AQNEURSA

Indicated For

Niemann-Pick disease type C (NPC)

About This Medication

# AQNEURSA Cares Patient Guide: How to Get AQNEURSA (levacetylleucine) at Low or No Cost AQNEURSA Cares is IntraBio's patient support program that helps eligible patients access **AQNEURSA (levacetylleucine)**, an FDA-approved oral treatment for neurological symptoms of **Niemann-Pick disease type C (NPC)**, by verifying insurance, assisting with prior authorizations, and providing co-pay support where applicable.[1][2][6] ## About AQNEURSA and Who It's For **AQNEURSA (levacetylleucine)** is a granule for oral suspension supplied in unit-dose packets (1g each). It's indicated to improve neurological symptoms in patients with NPC, a rare genetic disorder (ICD-10 code E75.242) that affects lipid metabolism and leads to progressive neurological decline.[7] Unlike supportive therapies, AQNEURSA targets symptoms like ataxia, dysarthria, and dysphagia to help maintain daily function.[1][6] This guide is for patients, families, or caregivers prescribed AQNEURSA. The **AQNEURSA Cares** program is the single point of contact for access, handling insurance verification, co-pay assistance eligibility, prior authorization (PA) support, and direct medication shipment to your home.[3][4] It's designed to reduce barriers, especially for those with commercial insurance facing high out-of-pocket costs.[2][5] ## Who Qualifies for AQNEURSA Cares? Most patients with a valid AQNEURSA prescription qualify for basic services like insurance verification and shipment. Enhanced **financial assistance** and **co-pay programs** target specific groups: - **Commercially insured patients** (employer-sponsored or individual plans): Eligible for co-pay assistance to lower or eliminate out-of-pocket costs, where allowed by law. Restrictions and maximum benefits apply.[2][4] - **Underinsured or cash-pay patients**: May qualify for financial support programs or third-party resources.[6] - **Exclusions**: Patients in **Medicaid, Medicare, or any federal healthcare program** are **not eligible** for co-pay assistance.[4] **Income eligibility** details are not publicly specified; the program assesses on a case-by-case basis. Contact AQNEURSA Cares at (866) 200-0419 for personalized evaluation.[1][2] | Household Size | Income Threshold | FPL % | Notes | |----------------|------------------|-------|-------| | Individual | Not specified | Not specified | Case-by-case; call for details | | Couple | Not specified | Not specified | Commercial insurance prioritized for co-pay help | | Family of 3 | Not specified | Not specified | Federal program patients excluded from co-pay aid | | Family of 4 | Not specified | Not specified | Financial assistance via referral if needed | Always confirm with the program, as criteria may update.[2][6] ## Insurance Requirements AQNEURSA Cares verifies your coverage, checks out-of-pocket costs, and supports PA if required (common for specialty drugs like AQNEURSA).[2][3] Provide front/back copies of your **pharmacy insurance card**. The team contacts your plan and assists your doctor with PA submissions or appeals.[4][6] Electronic prescriptions work for refills.[4] - **Commercial insurance**: Best for co-pay assistance. - **Government insurance**: Coverage possible, but no co-pay help; explore other aid.[4] - **No insurance**: Program connects to financial resources.[6] ## Step-by-Step Application Process Getting started is straightforward—your doctor leads, but your signature is key. Here's how: 1. **Get Prescribed**: Discuss AQNEURSA with your healthcare provider. They'll confirm NPC diagnosis (E75.242) and suitability.[7] 2. **Complete Enrollment Form**: Download from https://aqneursa.com/wp-content/enrollment-form.pdf. Your doctor fills prescriber/prescription sections; you complete patient/insurance info and sign the authorization.[8][2] 3. **Gather Documents**: - Signed **Patient Enrollment Form** (physician + patient signatures required).[1][8] - **Front and back** of pharmacy insurance card.[4][8] - Clinical info for PA (use Prior Authorization Checklist: diagnosis, dosing, etc.).[3][7][8] 4. **Submit by Fax**: Doctor faxes the full packet to **470-751-8639**. (Application method: fax only.)[3][4][8] 5. **AQNEURSA Cares Contacts You**: A Care Coordinator calls (add (866) 200-0419 to contacts) to confirm consent (if missing), explain benefits, handle PA, and check co-pay eligibility. Available Mon-Fri, 8:30am-8pm ET.[2][4] 6. **Approval and Shipment**: Once verified, medication ships **direct to patient/caregiver**. They'll collect any co-pay if applicable.[2][3] Call (866) 200-0419 with questions anytime.[1] ## Timeline and Delivery Processing varies by insurance/PA needs—typically days to weeks. Expect coordinator contact soon after fax receipt for next steps like benefits investigation.[6] No fixed timeline listed; follow up by phone. Medication arrives via **direct shipment** to your home—no pharmacy pickup needed.[3][4] Instructions for Use provided.[3] ## If Denied or Alternatives - **Appeal/Denial Help**: Program assists with PA appeals or claim denials.[6] - **Financial Referral**: Connected to third-party aid if ineligible for co-pay program.[6] - **No Alternatives**: No biosimilars listed. If AQNEURSA unavailable, discuss with doctor; patients can receive medication without full program enrollment.[6] - **Other Resources**: National Niemann-Pick Disease Foundation (nnpdf.org).[3] ## Important Disclaimer This guide summarizes publicly available info as of latest updates. **AQNEURSA Cares** may change terms; **always verify directly** at (866) 200-0419 or aqneursa.com. Not medical/financial advice—consult your doctor/insurer. Co-pay assistance restricted; federal program patients ineligible. IntraBio not liable for coverage decisions.[2][4][5] (Word count: 952)

Program information last verified: March 30, 2026