYSTEM
levonorgestrel
50419042201 Medicaid-HTW
MIRENA 52 MG SYSTEM
levonorgestrel
50419042301 Medicaid-HTW

Providers can prescribe and obtain LARC products on the Medicaid and Healthy Texas Women (HTW) Program formularies from certain specialty pharmacies for women participating in those programs. LARC products are only available through these specialty pharmacies working with LARC manufacturers. Providers who prescribe and obtain LARC products through these specialty pharmacies will be able to return unused and unopened LARC products to the manufacturer's third-party processor. Providers may continue to obtain products through the existing buy-and-bill process.

Refer to the Outpatient Drug Services Handbook for detailed information regarding prescribing and obtaining LARC products and the LARC buy-back program.

Refer to the Formulary Search and select the "LARC" filter to identify products available through the pharmacy benefit