ALTUVIIIO

Indicated For

hemophilia A

About This Medication

# HemAssist Patient Assistance Program Guide: Getting ALTUVIIIO at Low Cost ## What Is HemAssist? The HemAssist Patient Assistance Program helps eligible patients with hemophilia A access ALTUVIIIO (antihemophilic factor) at reduced or no cost. ALTUVIIIO is a prescription medication that replaces missing clotting factor in the blood. If you're struggling to afford this vital treatment, HemAssist may help you get the medication you need. ## Who Can Apply? You may qualify for HemAssist if you meet these criteria: **Insurance Status** - You are uninsured - You have insurance but it doesn't cover ALTUVIIIO or you face high out-of-pocket costs - You recently lost insurance coverage **Income Requirements** Income limits vary based on household size and state of residence. Generally, HemAssist serves patients with annual household incomes up to a certain threshold—contact the program directly to confirm current limits for your situation. The program is designed to help middle and lower-income patients who cannot afford treatment. **Residency** You must be a U.S. resident to qualify. ## What Documents Do You Need? Prepare these three documents before applying: 1. **Proof of Income**: Recent tax returns, pay stubs, W-2s, or a letter from your employer showing annual income 2. **Proof of Residency**: A utility bill, lease agreement, or government-issued ID with your current address 3. **Proof of Insurance Status**: A copy of your insurance card, denial letter, or documentation showing loss of coverage Having these ready speeds up the application process. ## How to Apply Following these four simple steps: **Step 1: Start Your Application** Visit www.altuviiio.com/financial-support or contact the HemAssist team directly. You can apply online or request a paper application. **Step 2: Complete the Application** Fill out all required sections with accurate information. Include your medical history, current insurance details, and household income. Attach your supporting documents. **Step 3: Submit Your Application** Submit your completed application along with all required documents. You can apply online, by mail, or by phone. Keep copies for your records. **Step 4: Wait for Approval** The HemAssist team will review your application and notify you of the decision. Once approved, they'll coordinate with your pharmacy or healthcare provider to deliver your medication. ## What to Expect: Timeline - **Application review**: 5-10 business days - **Decision notification**: Via phone, mail, or email - **Medication delivery**: Within 1-2 weeks of approval - **First refill**: Processed within 2-3 business days If your application is incomplete, HemAssist will contact you to request missing information. This may extend the timeline, so submitting complete documentation upfront helps. ## Savings Card Option If you have insurance but face high copays or deductibles, ask about the ALTUVIIIO savings card. This card may reduce your out-of-pocket cost per prescription, even if you don't qualify for the full assistance program. ## How Long Does Assistance Last? HemAssist coverage is approved for one year. You must reapply annually to continue receiving assistance. The program will remind you when it's time to renew. ## What If You're Denied? If your application is denied, you have options: - Ask HemAssist why you were denied and what you can do - Reapply if your circumstances change (income, insurance status) - Ask about the savings card as an alternative - Contact a patient advocate or social worker at your treatment center for additional resources ## Questions About Your Coverage If HemAssist doesn't fully cover your needs or you want to explore other options, ask your healthcare team about: - Other manufacturer support programs - State pharmaceutical assistance programs - 340B program discounts - Local hemophilia foundation resources ## Contact HemAssist **Website**: www.altuviiio.com/financial-support **Hours**: Available to answer questions about eligibility and the application process Don't let cost prevent you from getting ALTUVIIIO. HemAssist exists to help—apply today.

Program information last verified: March 25, 2026