Beovu

Novartis Patient Assistance Foundation (NPAF) Patient Guide: How to Get Beovu at Low or No Cost

About Beovu

Beovu (brolucizumab-dbbl) is a prescription medication manufactured by Novartis. If you have been prescribed Beovu but are concerned about the cost, the Novartis Patient Assistance Foundation (NPAF) may be able to help you access this medication at low or no cost.

Who Qualifies for NPAF Assistance

To be eligible for the NPAF program, you must meet all of the following criteria[2]:

• Reside in the United States or a U.S. Territory
• Have limited or no prescription insurance coverage, or cannot afford your medication even with insurance
• Meet income guidelines for Beovu (income thresholds vary and may differ for Alaska and Hawaii)
• Have a valid prescription for Beovu from a licensed U.S. healthcare provider
• Receive treatment on an outpatient basis

Understanding Income Eligibility

The NPAF program has specific income limits that determine whether you qualify for assistance. These limits are based on your household size and total annual income[2]. Income guidelines vary by medication and may be adjusted for residents of Alaska and Hawaii.

To determine if you meet the income requirements for Beovu, visit the NPAF website at www.PAP.Novartis.com or call NPAF at 1-800-277-2254 to speak with a representative who can review your specific situation.

Insurance Requirements

You are eligible for NPAF assistance if you[2]:

• Have no prescription insurance coverage, or
• Have prescription insurance but cannot afford your medication, or
• Have insurance that requires a Prior Authorization (PA) that was denied

If you have insurance and a Prior Authorization was required, you will need to submit a copy of the PA denial or appeal outcome with your application[1].

Step-by-Step Application Process

Step 1: Check Your Eligibility

Before starting your application, verify that you meet the basic eligibility requirements by visiting www.PAP.Novartis.com or calling 1-800-277-2254[3]. A representative can answer questions about whether Beovu assistance is available and whether you may qualify based on your income.

Step 2: Gather Required Documentation

Before completing your application, collect the following documents[1][5]:

• Proof of income: Copies of the first two pages of your most recent federal income tax return (Form 1040). If you are not required to file taxes, contact NPAF directly.
• Insurance information: Copies of the front and back of all insurance cards (primary, secondary, and prescription insurance)
• Prior Authorization documentation (if applicable): If your insurance denied a Prior Authorization for Beovu, include a copy of the denial letter or appeal outcome
• Valid prescription: Your healthcare provider will provide this as part of their application section

Step 3: Complete Your Application Section

Obtain the NPAF application form and complete the patient section, which includes[1][4]:

• Your full name, address, date of birth, and contact information
• Your household size (as determined on your tax return)
• Your healthcare provider's name and contact information
• Authorization for NPAF to speak with your healthcare provider about your health condition
• Your signature and date

Ensure all required fields are completed. An incomplete application will result in processing delays or denial[1].

Step 4: Have Your Healthcare Provider Complete Their Section

Provide your healthcare provider with the application form. Your provider must complete their section, which includes[4]:

• Confirmation of your diagnosis and medical need for Beovu
• A valid prescription for Beovu
• Their signature and date
• Authorization to disclose medical information to NPAF

Step 5: Submit Your Complete Application

Once you and your healthcare provider have completed your sections and gathered all required documentation, submit your application by[1][4]:

Fax: 1-855-817-2711

Mail: Novartis Patient Assistance Foundation, Inc. P.O. Box 2529 Columbus, OH 43216

Make copies for your records before submitting.

Timeline and What to Expect

After you submit your complete application, the NPAF will review it and notify you of the outcome[3]. You will receive a decision letter within approximately 4 weeks[3][5]. If you have opted in to text message notifications, you may also receive a text message with updates about your application status.

If your application is incomplete, you will receive a letter with instructions on what additional information is needed[3].

How You'll Receive Your Medication

Once your application is approved, NPAF will work with you and your healthcare provider to ensure you receive your Beovu medication. Contact NPAF at 1-800-277-2254 for specific details about medication delivery and how to obtain your prescription.

What to Do If Your Application Is Denied

If your application is denied, you will receive a letter explaining the reason. Common reasons for denial include[2]:

• Incomplete application or missing documentation
• Income exceeding program limits
• Having adequate prescription insurance coverage
• Not meeting other eligibility criteria

If you believe your application was denied in error, or if your financial situation has changed, you can contact NPAF at 1-800-277-2254 to discuss your options. A representative may be able to help you reapply or explore other assistance programs.

Contact Information

For questions about the NPAF program or your application:

Phone: 1-800-277-2254 Hours: Monday through Friday, 9:00 AM to 6:00 PM EST Website: www.PAP.Novartis.com Fax: 1-855-817-2711

Important Disclaimer

This guide provides general information about the Novartis Patient Assistance Foundation program. Program eligibility, requirements, and benefits may change. For the most current and accurate information, please visit www.PAP.Novartis.com or contact NPAF directly. This guide is not a guarantee of program eligibility or approval. Your individual circumstances will be evaluated during the application review process.