Please check out the follow resources for information about Hemophilia, Patient Advocacy, and Treatment guidelines.

Manufacturers’ Co-Pay Programs 

 

Manufacturer

Program Name & Contact Information

Limit Total

Notes

Aptevo Therapeutics IXINITY Savings Program1-800-494-6489 $12,000
  •   Must have valid   Rx for IXINITY
  •   Must have   commercial insurance
  •   No monthly   limits unless limit total reached
  •   No income   requirements
  •   Program can be   used retroactively up to 12 months.
Bayer Bayer Access Solutions Kogenate FS Co-pay/Co-Insurance Program1-800-288-8374 $12,000
  •   Must have a diagnosis of hemophilia A
  •   Must have private health insurance
  •   No income requirements
  •   Must first contact Bayer Access Solutions
Biogen ALPROLIX Co-pay Program1-855-692-5776ELOCTATE Co-pay

1-855-963-5628Program

$12,000
  •   Must have commercial insurance.
  •   No income requirements or caps.
CSL Behring MySource Cost-Share Program1-800-676-4266 $12,000 for Afstyla, Idelvion, Helixate or Humate
  •   Must have commercial insurance.
  •   Only products purchased from SP, HTC and   Outpatient Hospital services are eligible.
  •   Program is not retroactive.
  •   No financial restrictions apply.
Grifols AlphaNine SD Co-pay card1-844-693-2286 $6,000$500 monthly max)
  •   Rx is covered up to patient’s annual   out-of-pocket maximum.
  •   No income requirements.
  •   Annual program enrollment required.
  •   Must have commercial insurance.
  •   Must have valid AlphaNine SD prescription.
  •   Not for inpatient use.
Novo Nordisk Co-pay Assistance Program1-844-668-6732 $12,000
  •   Must have FDA-approved diagnosis.
  •   Must have commercial insurance plan.
Octapharma Octapharma Co-pay Program1-800-554-4440 Up to $12,000 for NUWIQ per year.Up to $6,000 for Wilate per year.
  •   No income requirements.
  •   Must have commercial insurance.
  •   Must have Rx for NUWIQ and/or Wilate.
Pfizer Pfizer Factor Savings Program1-888-240-9040 $12,000
  •   Patient financial responsibility of $10/month.
  •   No financial eligibility requirements.
  •   Must have commercial insurance that covers   factor.
  •   Medicare/Medicaid beneficiaries are not   eligible.
Shire Shire’s Hemophilia Co-pay Program1-888-229-8379 $12,000
  •   Must have commercial insurance.
  •   Must use Shire hemophilia products.
  •   No income requirements.
  •   Eligible patients with private insurance   receive up to $12,000 every 12 months for medication-related   co-payment/co-insurance with retroactive assistance for a date of service   within 120 days prior to their co-pay activation date.

 

Manufacturer Product Assistance Programs

Manufacturer

Product Assistance Program Name &

Contact Information

Aptevo IXINITY Patient Assistance Program: for patients who are uninsured or   experiencing a lapse in coverage to access treatment. 1-855-494-6489.
Bayer GAP Coverage Program : Patients who are unemployed or have a   loss/lapse in private insurance coverage;    Patient Assistance Program: Patients who do not have insurance, lack 3rd-part   coverage, or have pending Medicaid approval maybe be eligible to receive   Kogenate FS.1-800-288-8374.
Biogen Factor Access Program: Patients using ALPROLIX or ELOCTATE who have   no prescription coverage, are facing a gap in coverage, or have reached their   maximum insurance coverage limit, may be eligible to receive product for   free.ALPROLIX: 1-855-692-5776

ELOCTATE: 1-855-693-5628

CSL Behring Patient Assistance Program: Patients must be underinsured or   uninsured & when enrolled, actively seeking insurance.Assurance Program: Must have private health insurance; certificate   program that helps with potential future lapses in private insurance plans.

1-800-676-4266

Grifols Grifols Patient Care Program: For patients using ALPHANATE or   AlphaNine SD who are uninsured or experiencing a temporary lapse of insurance   coverage.1-844-693-2286
Novo Nordisk Novo Nordisk Product Assistance Program: Provides medication to   qualifying applicants at no charge; patients must have been prescribed a Novo   Nordisk product for an eligible indicated condition, have no insurance   coverage & actively seeking insurance coverage.1-844-668-6732
Octapharma NUWIQ Free Trial Program: allows for up to six doses or 20,000 IUs of   NUWIQ. A prescription for NUWIQ is required.Wilate Free Trial Program: allows for up to 5,000 IUs of Wilate. A   prescription for Wilate is required.

1-800-554-4440

Pfizer Pfizer RxPathways Program: Provides co-pay assistance up to $10,000,   free product or premium assistance. Must be prescribed a Pfizer specialty   drug, must have private insurance with prescription drug coverage and meet income   eligibility requirements.1-866-706-2400

 

Shire Shire Patient Assistance Program: Provides uninsured &   financially-eligible patents free products for eligible Shire’s hemophilia   products.1-888-229-8379