Benlysta

GSK For You Patient Assistance Program Patient Guide: How to Get Benlysta (belimumab) at Low or No Cost

Benlysta (belimumab) is a prescription medicine used to treat people 5 years of age and older with active systemic lupus erythematosus (SLE or lupus) or active lupus nephritis (LN)—lupus-related kidney inflammation—along with other lupus medicines. This guide explains the GSK For You Patient Assistance Program (PAP), which provides Benlysta free of charge to eligible uninsured or functionally uninsured patients, and certain Medicare patients, helping those who can't afford their medication.

About Benlysta

Benlysta is not a cure for lupus but helps reduce disease activity when used with other treatments. It's given as a weekly subcutaneous injection (under the skin) at home or an intravenous (IV) infusion every 4 weeks in a doctor's office. It's approved for patients 5 years and older with active SLE or LN, but not for those with severe active central nervous system lupus. Common side effects include nausea, diarrhea, fever, and arm/leg pain; serious risks include infections, allergic reactions, and rare conditions like progressive multifocal leukoencephalopathy (PML). Always discuss risks with your doctor.

Who Qualifies for the Program?

The GSK For You PAP is for U.S. residents (including Puerto Rico and U.S. Virgin Islands) who are uninsured or functionally uninsured (insurance doesn't cover Benlysta), or eligible Medicare patients. You must have a valid prescription and meet income limits. Patients with high medical expenses exceeding income limits may still qualify—contact the program to check.

Key eligibility:

• No enrollment in government programs like Medicaid, VA, DOD, TriCare (Medicare patients excluded from Extra Help/Low-Income Subsidy).
• Live in the U.S.
• Meet income guidelines (see table below).

Income Eligibility Breakdown

Income limits are based on annual gross household income before taxes. Use the table for your household size. For uninsured patients (48 states/DC): Individual: $60,000; Couple: $80,000; Family of 3: $72,000; Family of 4: $84,000. Add $12,000 per additional person. Medicare patients have separate, often higher limits (e.g., Individual: $63,840; add $22,720 per extra person)—call (877) 423-6597 for details.

Notes: Income from tax returns, W-2s, pay stubs. Medical expenses can offset higher incomes.

Insurance Requirements

• Uninsured/Functionally Uninsured: No prescription coverage or insurance denies Benlysta.
• Medicare: Eligible if on Medicare Part D, not in Extra Help, and no other government coverage (Medicaid, VA, etc.). Medicare patients can't use copay programs even in the coverage gap.
• Commercially Insured: This PAP is not for you—check BENLYSTA Copay Program (up to $9,000/year assistance) instead. Contact the program for your situation.

Step-by-Step Application Process

1. Get a Prescription: Ask your doctor for Benlysta and discuss if PAP is right.
2. Check Eligibility: Call (877) 423-6597 (Mon-Fri, 8 AM-8 PM ET) or visit gskpaf.org. Provide income/household details.
3. Gather Documents:
   • Valid Benlysta prescription.
   • Proof of income (2024/2025 tax return, W-2, 4+ recent pay stubs).
   • Completed enrollment form (English/Spanish available online), signed by you and your prescriber.
4. Submit Application: Mail to GSK Patient Assistance Program, PO Box 5490, Louisville, KY 40255, or fax/follow form instructions. Multiple methods available.
5. Wait for Approval: Processing takes 2-3 business days.
6. Receive Medication: Shipped free to your home or doctor's office.

Tip: BENLYSTA Gateway (via program phone) helps with prior authorizations or questions.

Timeline and Delivery

• Approval: 2-3 business days after complete submission.
• Delivery: Direct ship to patient or prescriber's office—no cost.
• Supply Duration: Typically 1-3 months; reauthorization required annually or as needed (resubmit income/proof).

If Denied or No Alternatives

• Common Denials: Income too high, insured status, incomplete docs. Appeal by providing medical expense proof.
• Next Steps:
  • BENLYSTA Copay Program for commercial insurance.
  • Simplefill (1-877-386-0206) matches other aid.
  • Lupus Foundation resources or state programs.
  • No biosimilars currently available.
  • Ask doctor about generics/other lupus treatments.

Reauthorization and Refills

Reauthorization is required—program doesn't auto-renew. Your doctor resubmits form/proof before supply ends. Stay proactive to avoid gaps.

Disclaimer

This guide is for informational purposes only and based on program details as of 2026. Eligibility, terms, and income limits can change—always verify with GSK at (877) 423-6597 or gskpaf.org. Not health insurance. Consult your doctor for medical advice. GSK not liable for application errors.