ACCC | Incyte Corporation Patient Assistance and Reimbursement Guide

Incyte Corporation offers the IncyteCARES program for patients prescribed Jakafi or Pemazyre. IncyteCares can help healthcare professionals and patients with access and support.

For more information, search Jakafi or Pemazyre in this Guide or go online. For patients prescribed Jakafi, call 1.855.452.5234, Monday through Friday, 8:00 AM to 8:00 PM EST. For patients prescribed Pemazyre, you can reach the program at 1.866.708.8806, Monday through Friday, 8:00 AM to 8:00 PM EST.

Oncology-related products: Jakafi^® (ruxolitinib) tablets, Pemazyre^® (pemigatinib) tablets

Reimbursement Assistance

IncyteCARES

IncyteCares can help help eligible patients and healthcare professionals with reimbursement support, including:

Patient benefits verification
Billing codes and forms healthcare professionals may need
Prior authorization follow ups
Information for coverage appeals.

For patients prescribed Pemazyre, the program can also complete pharmacy outreach calls to help patients get started on their treatment.

Enroll patients prescribed Jakafi online or fax the completed enrollment form to 1.855.525.7207.

Enroll patients prescribed Pemazyre online or fax the completed enrollment form to 1.888.714.0016.

For more information, call 1.855.452.5234 (for Jakafi) or 1.866.708.8806 (for Pemazyre), Monday through Friday, 8:00 AM to 8:00 PM EST.

Patient Assistance Program

IncyteCARES Patient Assistance Program

The IncyteCares Patient Assistance Program helps eligible patients who do not have prescription drug insurance or who have trouble affording their out-of-pocket costs for their Incyte medications. Eligible patients can receive their Incyte medication free of charge. Terms and conditions apply. Terms of this program may change at any time.

To qualify, patients must:

Be confirmed as eligible for and enrolled in IncyteCares for Jakafi or Pemazyre
Be a resident of the United States or U.S. territory
Have a valid prescription for Jakafi or Pemazyre for an FDA-approved use
Meet certain uninsured or underinsured criteria.

Medicare Part D patients may be eligible by meeting additional criteria and program requirements, including but not limited to earning less than 600 percent of the federal poverty level. Commercially insured patients who have exhausted their benefit and have an inability to afford their medication or out-of-pocket costs may be eligible.

Enroll patients prescribed Jakafi online or fax the completed enrollment form to 1.855.525.7207.

Enroll patients prescribed Pemazyre online or fax the completed enrollment form to 1.888.714.0016.

Within two business days, patients will be notified of "conditional approval," which allows them to receive free medication for 90 days. Full approval is only granted once income information is submitted and confirmed.

For more information, call 1.855.452.5234 (for Jakafi) or 1.866.708.8806 (for Pemazyre), Monday through Friday, 8:00 AM to 8:00 PM EST.

Independent Charitable Foundations/Organizations

IncyteCARES Referrals

Patients may be eligible for help with medication, treatment-related travel, and other costs.

If patients do not qualify for the IncyteCares for Jakafi savings program or patient assistance programs, InctyeCares may be able to provide information about other organizations or independent foundations that may offer help. Some assist with medication costs, transportation or lodging expenses related to treatment, or counseling services, offered at a reduced or no cost.

Eligibility and availability of these programs are determined by the individual organizations.

To learn more, call 1.855.452.5234, Monday through Friday, 8:00 AM to 8:00 PM EST or visit incytecares.com.

Co-Pay Card/Out-Of-Pocket Cost Assistance

IncyteCARES Savings Program

Eligible patients can receive their medication for as little as $0 per month, subject to monthly and annual limits. To qualify, patients must:

Have commercial prescription drug coverage
Be a resident of the United States or a U.S. territory
Have a valid prescription for an Incyte medication for an FDA-approved use.

Patients insured under federal or state government prescription drug programs—including Medicare Part D, Medicare Advantage, Medicaid, or TriCare—are not eligible. Patients without prescription drug coverage are also not eligible. Uninsured, cash-paying patients are not eligible.

Amount of savings for the purchase of Jakafi will not exceed $11,977 per month and $25,000 per year. Amount of savings on Pemazyre will not exceed $9,000 per claim and $25,000 per year.

For patients prescribed Jakafi, enroll online or complete the IncyteCares program enrollment process. For more information, call 1.855.452.5234, Monday through Friday, 8:00 AM to 8:00 PM EST.

For patients prescribed Pemazyre, contact IncyteCares at 1.866.708.8806 to request a savings card or enroll patients online. Once a patient or healthcare provider submits the enrollment form, a patient membership number is immediately issued and accessible by Biologics, the specialty pharmacy for Pemazyre. Patients can begin receiving their prescription for as little as a $0 out-of-pocket cost right away.

Insurance Coverage-Related Delay Program

IncyteCARES Temporary Access Program

Eligible patients receive a free short-term supply of medication. If patients' prescription insurer requires more than a three-day wait for determining coverage approval, IncyteCares may be able to provide a free 30-day supply of the prescribed Incyte medication. No purchase contingencies or other obligations apply.