Arikayce

Indicated For

MAC lung disease, NTM

About This Medication

# inLighten Patient Support Program Patient Guide: How to Get Arikayce at Low or No Cost Arikayce (amikacin liposome inhalation suspension) is a specialized antibiotic treatment for adults with refractory Mycobacterium avium complex (MAC) lung disease, delivered via nebulizer directly to the lungs. The **inLighten Patient Support Program** from **Insmed Incorporated** helps eligible patients access Arikayce through copay assistance and specialty pharmacy coordination, potentially reducing costs significantly for those with commercial insurance. ## About Arikayce and Who It's For **Arikayce** is the only FDA-approved inhaled liposomal amikacin specifically designed for treatment-resistant MAC lung infections, a serious nontuberculous mycobacterial (NTM) condition affecting breathing. Unlike oral or IV antibiotics, its liposomal formulation targets the lungs while minimizing systemic side effects like kidney damage. Patients typically use it alongside other standard therapies after at least 6 months of failed treatment. This guide focuses on the **inLighten Patient Support Program**, which primarily offers **copay assistance** to lower out-of-pocket costs. It's ideal for patients battling chronic NTM lung disease who face high expenses—annual costs can exceed $100,000 without assistance. The program connects you to specialty pharmacies like PANTHERx Rare Pharmacy or Accredo for delivery and support. ## Who Qualifies for the Program? Eligibility centers on insurance type rather than strict income limits. Key qualifiers include: - Adults prescribed Arikayce for refractory MAC lung disease. - **Commercial insurance** holders (e.g., employer plans, marketplace insurance) for copay card assistance, which can cover copays, coinsurance, or deductibles up to program limits. - Medicare or Medicaid patients may access **alternative support** through foundations, as copay cards are ineligible for government insurance. **Income eligibility** is flexible with no fixed Federal Poverty Level (FPL) thresholds listed, prioritizing commercially insured patients. Medicare patients should verify plan coverage, as prior authorization is often required. ### Income Eligibility Breakdown | Household Size | Income Threshold | FPL % | Notes | |---------------|------------------|-------|-------| | Individual | Not specified | N/A | Primarily copay-focused; income reviewed case-by-case for broader aid. | | Couple | Not specified | N/A | Commercial insurance key qualifier. | | Family of 3 | Not specified | N/A | Medicare/Medicaid directed to foundations. | | Family of 4 | Not specified | N/A | Contact program for personalized assessment. | *Table note: No rigid income caps; program emphasizes insurance eligibility over FPL.* ## Insurance Requirements - **Commercial insurance**: Eligible for copay assistance via the inLighten copay card. This can reduce costs for eligible copays/deductibles. - **Medicare/Medicaid**: Ineligible for copay card. Explore other Insmed support or independent foundations like Patient Access Network (PAN) Foundation, Good Days, or HealthWell Foundation. - **Prior authorization (PA)** often required by insurers (e.g., Blue Cross Blue Shield). Your doctor must document 6+ months of failed MAC therapy. Uninsured or underinsured? Call for foundation referrals. ## Step-by-Step Application Process 1. **Get Prescribed**: Discuss Arikayce with your pulmonologist or NTM specialist. They complete the Arikares Enrollment Form (Page 3) proving medical necessity. 2. **Contact inLighten**: Call **(833) 544-4800** to enroll. Provide your insurance details, prescription info, and personal contact. 3. **Submit Benefits Verification**: Program verifies insurance coverage and PA status. Your doctor may need to submit PA with failure-of-therapy evidence. 4. **Receive Copay Card (if eligible)**: For commercial plans, get a copay savings card digitally or by mail. 5. **Fill at Specialty Pharmacy**: Prescription routes to PANTHERx, Accredo, or similar. Pharmacy handles shipping. Application is **phone-based**—no online portal needed. No specific documents listed beyond prescription and insurance proof. ## Timeline and Delivery - **Enrollment to Approval**: 15-18 days typical, including PA processing. - **Notification**: Sent to your doctor and pharmacy. - **Delivery**: Shipped directly to your home via specialty pharmacy (Days 18-21). Expect clinical monitoring support. - **Supply Options**: 30-day or 90-day (if insurer approves) to optimize costs. Refills follow similar coordination; reauthorization may apply periodically. ## Alternatives if Denied or Ineligible - **Appeal Denials**: Request formulary exceptions or appeals (e.g., Texas Independent Review Organization for BCBSTX). - **Foundation Assistance**: PAN Foundation, Good Days, HealthWell for copay/premium grants. - **The Assistance Fund**: Independent copay program for Arikayce. - **Arikares Support**: Separate Insmed line at (833) 274-5273 for additional help. - **90-Day Supply**: Ask insurer/pharmacy to lower frequency costs. No biosimilar alternatives exist. ## Important Disclaimer This guide provides general information based on available program details as of 2026. Eligibility, benefits, and terms can change—**always verify directly with inLighten at (833) 544-4800**. Not medical advice; consult your doctor. Program not guaranteed; insurer rules apply. Insmed or pharmacies not liable for coverage decisions. For Medicare, contact your plan provider.

Program information last verified: March 30, 2026