Daliresp

Indicated For

COPD

About This Medication

# Daliresp Patient Assistance Program Guide: How to Get Your COPD Medication at Low Cost ## About Daliresp and COPD Daliresp (roflumilast) is an oral medication prescribed to prevent bronchospasm and slow disease progression in people with severe chronic obstructive pulmonary disease (COPD)[1]. COPD is a group of diseases affecting the lungs, primarily emphysema and chronic bronchitis. For many patients, Daliresp represents an important part of their treatment plan to avoid hospitalizations and manage symptoms effectively. However, the cost of Daliresp can be a significant barrier to treatment. Pharmaceutical manufacturers recognize this challenge and maintain specialized patient assistance programs (PAPs) designed to help patients who lack the financial resources to pay retail drug prices[3]. ## Who Qualifies: Income Eligibility Daliresp patient assistance programs evaluate eligibility primarily based on annual household income. The income thresholds are: | Household Type | Annual Income Limit | |---|---| | Single individual | Under $40,000 | | Married couple | Below $60,000 | | Family of three or more | Less than $100,000 | Meeting these income thresholds is the primary qualification criterion, though different manufacturers may use additional specific criteria when evaluating applications[3]. Even if your income falls within these ranges, it's important to note that meeting the threshold doesn't automatically guarantee acceptance—each application is reviewed individually. ## Additional Requirements Beyond income eligibility, you'll need: - A current valid prescription from your treating physician[3] - Documentation of your household income - Proof of citizenship or legal residency (typically required) ## Insurance Requirements Patient assistance programs through pharmaceutical manufacturers are designed to work alongside or independently of insurance coverage. These programs price medications based on financial need rather than market rates or insurance formularies[3]. You do not need to have insurance to qualify, though if you do have coverage, the program will coordinate with your existing plan. ## How the Program Works: Cost Savings Through Daliresp patient assistance programs, eligible patients receive the medication at substantially discounted rates[3]. Approved applicants typically pay around $80 per month, compared to significantly higher retail prices[3]. This pricing structure prevents cost barriers from forcing patients to skip doses or abandon treatment. ## Step-by-Step Application Process ### Step 1: Choose Your Enrollment Partner You can apply directly through patient advocacy organizations that specialize in connecting COPD patients to manufacturer assistance programs. Two primary resources include: - **Simplefill**: Call 1(877)386-0206 or apply online. Within 24 hours, a trained patient advocate will contact you to conduct a brief profiling interview[1]. - **The Rx Advocates**: Specializes in COPD patient enrollment and handles all application materials on your behalf[3]. ### Step 2: Provide Required Documentation You'll submit: - Your current Daliresp prescription - Documentation of household income (tax returns, pay stubs, or benefit statements) - Basic demographic and contact information The enrollment organization handles compilation of all application materials—you don't need to worry about paperwork[1]. ### Step 3: Coordination with Your Healthcare Provider Your enrollment partner will work directly with your pulmonologist's office to obtain any necessary medical documentation and paperwork[3]. You don't need to manage this communication yourself. ### Step 4: Application Submission and Approval Your enrollment organization submits applications on your behalf to the programs you qualify for[1]. Once approved by the manufacturer, you'll be officially enrolled in the program[1]. ## Timeline and Medication Delivery While specific processing times vary by manufacturer, most applications are processed within a reasonable timeframe once submitted. Once approved, Daliresp ships directly to your home each month[3], ensuring an uninterrupted supply of your medication. ## What Happens If Your Application Is Denied If your initial application is denied, don't lose hope. Work with your enrollment partner to understand the specific reason for denial. Common reasons include: - Income exceeding program thresholds - Missing or incomplete documentation - Not meeting specific manufacturer criteria Your enrollment organization can help you explore alternative options, including: - Other manufacturer assistance programs with different eligibility criteria - State pharmaceutical assistance programs (available in many states)[2] - Medicare Extra Help/Low-Income Subsidy programs if you're eligible[2] - GoodRx coupons or other discount programs - The Medicare Prescription Payment Plan, which allows you to spread costs over the year[2] ## Reauthorization and Ongoing Support Once enrolled, your enrollment partner continues to monitor your application and handles the ongoing relationship with the manufacturer. When your prescription needs renewal, the program typically continues to provide your medication at the same discounted rate, though you may need to recertify your income periodically depending on the specific program requirements. ## Important Disclaimer This guide provides general information about Daliresp patient assistance programs. Specific program details, eligibility requirements, and benefits may vary by manufacturer and change over time. Income thresholds, copay amounts, and application procedures are subject to change. For the most current and accurate information specific to your situation, contact your enrollment partner directly or speak with your healthcare provider. This information is not a guarantee of program enrollment or medication pricing. ## Next Steps If you believe you may qualify for Daliresp patient assistance, contact one of the enrollment organizations today: - **Simplefill**: 1(877)386-0206 - **The Rx Advocates**: Visit their website or call for more information Within 24 hours of applying, you'll be connected with a patient advocate who can assess your individual situation and guide you through the enrollment process.

Program information last verified: March 30, 2026