NEJM APC and Open Access: What Authors Pay, What's Covered, and the OA Landscape

NEJM's author pages describe a public-access approach built around free access to important articles and deposit of the Author Accepted Manuscript, not an author-paid open access fee. Here's the practical landscape:

What NEJM offers:

• Free access for all readers, on publication, to articles that meet its criteria for global and public health importance

• A PDF of the Author Accepted Manuscript that can be deposited in a noncommercial repository after publication

• For U.S. government and NIH-funded research, deposit of the AAM to PubMed Central by NEJM, after publication, under the CC BY-NC-ND license

• Free access to NEJM.org for low-income countries through Research4Life's Hinari program

What NEJM doesn't offer:

• A paid immediate open access option

• Author fees of any kind, so there is no APC to waive or reduce

Most NEJM papers are published without any author payment. This is free for authors and works as follows:

1. Your paper is accepted and published in NEJM.

1. Articles that meet the criteria for global and public health importance are freely available to all readers upon publication; other articles are available to subscribers (virtually every medical library and many individual clinicians).

1. NEJM provides a PDF of the Author Accepted Manuscript, which may be deposited in a noncommercial repository after publication, and which must link to the Version of Record at NEJM.org.

1. If your research is NIH or U.S. government-funded, NEJM deposits the AAM to PubMed Central for you.

NEJM's readership is more than 1 million medical professionals in nearly every country, and it partners with Research4Life's Hinari program to grant low-income countries immediate free access to NEJM.org. NEJM's pages do not state an embargo period; they say the AAM can be deposited after publication.

For clinical research especially, the practical access impact is small. The clinicians who need to read your randomized trial today already have NEJM access through their institution.

This is where NEJM differs most from its competitors. NEJM has no author fee, so there is nothing for an institution or funder to pay on your behalf:

Funders whose policies require a Creative Commons Attribution license can be accommodated: NEJM states that CC BY 4.0 is permitted for the Author Accepted Manuscript if the funder requires it, naming NIHR, UKRI, and Wellcome Trust.

Because there is no fee, there is nothing to budget for in your grants office.

NEJM charges no submission or publication fees, so there is no fee to waive:

• There is no APC, so no waiver program is needed.

• Low-income countries receive immediate free access to NEJM.org through Research4Life's Hinari program.

• Authors do not need to ask NEJM for a fee reduction.

The practical reality: if you're NIH-funded, NEJM deposits the Author Accepted Manuscript to PubMed Central after publication. If your funder requires something different, contact NEJM Editorial (+1-617-734-9800 or editorial@nejm.org) about compliance with funding body mandates.

The NIH route is the simplest: publish, and NEJM deposits the Author Accepted Manuscript to PMC after publication. This satisfies the NIH public access policy without any APC.

For Plan S compliance: there is no APC to find funding for, but confirm the license your funder requires before acceptance. Check with your funder's OA policy office and with NEJM Editorial.

The NEJM family has expanded beyond the flagship:

NEJM Evidence is worth knowing about if your research is strong but not flagship-level. It charges authors no submission or publication fees.

• No submission fee. NEJM does not charge to submit. This is notable because some medical journals do charge submission fees.

• No publication fees. NEJM states it does not charge authors any publication fees, so there are no page or figure charges to budget for.

• The real hidden cost is time. NEJM publishes no total review time. If you're budgeting against a grant timeline, factor in initial in-house review (typically under a week), peer review, and the multiple rounds of revision NEJM says will most likely occur.

For most NEJM authors, the decision tree is simple:

1. NIH-funded? Publish, and NEJM deposits the accepted manuscript to PMC after publication. Done.

1. Plan S funder? NEJM makes the AAM available for deposit to PMC or Europe PMC under CC BY-ND 4.0 (CC BY 4.0 if your funder requires it). No fee.

1. No funder mandate? Publish without paying anything. You may deposit the AAM in a noncommercial repository after publication.

1. Funder requirement unclear? Contact NEJM Editorial about compliance with funding body mandates before acceptance.

Access terms are secondary to getting accepted. NEJM says about 5% of original research submissions achieve publication. The editorial question is whether your findings change clinical practice broadly enough to justify the flagship. If you want to gauge your paper's fit before submitting, NEJM submission readiness check to identify the issues that matter at this level.

Method note: this page was reviewed against NEJM author center pages, open-access policy language, JCR context, funder-compliance notes, and Manusights clinical-trial submission-screening patterns. We checked the APC and open-access choice separately from journal fit because cost, access route, and citation metrics do not change the manuscript evidence an editor sees.

In our audit of the 16 metric reports our team reviewed, the specific risk pattern was treating a fee, JIF, or unofficial rate as the submission decision. The editorial triage pattern is stricter in practice: editors actually screen for scope, evidence strength, and audience fit before cost or citation metrics matter.

Use this year-over-year checklist before citing numbers from NEJM in a grant, CV, or submission memo. It is a verification aid, not a claim that every older value is stable.

Do not use one number as the whole NEJM decision. Check CiteScore, SJR, H-index, article type, publication volume, and the journal's real audience before treating the fee, acceptance rate, or JIF as decisive.

In our review work, the common mistake is using a metric to justify a weak fit. A stronger submission decision asks whether the manuscript would still look native to the journal if the headline number disappeared.

NEJM has no APC, so the question is which access route fits your funder and your goals.

Worth confirming with NEJM if:

• Your funder mandates open access (check Plan S / cOAlition S requirements)

• Your funder requires a particular Creative Commons license

• Open access visibility meaningfully benefits your research area

• You need the Author Accepted Manuscript deposited in a specific repository

Consider alternatives if:

• Your funder requires immediate open access in the published version

• Another OA journal would provide similar visibility

• A subscription option or green OA (the AAM deposited after publication) does not satisfy your funder

For a manuscript-specific signal before you submit, run an NEJM submission readiness check.

Or see example reports before you finalize.