In some examples, a medical device package may include a backing card that is configured to secure a medical device to a major surface of the backing card. The backing card is configured to be assembled from an open state into a closed state in which flaps on one or more ends of a central region of the backing card move over some of the central region and cover some of the secured medical device. The closed state defines a reduced footprint relative to the unfolded state. The backing card may be sealed in a pouch, which may then be housed in a carton. The carton includes exterior walls that enclose the sealed backing card and spacing elements that receive the sealed backing card at a relative location within the carton and holds the backing card a threshold distance from the exterior walls of the carton.