Novartis Patient Support is a comprehensive program designed to help your eligible patients start, stay, and save on FABHALTA® (iptacopan)
Your practice and patients will have access to a Novartis Patient Support team committed to supporting your patients, including:
Dedicated assistance with access and reimbursement
Personalized support for your patients on therapy
Single points of contact for you and your patients
Get your patients started by downloading the Start Form
We support you throughout your patient’s journey with:
Insurance Support
Financial Support
Vaccination Support
Ongoing Support
Insurance Support
Help navigating the insurance process, including benefits verification and support with the prior authorization and appeals processes.
Benefits Verification
Once you’ve enrolled your patients in Novartis Patient Support, our team will conduct a benefits verification to better understand your patient’s coverage, including:
Informing your practice about additional requirements, such as prior authorization
Identifying savings options available to your patients
Prior Authorization (PA) and Appeals
Novartis Patient Support can help with PA requests or letters of appeal by working directly with you or your office, including:
Providing helpful information and timely updates via phone
PA and Appeals guides that includes the following:
PA Checklist
Exception Request Checklist
ICD-10-CM Flashcard
PA Submission Checklist
Sample letters
PA and Appeals guide
Download the Start Form to sign up for assistance with the PA and Appeals process
Financial Support
Assist with connecting patients to relevant saving options.
At Novartis Patient Support, we understand that affordability is important. That’s why we offer a range of savings options and resources to help your patients access treatment regardless of their ability to pay.
Co-Pay Plus*
With one sign-up, Co-Pay Plus can help your eligible patients with private insurance:
Get FABHALTA if coverage is delayed. Co-Pay Plus can provide up to 12 months of FABHALTA for free* while seeking coverage
Pay for FABHALTA out-of-pocket costs once coverage is approved. Out-of-pocket costs could be your co-pay, co-insurance, or deductible
Co-Pay Plus* offer
Eligible patients may pay as little as $0 for FABHALTA
Start FABHALTA at no cost for your eligible patients
The Bridge Program offers up to 12 months of FABHALTA for free to your privately insured eligible per patients while insurance coverage is pursued†
To sign up for Co-Pay Plus:
Patients can sign up online
Patients can call Novartis Patient Support to sign up at 833-99FABHA (833-993-2242)
Providers, with their patients, can complete the FABHALTA Start Form and send to Novartis Patient Support
Providers can fill out the electronic Start Form on the CoverMyMeds® portal by visiting covermymeds.health
CoverMyMeds is a registered trademark of CoverMyMeds LLC.
Once we’ve determined your patient’s coverage status, we’ll help you connect them to any appropriate financial support offering.
To be eligible for the Bridge Program, patients must have:
Private insurance
A valid prescription for FABHALTA
Additional requirements may apply.
*Limitations apply. Patients with private insurance coverage for FABHALTA may receive up to $20,000 in annual co-pay benefits for the cost of FABHALTA and up to $1,000 for qualifying vaccination costs (excluding administrative fees). Patient is responsible for any costs once the limit is reached in a calendar year. Program not valid (i) under Medicare, Medicaid, TRICARE, VA, DoD, or any other federal or state health care program, (ii) where patient is not using insurance coverage at all, (iii) where the patient’s insurance plan reimburses for the entire cost of the drug, or (iv) where product is not covered by patient’s insurance. The value of this Program is exclusively for the benefit of patients and is intended to be credited towards patient out-of-pocket obligations and maximums, including applicable co-payments, coinsurance, and deductibles. Patient may not seek reimbursement for the value received from this Program from other parties, including any health insurance program or plan, flexible spending account, or health care savings account. Patient is responsible for complying with any applicable limitations and requirements of their health plan related to the use of the Program. Valid only in the United States, Puerto Rico, and select territories. Void where prohibited by law. Additional restrictions may apply. This Program is not health insurance. Program may not be combined with any third-party rebate, coupon, or offer. Proof of purchase may be required. Novartis reserves the right to rescind, revoke, or amend this Program and discontinue support at any time without notice.
†The Bridge Program applies to FABHALTA only. Eligible patients must have private insurance and a valid prescription for FABHALTA, and a prior authorization or an initial denial of coverage. Program requires the submission of a prior authorization or an appeal of the coverage denial within the first 45 days of enrollment to remain eligible. Program provides FABHALTA for free to eligible patients for up to 12 months, or until they receive insurance coverage approval, whichever occurs earlier. A valid prescription consistent with FDA-approved labeling is required. Program is not available to patients whose medications are reimbursed in whole or in part by Medicare, Medicaid, TRICARE, or any other federal or state program. Patients may be asked to reverify insurance coverage status during the course of the Program. No purchase necessary. Program is not health insurance, nor is participation a guarantee of insurance coverage. Additional limitations may apply. Novartis Pharmaceuticals Corporation reserves the right to rescind, revoke, or amend this Program without notice.
Vaccination Support
The Vaccination Support program provides in-home vaccination and guided navigation to help simplify the process for all eligible patients, regardless of insurance.
Vaccination Support consists of:
In-home vaccination
A licensed clinician administering all required vaccination in the patient’s home at no cost
Guided navigation
Help navigating the steps needed to receive the required vaccinations (eg, finding a vaccination location near the patient)
Guidance on accessing existing vaccination records
Eligible patients can use their Co-Pay Plus offer* to lower their out-of-pocket costs to as little as $0 for the required vaccination(s), up to $1,000 annually, excluding administration costs.
Vaccination Resource Guide
Tips and Checklist for Getting Your Vaccinations
Ongoing Support
Novartis Patient Support provides patients with ongoing help to stay on track with their FABHALTA treatment plan, including:
A dedicated Novartis Patient Support team member to answer their questions at every step
Information on financial support options
Help navigating health care changes
Welcome kit with resources to help them get started on treatment
Vaccination support that can help patients locate vaccinations and provide tips for how to find their existing vaccine history
Resources like the dose reminder program to help them remember to take their medication
A choice of texts, calls, virtual calls, and emails to get ongoing resources
Novartis Patient Support does not provide clinical advice or care and is not a substitute for patient consultation with a health care provider.
Getting Patients Started With Novartis Patient Support
CoverMyMeds is a registered trademark of CoverMyMeds LLC.
Resources
Novartis Patient Support has helpful resources for you and your practice to help support your patients throughout their treatment journey
FABHALTA Start Form
Co-Pay Plus Brochure
Navigating the PA and Appeals Process for FABHALTA
FABHALTA ICD-10-CM Flashcard
Vaccination Resource Guide
Other Affordability Assistance
Novartis Patient Assistance Foundation, Inc. (NPAF)
Novartis Patient Assistance Foundation, Inc. (NPAF) is an independent, 501(c)(3) non-profit entity that provides certain medications at no cost to eligible patients who cannot afford the cost of their Novartis medication, are uninsured or have government insurance, and meet income guidelines and other eligibility criteria. NPAF does not provide product to individuals having insurance associated with any type of alternative funding program that conditions, restricts, or adjusts coverage based on application to NPAF or any other free goods program. Other terms and conditions may apply.
To be eligible, your patients must:
Reside in the United States or a US Territory
Be treated by a licensed US health care provider on an outpatient basis
Meet income and insurance guidelines
Visit www.PAP.Novartis.com or call NPAF at 800-277-2254 to learn more about eligibility and how to apply.
Questions?
Novartis Patient Support and a dedicated Novartis Patient Support team are available to work alongside you and your patients every step of the way. Call us at 833-99FABHA (833-993-2242), Monday-Friday, 8:00 AM-8:00 PM ET, excluding holidays.
Discover what FABHALTA could do for your patients