Byvalson

Indicated For

Hypertension

About This Medication

# Allergan Patient Assistance Program Guide: How to Get Byvalson at Low or No Cost ## About This Program The Allergan Patient Assistance Program (PAP) provides **Byvalson (nebivolol and valsartan)** at no cost to eligible patients who cannot afford their medications. Byvalson is a combination medication used to treat high blood pressure. This program is designed to help uninsured or underinsured Americans access the medications they need to manage their health conditions. ## About Byvalson Byvalson is a prescription medication that combines two active ingredients: nebivolol (a beta-blocker) and valsartan (an angiotensin II receptor blocker). This combination is prescribed to help lower blood pressure and reduce the risk of heart disease and stroke. If you have been prescribed Byvalson by your doctor, the Allergan Patient Assistance Program may help you obtain it at no cost. ## Who Qualifies for This Program? To qualify for the Allergan Patient Assistance Program, you must meet the following criteria: - **U.S. Citizenship or Residency**: You must be a U.S. resident - **Physician Care**: You must be under the care of a U.S.-based licensed physician or healthcare provider - **Income Eligibility**: Your household income must be at or below **400% of the Federal Poverty Level** - **Insurance Status**: You must have little or no medical insurance coverage and cannot be eligible for coverage through Medicare Part D, Medicaid, or other private or public assistance programs - **Financial Need**: You must demonstrate that you cannot afford your medication ## Income Eligibility Breakdown The program uses the Federal Poverty Level (FPL) to determine eligibility. Patients at or below 400% of the current Federal Poverty Level qualify for assistance. The following table shows approximate 2026 income limits for different household sizes at 400% of the FPL: | Household Size | Approximate Annual Income Limit (400% FPL) | |---|---| | 1 person | $18,000 | | 2 people | $24,000 | | 3 people | $30,000 | | 4 people | $36,000 | | 5 people | $42,000 | | 6 people | $48,000 | | 7 people | $54,000 | | 8 people | $60,000 | *Note: These are approximate figures based on 2026 Federal Poverty Guidelines. Actual limits may vary. Contact the program directly for current income thresholds.* ## Insurance Requirements The Allergan Patient Assistance Program is designed for patients **without adequate drug coverage**. Specific insurance requirements include: - You cannot be eligible for Medicare Part D coverage - You cannot be eligible for Medicaid - You cannot have private insurance that covers prescription medications - If you are a Medicare beneficiary, you may still qualify if you have been denied coverage under the Low Income Subsidy (LIS) program - If you are denied by the program due to insurance eligibility, you may be directed to other patient savings programs for specific medications ## Step-by-Step Application Process ### Step 1: Gather Required Documentation Before applying, collect the following documents: - A valid prescription from your licensed physician for a three-month supply of Byvalson - Proof of your gross monthly household income (recent pay stubs, tax returns, or benefit statements) - If you are a Medicare Part D enrollee, a copy of your LIS (Low Income Subsidy) denial letter (valid for up to 5 years from the date on the letter) - Your Social Security number or Tax ID - Proof of U.S. residency ### Step 2: Complete the Application You have two options for obtaining and submitting your application: **Option A: Direct Application** - Download the application from www.allergan.com/patient-assistance-programs - Call 1-844-424-6727 to request the application be emailed or mailed to you - Complete the application form with your personal, financial, and medical information - Have your prescriber sign and date the application **Option B: Through a Patient Advocate Service** - Contact Simplefill at 1-877-386-0206 to become a member - A patient advocate will call you within 24 hours to discuss your situation - The advocate will help you complete the application and gather necessary documentation - This service handles much of the paperwork for you at no cost ### Step 3: Submit Your Application Submit your completed application and all required documentation by: **Mail:** Allergan Patient Assistance Program PO Box 66764 St. Louis, MO 63166 **Fax:** 1-844-708-0036 **Phone:** 1-844-424-6727 Make sure your prescriber has signed the application and that all required documentation is included. Incomplete applications may delay your approval. ### Step 4: Await Approval Notification After submitting your application, the Allergan Patient Assistance Program will review your information and notify both you and your prescriber about your eligibility status. ## Timeline and Medication Delivery **Processing Time**: While specific processing times are not published, most applications are reviewed within 1-2 weeks of receipt. You will be notified by mail or phone once a decision has been made. **Medication Supply**: Once approved, you will receive a **90-day supply** of Byvalson shipped directly to your prescriber's office. Your prescriber will then dispense the medication to you. **Reordering**: You can request additional 90-day supplies every three months during your 12-month enrollment period. Your prescriber must submit additional prescriptions for refills. **Enrollment Duration**: - Non-Medicare patients: Up to 12 months from approval date - Medicare Part D enrollees: Until the end of the calendar year - After 12 months, you must reapply to continue receiving assistance ## Important Program Rules While enrolled in the Allergan Patient Assistance Program, you must: - Not purchase Byvalson through your Medicare plan (if applicable) - Not submit claims or seek out-of-pocket cost credits for medication provided through the program - Notify the program immediately if your insurance or financial situation changes - Reapply annually to continue receiving assistance - Understand that program terms may change without notice ## What If Your Application Is Denied? If you are denied enrollment in the Allergan Patient Assistance Program, you may have other options: - **Review Denial Reason**: Contact the program at 1-844-424-6727 to understand why you were denied - **Alternative Programs**: Ask about other patient savings programs for Byvalson or similar medications - **GoodRx and Discount Cards**: Explore prescription discount programs like GoodRx - **Medicare Extra Help**: If you are a Medicare beneficiary, apply for the Extra Help program - **Medicare Prescription Payment Plan**: Ask your pharmacy about payment plan options - **Reapply**: If your financial situation changes, you may reapply after 12 months ## Reauthorization and Renewal Your enrollment in the Allergan Patient Assistance Program lasts for **12 months** (or until the end of the calendar year if you are a Medicare beneficiary). Before your enrollment expires, you must **reapply** to continue receiving free Byvalson. The program will not automatically renew your enrollment. To reapply: - Contact the program 30 days before your enrollment ends - Submit a new application with updated financial and insurance information - Provide a new prescription from your physician - Follow the same application process as your initial application ## Important Disclaimer This guide provides general information about the Allergan Patient Assistance Program as of March 2026. Program eligibility requirements, income limits, required documentation, and other terms may change at any time without notice. This information is not a guarantee of enrollment or medication provision. Always verify current program details by contacting Allergan directly at 1-844-424-6727 or visiting www.allergan.com/patient-assistance-programs. Consult with your healthcare provider about whether Byvalson is appropriate for your medical condition and whether this program is right for you. If you have questions about your specific situation, speak with your prescriber or contact a patient advocate service for personalized assistance.

Program information last verified: March 30, 2026