aimovig financial assistance guide · 2020. 1. 16. · sharps container available yes home delivery...

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I Have Been Prescribed Aimovig. What Financial Assistance Programs Exist To Help Me? Most insurance companies have added at least one or two of these CGRP inhibitors to the list of medicines they cover, but individual patients are still struggling to get the insurers to approve coverage of their prescribed CGRP inhibitor. Each pharmaceutical company is offering financial assistance programs to help bridge coverage until the insurance company agrees to cover and/or to help cover the cost of high copays. Each program is different and various programs exist to support patients with private, goverment-funded insurance, as well as the uninsured. To help patients understand each program, the Coalition For Headache And Migraine Patients (CHAMP) has created Financial Assistance Guides for the three CGRP inhibitors. These guides have not been produced or approved by the medication manufacturers. CHAMP is not endorsing the use of any CGRP inhibitor over another, nor promoting the use of this new class of preventive medications for everyone with migraine disease. Every patient needs to consult their healthcare provider to determine if CGRP inhibitors are right for you. I Have a Private/Commercial Insurance Plan This category includes insurance plans provided through an employer, purchased with subsidy support from the Affordable Care Act (Obamacare) or purchased privately. Highlights of Aimovig Ally™ Access Card If your health plan covers Aimovig, you will pay as little as $5 per month up to a $2700 annual cap. This applies to your out-of-pocket costs, including deductible, co-insurance and copayments for Aimovig. You are responsible for costs above the $2700 annual maximum. Offer expires after 12 months at which time you must re-enroll in the program to continue receiving this benefit. You should be notified at least 30 days prior to the end of the 12 month offer. However, if you do not receive that notification, please call Aimovig Ally to follow-up If your health plan does not cover Aimovig, or requires a Prior Authorization, you can qualify for the Bridge to Commercial Coverage Offer. Under this offer, you will receive Aimovig at no cost for up to 12 doses while insurance coverage is pursued. Once insurance coverage is approved, this offer is no longer valid, and you must call 1-833-246-6844 to stop participation. In 2018, a new class of medications was approved by the FDA for the prevention of migraine in adults. These drugs are referred to as calcitonin gene-related peptide (CGRP) inhibitors. There are currently three CGRP medications on the market. Dosing, frequency of use and method of action vary. Aimovig Financial Assistance Guide Information on how to get your Savings Card on the following page

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Page 1: Aimovig Financial Assistance Guide · 2020. 1. 16. · Sharps Container Available Yes Home Delivery Available Home delivery may be available from Aimovig Ally™ through their patient

I Have Been Prescribed Aimovig. What Financial Assistance Programs Exist To Help Me?

Most insurance companies have added at least one or two of these CGRP inhibitors to the list of medicines they cover, but individual patients are still struggling to get the insurers to approve coverage of their prescribed CGRP inhibitor. Each pharmaceutical company is offering financial assistance programs to help bridge coverage until the insurance company agrees to cover and/or to help cover the cost of high copays. Each program is different and various programs exist to support patients with private, goverment-funded insurance, as well as the uninsured.

To help patients understand each program, the Coalition For Headache And Migraine Patients (CHAMP) has created Financial Assistance Guides for the three CGRP inhibitors. These guides have not been produced or approved by the medication manufacturers. CHAMP is not endorsing the use of any CGRP inhibitor over another, nor promoting the use of this new class of preventive medications for everyone with migraine disease. Every patient needs to consult their healthcare provider to determine if CGRP inhibitors are right for you.

I Have a Private/Commercial Insurance Plan

This category includes insurance plans provided through an employer, purchased with subsidy support from the Affordable Care Act (Obamacare) or

purchased privately.

Highlights of Aimovig Ally™ Access CardIf your health plan covers Aimovig, you will pay as little as $5 per month up to a

$2700 annual cap. This applies to your out-of-pocket costs, including deductible, co-insurance and copayments for Aimovig. You are responsible for costs above

the $2700 annual maximum. Offer expires after 12 months at which time you must re-enroll in the program to continue receiving this benefit. You should be notified

at least 30 days prior to the end of the 12 month offer. However, if you do not receive that notification, please call Aimovig Ally to follow-up

If your health plan does not cover Aimovig, or requires a Prior Authorization, you can qualify for the Bridge to Commercial Coverage Offer. Under this offer, you will

receive Aimovig at no cost for up to 12 doses while insurance coverage is pursued. Once insurance coverage is approved, this offer is no longer valid, and

you must call 1-833-246-6844 to stop participation.

In 2018, a new class of medications was approved by the FDA for the prevention of migraine in adults. These drugs are referred to as calcitonin gene-related peptide (CGRP) inhibitors. There are currently three CGRP

medications on the market. Dosing, frequency of use and method of action vary.

Aimovig™ Financial Assistance Guide

Information on how to get your Savings Card on the following page

Page 2: Aimovig Financial Assistance Guide · 2020. 1. 16. · Sharps Container Available Yes Home Delivery Available Home delivery may be available from Aimovig Ally™ through their patient

STEP 1 - Your doctor writes you a prescription for Aimovig.

STEP 2 - Enroll in the Aimovig Ally™ Access Card program online at aimovigaccesscard.com/enroll.

