ARIKAYCE is covered for 85% of insured patientsa*

Most plans require the completion of a prior authorization, which for the majority of plans is aligned with the ARIKAYCE label

Eligible patients using private or commercial insurance may pay as little as $0 co-pay for ARIKAYCEb

Insmed is committed to providing access to ARIKAYCE. The Arikares® Support Program can help

  • Commercial insurance
  • Government coverageb

ARIKAYCE co-pay savings programa

  • Eligible patients using private insurance can save on out-of-pocket costs for ARIKAYCE
  • Not valid for prescriptions covered by or submitted for reimbursement under Medicaid, Medicare, VA, DoD, TRICARE or similar federal or state programs, including any state pharmaceutical assistance program
  • Eligibility can be determined by calling Arikares at 1-833-ARIKARE (1-833-274-5273)

aSee full terms and conditions.

Medicare Part D Extra Help Programc

Medicare patients with limited income and resources may qualify for extra help to pay for medication. The Extra Help program from Medicare provides financial assistance for patients who may not be able to afford the costs associated with their Medicare Part D plan.


Those eligible for Extra Help may:


  • Receive assistance paying monthly minimum, have a reduced or no deductible, or have a reduced or no prescription coinsurance and co-payments
  • Have no gap in coverage



State-sponsored programs

  • Some states sponsor prescription financial assistance programs, each with their own eligibility requirements
  • The specialty pharmacy will work with your patient to let them know of any additional financial assistance programs including state-sponsored financial assistance programs



b

These programs are not offered by Insmed.

c

Also known as the Low-Income Subsidy (LIS) program.

Find ARIKAYCE coverage on selected plans in:

To prescribe ARIKAYCE, complete the Arikares Enrollment Form with your patients

This gives your patients a prescription of ARIKAYCE and the opportunity for additional support





Step 1

Complete and sign the Arikares Support Program Enrollment Form

Step 2

Contact an Arikares Patient Access Lead to provide publicly available payer approval, prior authorization, and appeals process information

Step 3

Enrollment in the Arikares Support Program provides:


  • Coordination of ARIKAYCE shipments
  • Voluntary in-home or virtual device training by an Arikares Trainer
  • One in-office or virtual train-the-trainer session by an Arikares Trainer to prescribing HCP and staff
  • Ongoing patient support during their treatment journey

To prescribe ARIKAYCE, complete the Arikares Enrollment Form with your patients

The Arikares Enrollment Form is the way for you to prescribe ARIKAYCE and to automatically enroll your patients in the Arikares Support Program.


Download the Arikares Enrollment Form

After I prescribe ARIKAYCE, what will my patients receive?

  1. A Welcome Pack and a call from their Arikares Coordinator to discuss questions and next steps
  2. Their first shipment of ARIKAYCE, arriving in 2 boxes: the first containing the 28-day supply of medicine and the second delivering the Lamira® Nebulizer System and Getting Started Kit

Patients can receive voluntary device training that can be scheduled with an Arikares Trainer after the ARIKAYCE delivery date is confirmed.




ARIKAYCE Co-pay Savings Program Terms and Conditions

Patients who are eligible may pay as little as a $0 co-pay every month. Co-pay savings offered under this program are subject to the following limits: $10,000 per month and up to a total of $45,000 maximum program benefit per calendar year. Patient will be responsible for any co-pay amounts once these limits are reached. Depending on the private or commercial health insurance plan, savings may apply toward co-pay, coinsurance, or deductible. Keep in mind that co-payments, coinsurance, and deductibles are all different types of out-of-pocket costs and you may still have out-of-pocket costs even if you are eligible for this program. Refer to your insurance plan documents if you have questions related to your total out-of-pocket costs for ARIKAYCE.

Who is eligible?

Patients who have been prescribed ARIKAYCE, are at least 18 years of age, a resident of the 50 United States, the District of Columbia, or Puerto Rico, and have commercial or private health insurance may be eligible for the ARIKAYCE Co-pay Savings Program. ARIKAYCE must be covered by your commercial or private insurance. This program is not valid for cash-paying customers. This offer is not valid for prescriptions covered by or submitted for reimbursement under Medicaid, Medicare, VA, DoD, TRICARE or similar federal or state programs, including any state pharmaceutical assistance program.

Patients who are currently ineligible for the ARIKAYCE Co-pay Savings Program may reapply if their circumstances change.

This is not an insurance benefit, and does not cover or provide support for supplies, procedures, or any physician-related services associated with ARIKAYCE. General, non-product specific insurance deductibles are also not covered by this program. Insmed reserves the right to rescind, revoke, terminate, or amend this offer, eligibility, and terms and conditions at any time without notice. Patients, pharmacists, and prescribers cannot seek reimbursement from health insurance or any third party for any part of the benefit received by the patient through this offer. This offer is not conditioned upon, or reward for, any past, present, or future purchase, including refills. The co-pay card is non-transferable, limited to one per person, and cannot be combined with any other offer or discount. This program is not valid where prohibited by law, taxed, or restricted. Offer has no cash value.

Footnote

*Source: Managed Markets Insights & Technology, LLC, database as of June 2021. All information provided is as of 6/30/2021. The information includes applicable public and private payers. The information available here is compiled from a source believed to be accurate, but Insmed makes no representation that it is accurate. This information is subject to change. Payer requirements may vary or change over time, so it is important to regularly check with each payer as to payer-specific requirements. The use of this information does not guarantee payment or that any payment received will cover your costs.

DoD=Department of Defense; VA=Veterans Affairs.

Footnotes

aAll information provided as of 6/30/2021.

bSee full terms and conditions.

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Source: Managed Markets Insight and Technology, LLC™, a trademark of MMIT, as of 8/9/2022.

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