Dacogen

Indicated For

MDS, AML

About This Medication

# Patient Access Network Foundation Patient Guide: How to Get Dacogen (Decitabine) at Low or No Cost ## About This Program The Patient Access Network Foundation (PAN) offers a **copay assistance program** designed to help patients with health insurance afford Dacogen (decitabine), a medication used to treat blood and bone marrow cancers, including myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML). This program helps eligible patients reduce their out-of-pocket costs by assisting with copayments, coinsurance, and other cost-sharing expenses. ## About Dacogen (Decitabine) Dacogen is an intravenous chemotherapy medication that works by slowing the growth of cancer cells in the blood and bone marrow. The medication is typically administered as an IV infusion in an outpatient infusion center. Treatment follows one of two main schedules: - **Five-Day Regimen**: 20 mg/m² administered intravenously over 1 hour, once daily for 5 consecutive days, with cycles repeated every 4 weeks - **Three-Day Regimen**: 15 mg/m² administered as a continuous IV infusion over 3 hours, every 8 hours for 3 days, with cycles repeated every 6 weeks Your healthcare provider will determine which regimen is appropriate for your specific condition. ## Who Qualifies: Income Eligibility To qualify for PAN's Dacogen assistance program, your household income must fall at or below **400-500% of the federal poverty level**. This threshold varies based on household size. | Household Size | 2026 Federal Poverty Level | 400% FPL | 500% FPL | |---|---|---|---| | Individual | $15,060 | $60,240 | $75,300 | | Couple (2 people) | $19,320 | $77,280 | $96,600 | | Family of 3 | $24,360 | $97,440 | $121,800 | | Family of 4 | $29,400 | $117,600 | $147,000 | *Note: These figures are estimates based on 2026 federal poverty guidelines. Contact PAN directly for current thresholds, as they may be updated annually.* ## Additional Eligibility Requirements Beyond income limits, you must meet these criteria: - **Have active health insurance** that covers Dacogen (this is required) - **Have a medically appropriate diagnosis** for which Dacogen is prescribed - **Reside and receive treatment in the United States** - **Be a U.S. citizen or permanent resident** (typically required) ### Special Consideration for Medicare Part D If you have Medicare Part D coverage, PAN will evaluate your eligibility on a **case-by-case basis**. Contact the program directly to discuss your specific situation, as Medicare Part D patients may have different eligibility criteria or limitations. ## Insurance Requirements This is a **copay assistance program for insured patients only**. Your health insurance must actively cover Dacogen for your specific diagnosis. PAN cannot assist patients whose prescriptions are covered entirely by government programs or who lack insurance coverage. If you have Medicare, Medicaid, or other government insurance, you may qualify for alternative assistance programs: - **Medicare Extra Help/Low-Income Subsidy (LIS)**: Reduces out-of-pocket costs for Part D beneficiaries with limited income - **State Pharmaceutical Assistance Programs**: Many states offer additional support for medication costs - **RXOUTREACH**: Offers free or low-cost medications to uninsured or underinsured patients ## How to Apply ### Step 1: Gather Your Information Before applying, have the following ready: - Your household income documentation (recent tax return, pay stubs, or benefit statements) - Proof of U.S. residency - Your insurance information (policy number, group number) - Your prescription or medical records showing Dacogen is medically appropriate for your condition - Contact information for your healthcare provider ### Step 2: Choose Your Application Method You have two options: **Option A: Online Application** - Visit the PAN website or contact them for the online application portal - Complete the application electronically with your information - Upload required documentation **Option B: Phone Application** - Call PAN at **(866) 316-7263** - A representative will guide you through the application process - You can discuss your specific situation and ask questions **Option C: Paper Application** - Request a printable application form from PAN - Complete the form and have your doctor sign it - Mail the completed form to: Patient Access Network Foundation (PAN) PO Box 221858 Charlotte, NC 28222 ### Step 3: Submit Your Application - If applying online or by phone, you'll receive confirmation of your submission - If mailing a paper application, include all required documentation - Keep a copy of your application for your records ### Step 4: Await Approval Decision PAN will review your application and contact you with a decision. Processing typically takes **1-2 weeks**, though this may vary based on application completeness and volume. ## Timeline and Delivery **Processing Time**: Expect a decision within **1-2 weeks** of submitting a complete application. Incomplete applications may take longer. **Delivery Method**: Once approved, PAN will send you a **copay assistance card** to use at your pharmacy. This card works like a discount card—you present it when filling your Dacogen prescription to reduce your out-of-pocket costs. **How to Use Your Card**: 1. Present the card to your pharmacist when filling your Dacogen prescription 2. The card will be scanned to apply the copay assistance 3. You'll pay the reduced copay amount at the pharmacy ## What If Your Application Is Denied? If PAN denies your application, you have several alternatives: - **Appeal**: Contact PAN to understand the reason for denial and ask about appealing the decision - **Explore Other Programs**: Ask your doctor about other patient assistance programs, including manufacturer programs - **Medicare Options**: If you have Medicare, explore the Extra Help program or Medicare Prescription Payment Plan - **State Resources**: Contact your state Department of Aging for state-funded pharmaceutical assistance programs - **Clinical Trials**: Ask your oncologist about clinical trials for Dacogen, which often cover medication costs - **Financial Counseling**: Request a social worker referral to explore additional resources, grants, or support services ## Reauthorization and Refills Once approved, your copay assistance typically continues as long as you remain eligible. However: - **Annual Reauthorization**: You may need to reauthorize your eligibility annually - **Refills**: Present your card each time you fill a Dacogen prescription - **Changes in Circumstances**: Notify PAN immediately if your income, insurance, or medical status changes ## Important Disclaimers - This program is subject to change; contact PAN for the most current information - Eligibility and benefit limits apply - Your insurance must cover Dacogen for your specific diagnosis - This program does not replace your insurance coverage - PAN cannot assist if your prescription is covered by federal or state government programs - All information provided is current as of March 2026 and subject to program updates ## Contact Information **Patient Access Network Foundation (PAN)** - **Phone**: (866) 316-7263 - **Fax**: (866) 316-7263 - **Mailing Address**: PO Box 221858, Charlotte, NC 28222 - **Hours**: Contact for current business hours Don't hesitate to call with questions—PAN representatives are available to help you navigate the application process and understand your benefits.

Program information last verified: March 30, 2026