Access, coverage, and Reimbursement
Support to help patients access Palforzia
Aimmune is committed to making PALFORZIA accessible by providing financial options to eligible patients. PALFORZIA Pathway supports patients and caregivers with useful resources and assistance.
Available resources with PALFORZIA Pathway enrollment:
This program helps answer your patients' questions about:
- Accessing PALFORZIA
- Insurance coverage
- Financial assistance options
Co-Pay Savings Program
Commercially insured patients who meet eligibility criteria may*:
- Receive help with out-of-pocket costs for PALFORZIA
- Pay as little as $20 per month, with a maximum benefit of $4000 per calendar year
Patient Assistance Program (PAP)
Uninsured patients or patients whose insurance does not cover PALFORZIA may†:
- Receive PALFORZIA at no cost if they meet specific eligibility and financial criteria
- *Terms and conditions apply. See PALFORZIACoPay.com for full terms and conditions.
- †Terms and conditions apply. Call 1-844-PALFORZ for information about applying.
It's easy to enroll your patients in PALFORZIA Pathway
DOWNLOAD aPrescription and Enrollment Form
COMPLETE the form, and make sure you get the patient's information and signature
FAX the completed form to 1-844-708-0011