The Cost Challenge for Extended-Cycle Oral Contraceptives

Camrese 91 Day is a well-established extended-cycle oral contraceptive containing levonorgestrel 0.15 mg/ethinyl estradiol 0.03 mg (84 tablets) followed by ethinyl estradiol 0.01 mg (7 tablets). While the ACA contraceptive mandate has dramatically improved access, cost remains a significant barrier for certain patient populations — particularly uninsured individuals, those with high-deductible plans, and patients whose formularies favor alternative agents.

Brand-name Camrese 91 Day carries a cash price of $150–$300 per 91-day pack. Generic equivalents (Amethia, Daysee, Jaimiess) typically range from $30–$90 with a discount card. Understanding the full landscape of savings options enables providers to proactively address cost barriers during the prescribing encounter, improving adherence and reducing unintended gaps in contraceptive coverage.

ACA Contraceptive Coverage: What Providers Should Know

Under the Affordable Care Act, most commercial insurance plans are required to cover at least one form of each FDA-approved contraceptive method without cost-sharing. For extended-cycle oral contraceptives, this typically means:

• Generic preferred: Most plans will cover generic levonorgestrel/ethinyl estradiol extended-cycle formulations (Amethia, Daysee, Jaimiess) at $0 copay
• Brand coverage varies: Some plans may require prior authorization or medical necessity documentation for brand-name Camrese 91 Day when a generic is available
• Step therapy uncommon: Step therapy requirements are rare for oral contraceptives, but some plans may require trial of a 28-day formulation before covering extended-cycle options
• Religious exemptions: Some employer-sponsored plans may be exempt from the contraceptive mandate

When a patient reports a cost barrier, the first step is verifying whether their plan covers extended-cycle formulations and whether a formulary-preferred generic can be substituted.

Generic Substitution Strategies

For patients facing cost issues, generic substitution is often the most impactful intervention:

All generics are AB-rated and therapeutically equivalent. When prescribing, consider writing for "levonorgestrel/ethinyl estradiol extended-cycle" rather than a specific brand name, allowing the pharmacist to dispense whichever generic is in stock and least expensive. This also helps address current supply challenges by giving pharmacists flexibility.

Prescription Discount Cards and Coupons

For uninsured patients or those with high-deductible plans that haven't met their deductible, prescription discount cards can reduce costs substantially. Recommend that patients compare prices across platforms:

• GoodRx — Widely accepted; often shows the lowest available price at nearby pharmacies
• SingleCare — Accepted at most major chains
• RxSaver — Price comparison across local pharmacies
• Optum Perks — Competitive pricing on generics
• BuzzRx — Additional discount card option

These cards are free to use and cannot be combined with insurance. They work best for the generic formulations, where they can bring the cost below $50 per 91-day pack at many pharmacies.

Patient Assistance Programs (PAPs)

For patients who meet income eligibility requirements, several programs can provide Camrese 91 Day or its generics at no cost:

Teva Cares Foundation

Teva Pharmaceuticals (the manufacturer of Camrese) operates a patient assistance program through the Teva Cares Foundation. Eligible patients — typically those who are uninsured and meet income thresholds — can receive brand-name medications at no cost. Applications are available at teva.com.

Planned Parenthood and Title X Clinics

For patients without insurance or with significant financial barriers, Planned Parenthood clinics and Title X-funded health centers provide contraceptive services on a sliding fee scale. These facilities maintain their own medication inventories and can often provide oral contraceptives directly, bypassing pharmacy stock and cost issues.

Additional Resources

• NeedyMeds (needymeds.org) — Comprehensive database of patient assistance programs
• RxAssist (rxassist.org) — Patient assistance program directory
• RxHope (rxhope.com) — Connects patients with manufacturer programs

Addressing Supply-Related Cost Increases

The intermittent supply disruptions affecting extended-cycle oral contraceptives in 2026 have created secondary cost implications. When a patient's usual generic is unavailable, they may be dispensed a more expensive alternative or face delays that create gaps in coverage.

Proactive strategies include:

• Prescribing generically to allow pharmacist flexibility across equivalent formulations
• Authorizing 90-day fills through mail-order pharmacies, which often maintain better inventory
• Directing patients to MedFinder for Providers to check real-time pharmacy availability and help patients locate stock before prescriptions are sent
• Considering therapeutic alternatives when supply is constrained — see our provider's guide to finding Camrese 91 Day in stock

Integrating Cost Conversations Into the Clinical Encounter

Research consistently shows that patients often don't raise cost concerns unprompted. Consider incorporating routine cost screening into contraceptive counseling:

• "Do you anticipate any difficulty affording this medication?"
• "Do you have prescription drug coverage? Are there any cost-sharing concerns?"
• "Would you like me to prescribe a generic version to help keep costs down?"

Addressing cost proactively at the point of prescribing can prevent adherence gaps downstream. Non-adherence to oral contraceptives due to cost or access barriers is a well-documented contributor to unintended pregnancy.

Quick Reference: Cost-Saving Pathways

Bottom Line

Most patients can access Camrese 91 Day or its generics at low or no cost through insurance, discount programs, or patient assistance. The key provider intervention is raising the cost conversation proactively and knowing the available pathways. By prescribing generically, connecting uninsured patients with PAPs and community resources, and using tools like MedFinder for Providers to navigate supply challenges, clinicians can ensure that cost and availability don't become barriers to effective contraception.