CABLIVI

Indicated For

acquired thrombotic thrombocytopenic purpura (aTTP), immune-mediated thrombotic thrombocytopenic purpura (iTTP)

About This Medication

# HemAssist Patient Assistance Program Guide: Getting CABLIVI at Low Cost ## About This Program The HemAssist Patient Assistance Program helps patients with acquired thrombotic thrombocytopenic purpura (aTTP) or immune-mediated thrombotic thrombocytopenic purpura (iTTP) get CABLIVI (caplacizumab-yhdp) at little or no cost. This program is provided by Sanofi, the manufacturer of CABLIVI, to ensure cost doesn't prevent you from getting the medication you need. ## Who Can Apply You may be eligible for HemAssist if you: - Have been prescribed CABLIVI by your doctor - Are a U.S. resident - Are uninsured or underinsured - Have government insurance like Medicare, Medicaid, or Healthcare Marketplace coverage - Meet the program's income requirements **Important:** Patients with private insurance may also qualify if your out-of-pocket costs are too high. Contact the program directly to discuss your specific situation. ## Income Requirements Income limits vary based on your household size and situation. The program uses federal poverty guidelines as a reference point, but limits can be higher. Because income limits vary, you should apply even if you're unsure whether you qualify—the program will determine your eligibility during the application process. **Contact the program at (833) 723-5463 to ask about current income limits for your household size.** ## Insurance Coverage The HemAssist program works with: - **Uninsured patients:** Full assistance available - **Medicare patients:** Program can help with copays and coinsurance - **Medicaid patients:** Program can supplement coverage - **Healthcare Marketplace patients:** Program can assist with costs - **Underinsured patients with private insurance:** Program may help cover gaps **Important rule:** If you receive free CABLIVI through HemAssist, you and your healthcare provider cannot submit claims for that medication to any insurance company or third-party payer. ## How to Apply: 4 Easy Steps **Step 1: Gather Required Documents** - Proof of residency (utility bill, lease, or government ID) - Proof of income (recent tax return, pay stubs, or benefit statements) - Current insurance information (insurance card or proof of coverage status) **Step 2: Call the Program** - Phone: **(833) 723-5463** - Have your documents ready - A program representative will guide you through the application **Step 3: Complete Your Application** - Provide personal and financial information - Answer questions about your insurance and medical condition - Submit or upload your required documents **Step 4: Receive Your Decision** - The program will review your application - You'll be notified of approval status - Approved patients receive CABLIVI with shipping to their home or doctor's office ## What to Expect **Application Timeline:** Most decisions are made within 5-7 business days of submitting a complete application. **Approval Duration:** Your assistance is good for 12 months. You'll need to reapply annually to continue receiving program benefits. **Savings Card Option:** Even if you don't qualify for free medication, ask about the HemAssist Savings Card, which may reduce your out-of-pocket costs. ## Refills and Ongoing Support Once approved, you can request refills by contacting the program. Your doctor may also submit refill requests directly. Make sure to reapply before your 12-month approval period ends to avoid interruption in your medication. ## What If You're Denied? If your application is denied, you can: - Ask the program to explain the reason - Provide additional financial documentation if your situation has changed - Submit an appeal or reapply in the future if your circumstances change ## Additional Resources - **Program Website:** https://www.sanofihemassist.com/us/our-products/cablivi - **Phone Support:** (833) 723-5463 - **Hours:** Available to answer questions about eligibility and the application process ## Important Reminders - Apply as soon as your doctor prescribes CABLIVI—don't delay treatment while waiting for approval - Keep your contact information current so the program can reach you - Report changes in income or insurance to the program within 30 days - You must be a U.S. resident to qualify The cost of treatment shouldn't prevent you from getting the care you need. If you have questions about your eligibility or the application process, call **(833) 723-5463** today.

Program information last verified: March 25, 2026