How to Help Your Patients Save Money on Lentocilin: A Provider's Guide to Savings Programs

During the Lentocilin and Bicillin L-A shortage, patients face not just access challenges but also cost concerns. While Lentocilin itself is priced at approximately $15 per dose for healthcare businesses (versus $500+ for brand Bicillin L-A), the cost to patients depends heavily on where they receive care, what insurance they have, and how their provider bills for the injection. This guide helps providers reduce out-of-pocket costs for their patients and navigate the billing and financial assistance landscape for Lentocilin in 2026.

Understanding How Lentocilin Is Billed

Because Lentocilin is an injection administered in a clinical setting, it is billed differently from retail pharmacy drugs:

Medical benefit (not pharmacy benefit): The injection is typically billed as a medical procedure under CPT codes for drug administration (e.g., 96372 for subcutaneous/IM injection). The drug itself is billed as a supply. This means it flows through the patient's medical insurance, not their prescription drug benefit.

Medicare Part B: Covers drugs administered in the office under the medical benefit. Patients typically owe 20% of the Medicare-approved amount after meeting the deductible. With the drug costing ~$15 wholesale, the patient's 20% share on the drug itself should be minimal.

Medicaid: Penicillin G benzathine products are covered by Medicaid in all states with minimal or no patient copay. At public health facilities and Medicaid-covered STI clinics, treatment is often provided at no cost to the patient.

Private insurance: Most private plans cover in-office administered injections under the medical benefit. Patients pay their standard office copay plus any coinsurance. Call the insurer to verify coverage and whether prior authorization is needed.

Strategy 1: Source Lentocilin Through Cost Plus — Lower Your Acquisition Cost

The single most impactful cost-reduction step for your practice is sourcing Lentocilin through low-cost channels. Cost Plus Drug Company distributes Lentocilin to healthcare businesses at approximately $15 per dose — compared to $500+ for brand Bicillin L-A. When your drug acquisition cost is dramatically lower, the cost passed on to your patients is correspondingly reduced.

Cost Plus Drugs marketplace: Register at costplusdrugs.com to access healthcare business pricing. Questions: 682-428-8081 or dtc_quality@costplusdrugs.com

TopRx (authorized distributor): 800-542-8677 or STDmeds@toprx.com

Strategy 2: Use the 340B Drug Pricing Program

If your organization is eligible for the 340B Drug Pricing Program, you can purchase outpatient drugs at significantly discounted prices for eligible patients. 340B-eligible entities include:

Federally Qualified Health Centers (FQHCs)

Ryan White HIV/AIDS clinics

Title X family planning clinics

STD grantees (organizations that receive federal STD prevention funding)

Safety-net hospitals (disproportionate share hospitals, DSH)

Note: 340B pricing applies to FDA-approved drugs from U.S. manufacturers. Whether it applies to temporarily imported Lentocilin (not FDA-approved) should be verified with your 340B administrator. For Bicillin L-A acquired through Pfizer's medical request process, 340B pricing may be applicable — check with your compliance team.

Strategy 3: Refer Uninsured and Underinsured Patients to Public Health Clinics

For patients who are uninsured or underinsured, the most cost-effective option is referral to a local public health STI clinic or FQHC. These settings:

Often provide syphilis treatment at no cost or on a sliding-fee scale based on income

Receive priority supply allocations of penicillin G benzathine during shortages

Have trained clinical staff experienced in STI treatment and the current shortage protocols

Maintain a referral list of your local public health STI clinics and FQHCs so your staff can quickly direct patients when cost is a barrier. Find FQHCs at findahealthcenter.hrsa.gov.

Strategy 4: Prescribe Doxycycline When Clinically Appropriate

For non-pregnant adults with syphilis who can adhere to an oral regimen, doxycycline is both a clinically effective alternative AND an extremely cost-effective one. Generic doxycycline 100 mg is widely available and costs as little as $4-$20 for a full 14-day course at retail pharmacies with discount programs. This compares to potentially hundreds of dollars in clinical administration costs for an injectable antibiotic.

Appropriately directing patients who are good candidates for doxycycline not only conserves the limited Lentocilin supply for higher-priority patients but also significantly reduces the financial burden on patients who might struggle to pay for clinic-administered treatment.

Strategy 5: Optimize Insurance Billing for Administered Injections

When billing insurance for Lentocilin administration, proper coding maximizes reimbursement and minimizes patient out-of-pocket costs:

Drug administration: CPT 96372 (therapeutic, prophylactic, diagnostic IM or SQ injection)

Drug supply: Bill with the appropriate NDC (National Drug Code) for the specific product administered. Work with your billing team to verify the NDC for Lentocilin.

Diagnosis code: Use the appropriate ICD-10 code for the clinical indication (e.g., A51.0 for primary genital syphilis; A51.1 for primary anal syphilis; A51.3 for secondary syphilis of the skin and mucous membranes, etc.)

Patient Communication: Addressing Cost Concerns

When patients express cost concerns, here are clear talking points:

"We source Lentocilin at a significantly lower price than brand Bicillin L-A. The cost we pay for the drug is much less than you may have heard — that's one reason we use it during the shortage."

"Your insurance covers this through your medical benefit — not your pharmacy benefit. The copay for a clinical injection is usually your standard office visit copay."

"If you're uninsured, I can refer you to [local health department / FQHC] where this treatment is available at low or no cost based on your income."

Directing Patients to medfinder

For patients who need to find a facility that both has Lentocilin in stock and can administer it, medfinder for providers is a service that contacts pharmacies and healthcare facilities near the patient to check availability. This reduces the burden on your office staff for answering "where can I find this drug?" calls, and helps patients navigate access and find lower-cost settings (like public health clinics) that they might not know about.

Summary: Cost Reduction Strategies for Providers

Source Lentocilin through Cost Plus or TopRx (~$15/dose) instead of brand alternatives

Enroll in or verify 340B eligibility for further drug acquisition discounts

Refer uninsured patients to public health clinics and FQHCs for free or low-cost treatment

Prescribe doxycycline for appropriate non-pregnant patients — much lower cost and conserves limited supply

Optimize insurance billing with correct CPT and ICD-10 codes to maximize reimbursement

Recommend medfinder for providers to help patients find cost-effective access points nearby