Recarbrio

Indicated For

gram-negative infections, hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP)

About This Medication

# Merck Patient Assistance Program Guide: How to Get Recarbrio at Low or No Cost ## About This Program The **Merck Patient Assistance Program (Merck PAP)** is a free program designed to help uninsured and underinsured patients access Merck medications, including Recarbrio (imipenem cilastatin relebactam), at no cost or reduced cost. If you have been prescribed Recarbrio by your healthcare provider but cannot afford it, this program may help you obtain your medication. ## About Recarbrio Recarbrio is a prescription antibiotic combination medication used to treat serious bacterial infections. It combines three active ingredients to fight bacteria that may be resistant to other antibiotics. Your healthcare provider has determined that Recarbrio is the appropriate treatment for your condition. ## Who Qualifies for Merck PAP? To be eligible for the Merck Patient Assistance Program, you must meet ALL of the following requirements: **Residency and Prescription Requirements:** - You currently reside in the United States or a U.S. territory (you do not need to be a U.S. citizen) - You have a valid prescription for Recarbrio from a licensed U.S. healthcare provider - Your healthcare provider has determined that you need this medication **Insurance Requirements:** - You do not have insurance coverage for Recarbrio, OR - Your insurance does not cover this medication - Your insurance plan does not participate in an alternative funding program that requires you to apply to Merck PAP as a condition **Financial Requirements:** - You meet certain financial eligibility criteria based on your household income While specific income thresholds are not publicly listed, the program is designed for patients with financial need. The program evaluates your situation individually to determine if you qualify. ## Income Eligibility The Merck Patient Assistance Program uses a financial assessment to determine eligibility rather than strict income cutoffs. The program considers: - Your total household income - Your household size - Your ability to pay for medications - Other financial obligations If you are unsure whether you meet the financial criteria, you can still apply. The program will review your information and determine your eligibility during the application process. ## Insurance and Medicare Information **If You Have Medicare:** You may still be eligible for Merck PAP if Medicare does not cover Recarbrio or if you cannot afford your out-of-pocket costs. Contact the program to discuss your specific situation. **If You Have Private Insurance:** You are eligible if your insurance does not cover Recarbrio. If your insurance covers the medication but you cannot afford your copay or coinsurance, you may want to explore copay assistance programs in addition to or instead of Merck PAP. **If You Are Uninsured:** You are eligible to apply if you meet the other requirements. ## How to Apply: Step-by-Step Instructions **Step 1: Obtain the Enrollment Form** - Download the enrollment form from merckhelps.com, or - Call the Merck Patient Assistance Program at 1-800-727-5400 to request a form, or - Ask your healthcare provider's office if they have a form available **Step 2: Complete Your Section of the Form** - Fill out all fields in Section 1 (Patient Information) - Sign and date Sections 2 and 3 in ALL designated areas - Provide proof of income (see "Required Documentation" below) - Provide proof of residency **Step 3: Have Your Healthcare Provider Complete Their Section** - Give the form to your prescribing healthcare provider - Your provider must complete Sections 4 and 5 - Your provider must include their National Provider Identifier (NPI) number - Your provider must sign and date all designated areas - Your provider must write a separate prescription for Recarbrio (controlled substance rules apply) **Step 4: Submit Your Application** - Mail the original, completed, signed enrollment form to the Merck Patient Assistance Program, or - Fax the completed form to the program - Do NOT submit copies; the original form is required - Keep a copy for your records ## Required Documentation You must provide ONE of the following to prove your income: - Recent tax return - Recent pay stubs - Proof of unemployment benefits - Proof of Social Security or disability benefits - Bank statements - Other income documentation You must also provide proof of residency, such as: - Utility bill - Lease or mortgage statement - Government-issued ID with current address Your prescription for Recarbrio must be included with your application. ## Application Timeline and What to Expect **Processing Time:** If your enrollment form is fully completed, signed by both you and your healthcare provider, and you are eligible, the Merck Patient Assistance Program can typically process your application within **2-3 business days**. Some applications may be processed in less than 7 business days. Processing may take longer if: - Your form is incomplete - Signature fields are missing - Additional information is required - Your income documentation is unclear **After Approval:** Once approved, your medication will be shipped to either you or your healthcare provider's office, depending on what was arranged during the application process. You will receive notification when your application is received and when it is approved. **Eligibility Period:** Your assistance typically continues for 12 months from the date of approval. After 12 months, you will need to reapply to continue receiving assistance. ## Reauthorization and Refills Your enrollment in the Merck Patient Assistance Program is valid for up to 12 months. Before your eligibility expires, you will need to submit a new application to continue receiving Recarbrio through the program. Contact the program at 1-800-727-5400 to request a renewal form or to discuss your reauthorization. ## What If Your Application Is Denied? If your application is denied, you have several options: 1. **Request clarification:** Contact the Merck Patient Assistance Program to understand why you were not approved. You may be able to provide additional information or documentation. 2. **Reapply:** If your circumstances have changed (such as a change in income or insurance status), you can submit a new application. 3. **Explore alternatives:** Ask your healthcare provider about: - Other antibiotic options that may be covered by your insurance - Hospital or clinic programs that may help with medication costs - State or local assistance programs - Pharmaceutical company copay assistance programs - Non-profit organizations that help with medication costs 4. **Contact your healthcare provider:** Your provider may have resources or suggestions for obtaining Recarbrio or alternative treatments. ## Important Reminders - **Both you and your healthcare provider must sign the application.** Applications without both signatures will not be processed. - **Submit the original form, not a copy.** - **Complete all fields.** Incomplete applications will delay processing. - **Update your information.** If your income, insurance, or residency changes, notify the program. - **This program is for uninsured or underinsured patients.** If your situation changes and you obtain insurance coverage, you may no longer be eligible. ## Contact Information **Merck Patient Assistance Program** - Phone: 1-800-727-5400 - Website: merckhelps.com - Hours: Monday–Friday, 8 AM–8 PM ET ## Disclaimer This guide provides general information about the Merck Patient Assistance Program. Program eligibility, requirements, and benefits may change. For the most current and complete information, visit merckhelps.com or call 1-800-727-5400. This guide is not a guarantee of eligibility or assistance. Your individual circumstances will be evaluated by the program to determine your qualification. Always consult with your healthcare provider about your treatment options and medication needs.

Program information last verified: March 30, 2026