Corifact

Indicated For

congenital Factor XIII deficiency

About This Medication

# CSL Behring Patient Assistance Program Patient Guide: How to Get Corifact at Low or No Cost ## About This Program The **CSL Behring Patient Assistance Program** is designed to help patients access **Corifact (factor XIII concentrate (human))** when cost is a barrier to treatment. This program provides medically necessary therapy to qualified patients who are uninsured, underinsured, or unable to afford their prescribed medication. CSL Behring believes everyone should have access to the treatment they need, regardless of financial circumstances. ## About Corifact Corifact is a factor XIII concentrate used to treat patients with factor XIII deficiency. Factor XIII is a blood clotting factor essential for proper wound healing and blood clot stability. Corifact helps patients maintain adequate clotting function and prevent serious bleeding complications. Your healthcare provider has determined that Corifact is medically necessary for your condition. ## Who Qualifies for This Program? You may be eligible for the CSL Behring Patient Assistance Program if you meet these criteria: - You are a **resident of the United States** (excluding Puerto Rico and other U.S. territories) - You have a **valid, on-label prescription** for Corifact from your healthcare provider - You are **uninsured or underinsured** and cannot afford your prescribed therapy - Your medication is being obtained through a **Specialty Pharmacy, Hemophilia Treatment Center, or Outpatient Hospital** - You have **no prior free trial history** with Corifact through this program ## Insurance Requirements This program is specifically designed for patients who: - Have **no health insurance coverage** for Corifact, or - Have **insufficient insurance coverage** (high deductibles, limited coverage, or significant out-of-pocket costs) If you have commercial insurance, you may also be eligible for CSL Behring's **Co-Pay Assistance Program**, which helps with deductibles, co-payments, and coinsurance. Contact CSL Behring at **888-508-6978** to learn more about co-pay assistance options. ## Income Eligibility While specific income thresholds are not publicly listed, the program evaluates financial need on a case-by-case basis. You will need to provide documentation of your household income as part of the application process. This helps CSL Behring determine your eligibility and the level of assistance you may receive. ## Maximum Benefit The annual benefit under this program may be **up to $12,000 per enrollment year**. This maximum covers the cost of Corifact provided through the program. ## How to Apply: Step-by-Step ### Step 1: Gather Required Documentation Before starting your application, collect the following documents: - **Proof of income**: W2 forms, recent pay stubs, or a notarized letter explaining your financial situation - **Valid prescription**: Your healthcare provider's prescription for Corifact - **Insurance information**: Details about any current health insurance (or documentation of being uninsured) - **Identification**: Proof of U.S. residency ### Step 2: Complete the Patient Assistance Qualification Form You or your healthcare provider can obtain the **Patient Assistance Qualification Form** from CSL Behring. This form asks for: - Your personal and contact information - Household income and financial details - Current insurance status - Medical information about your condition - Your healthcare provider's information and authorization ### Step 3: Submit Your Application You have two options for submitting your application: **Option A: Through Your Healthcare Provider or Pharmacy** - Your prescriber or specialty pharmacy can submit the completed form and documentation on your behalf - This is often the easiest option, as your healthcare team handles the paperwork **Option B: Direct Submission** - You can submit the completed form and documentation directly to CSL Behring - Contact information for submission will be provided on the application form ### Step 4: Verification and Enrollment Once CSL Behring receives your application: - A case manager will review your eligibility - CSL Behring may contact you or your insurance carrier to verify information - You will be notified of your enrollment status once all eligibility requirements are confirmed ## Timeline and Delivery While specific processing times are not publicly listed, CSL Behring works to process applications efficiently. Once you are enrolled: - Your Corifact will be dispensed through your Specialty Pharmacy, Hemophilia Treatment Center, or Outpatient Hospital - Ongoing support is available through CSL Behring case managers - You can contact CSL Behring for assistance with scheduling shipments and refill reminders ## What Happens If Your Application Is Denied? If you are denied enrollment in the Patient Assistance Program, consider these alternatives: - **Co-Pay Assistance Program**: If you have commercial insurance, you may qualify for help with out-of-pocket costs. Call **888-508-6978**. - **CSL Behring Assurance Program**: If you experience a lapse in insurance coverage, this program may help you continue treatment. Call **1-800-676-4266**. - **Reimbursement Support**: CSL Behring's Reimbursement Resources Center can provide expert advice about insurance coverage. Call **1-800-676-4266**. - **Appeal**: Ask CSL Behring if you can appeal the decision or reapply if your circumstances change. ## Patient Support Services Beyond financial assistance, CSL Behring offers additional support: - **Clinical Nurse Education**: Personalized phone support to help you understand your medication and manage your condition - **In-Home Nurse Training**: Training for patients new to self-administration therapy - **Case Management**: Dedicated case managers to answer questions and help coordinate your care - **Benefit Investigation**: CSL Behring can contact your insurance carrier on your behalf to determine coverage and patient costs ## Important Terms and Conditions - CSL Behring reserves the right to modify, limit, or discontinue this program without notice - You must maintain a valid prescription for Corifact to continue receiving assistance - The product must be obtained through an approved pharmacy or treatment center - You are responsible for confirming that program participation complies with any insurance requirements - Annual benefits are limited to $12,000 per enrollment year ## Contact Information For questions about the CSL Behring Patient Assistance Program or to begin your application: - **General Patient Support**: Contact your healthcare provider or specialty pharmacy - **Co-Pay Assistance**: **888-508-6978** - **Reimbursement Resources**: **1-800-676-4266** - **Insurance Lapse Assistance (CSL Behring Assurance)**: **1-800-676-4266** ## Disclaimer This guide provides general information about the CSL Behring Patient Assistance Program for Corifact. Program eligibility, benefits, and terms are subject to change. For the most current and complete information, contact CSL Behring directly or visit their official website. This guide is not a guarantee of enrollment or benefits. Your healthcare provider and CSL Behring will determine your final eligibility based on individual circumstances.

Program information last verified: March 30, 2026