STEP 3 - Take your prescription (if your doctor did not call it in to your pharmacy) and Access Card to your regular retail pharmacy to be filled. The Access Card includes important information you need to provide the pharmacist to connect your prescription to the offered savings.

STEP 4 - If your pharmacy has Aimovig in stock, they will provide it immediately. If the pharmacy needs to order Aimovig, they should receive it within 24-48 hours. Some pharmacies may direct you to their specialty pharmacy service to arrange home delivery.

Congratulations on accessing your first dose of Aimovig! Amgen will now be working behind the scenes to get your doctor to complete a prior authorization form and to get your insurance company to cover your Aimovig prescription. To be a proactive and engaged patient, you should contact your doctor's office to see if they have completed the Aimovig prior authorization form on your behalf and your insurance company to see if they will be covering your prescribed medicine. If you have questions or encounter problems, contact the Aimovig Ally team at 1-833-246-6844.

Steps To Get Your Savings Card

Page 3: Aimovig Financial Assistance Guide · 2020. 1. 16. · Sharps Container Available Yes Home Delivery Available Home delivery may be available from Aimovig Ally™ through their patient

I Have Medicare,

Medicaid or other

Government Insurance

Plan

I Am Uninsured

The Aimovig Access Card is not available to patients whose medical insurance is provided by state or federal programs like Medicare, Medicaid or Tricare. This restriction is true for all three CGRP inhibitor medications.

The Federal Government does not allow people who are receiving insurance benefits through Medicare, Medicaid, etc. to use co-pay assistance, discount or savings cards offered by pharmaceutical companies. The intent is to steer patients to lower-cost generic drugs and not to support higher-cost brand-name drugs. Unfortunately, there are no generic/biosimilar medications in the class of CGRP inhibitors and won’t be for years to come.

Certain patients with Medicare Part D plans that cover Aimovig who cannot afford their out of pocket costs may be eligible to receive Aimovig at no cost from the Amgen Safety Net Foundation. It is required that you can demonstrate that:

For more information on the Amgen Safety Net Foundation, please visit amgensafetynetfoundation.com or call 1-888-762-6436.

The Aimovig Access Card is not available to patients who are uninsured.

You may be eligible to receive Aimovig at no cost from the Amgen Safety Net Foundation if you meet the following requirements:

You are unable to afford Aimovig (See household income guidelines below)

You are not eligible for Medicaid or Medicare’s Extra Help programYou have fulfilled all insurance carrier guidelines and Prior Authorization requirements prior to applying for assistance, andYou do not have any other financial support options

You have lived in the US or its territories for six months

or longer

You are uninsured, or your insurance plan does not

include Aimovig

You meet the household income eligibility requirements below

If you have this many people in your household

Your household income must be equal to or below this much

each year

1 $60,700

2 $82,300

3 $103,900

4 $125,500

Each additional person Add $21,600

For more information on the Amgen Safety Net Foundation, please visit amgensafetynetfoundation.com or call 1-888-762-6436.

Page 4: Aimovig Financial Assistance Guide · 2020. 1. 16. · Sharps Container Available Yes Home Delivery Available Home delivery may be available from Aimovig Ally™ through their patient

About CHAMP

Aimovig Basics

Brand Name Aimovig

erenumab-aooeBiologic Name

Pharmaceutical Company Amgen and Novartis

Dosing & Administration Option 1: 70 mg monthly injection via the SureClick® autoinjector at home.Option 2: 140 mg monthly injection (now offered as 1 140 mg injection, originally offered as 2 separate 70 mg injections one right after the other) via the SureClick® autoinjector at home.Your doctor will determine which option is best for you.

Indication Adults living with either chronic migraine (15 or more headache days per month) or episodic migraine (fewer than 15 headache days per month).

Website Aimovig.com

Full Prescribing Information www.pi.amgen.com/~/media/amgen/repositorysites/pi-amgen-com/aimovig/aimovig_pi_hcp_english.ashx

Helpline Aimovig Ally™ team at 1-833-AIMOVIG (1-833-246-6844).

Injection Training Available Yes, your healthcare provider should demonstrate how to use the autoinjector prior to your first use. Detailed instructions and video are available on the Aimovig website.

Sharps Container Available Yes

Home Delivery Available Home delivery may be available from Aimovig Ally™ through their patient access program or through your insurance company. Please call either Aimovig Ally™ or your insurance for more information.

Where do I turn if I am not eligible for a financial assistance program?

CHAMP provides support to people with headache, migraine and cluster diseases who are often stigmatized and under-served. CHAMP brings together organizations and leaders in this disease area to enhance communication, coordination and collaboration. CHAMP also organizes patient advocates to fight stigma and achieve fair access to treatments. If you would like to be a patient advocate for people living with headache diseases, sign up at the CHAMP website: HeadacheMigraine.org.

The Patient Advocate Foundation (a CHAMP member organization) can be a helpful resource for patients and caregivers who are experiencing access challenges. PAF provides a suite of expert tips to help navigate insurance denials, appeals and common barriers

at: patientadvocate.org/migrainematters.

PAF also offers one-on-one assistance to help patients navigate insurance problems and other challenging issues (workplace accommodations, applying for disability, etc.) faced by people living with migraine disease. The best way to access these case management services is to fill out the one-on-one insurance assistance application on their website. You can also call 1-800-532-5274 to connect with support.