DANYELZA

Indicated For

relapsed or refractory high-risk neuroblastoma in the bone or bone marrow

About This Medication

# Y-mAbs Connect Patient Assistance Program: How to Get DANYELZA at Low or No Cost ## About DANYELZA DANYELZA (naxitamab-gqgk) is a prescription medication prescribed by healthcare providers for FDA-approved indications. If you've been prescribed DANYELZA but are concerned about the cost, the Y-mAbs Connect Patient Assistance Program may be able to help you access this medication at reduced or no cost. ## Who Qualifies for Assistance The Y-mAbs Connect program offers two separate financial assistance options depending on your insurance status: **Patient Assistance Program (PAP):** Available to patients who are uninsured or underinsured. This program may provide DANYELZA at no cost to eligible patients. **Co-Pay Program:** Available to patients with commercial or private insurance. This program can reduce your out-of-pocket costs to as little as $0, with a maximum annual benefit of $15,000 per enrollment period. ## Insurance Requirements and Eligibility The Y-mAbs Connect program accepts patients with various insurance statuses: | Insurance Type | Eligible for PAP | Eligible for Co-Pay Program | |---|---|---| | Uninsured | Yes | No | | Underinsured | Yes | No | | Commercial/Private Insurance | No | Yes | | Medicare | Potentially | No | | Medicaid | Potentially | No | | Government/Public Insurance | No | No | **Important Note:** Government-insured patients (Medicare/Medicaid) are not eligible for the Co-Pay Program. However, if you have Medicare or Medicaid and are considered underinsured for DANYELZA, you may qualify for the Patient Assistance Program. ## Income Eligibility The Patient Assistance Program uses a needs-based assessment to determine eligibility. While specific income thresholds are not publicly listed, the program evaluates your financial situation to determine if you qualify for assistance. The program is designed to support families who cannot afford DANYELZA through standard insurance coverage. To learn your specific eligibility based on your household income and financial circumstances, you'll need to complete the enrollment form and speak with a Y-mAbs Connect case manager. ## Geographic Requirements The Y-mAbs Connect program is available only to residents of the United States and Puerto Rico. ## How to Apply: Step-by-Step **Step 1: Get the Enrollment Form** Your healthcare provider (HCP) can obtain the Y-mAbs Connect enrollment form, or you can request it by calling the Y-mAbs Connect support line. **Step 2: Complete the Enrollment Form** Both you (or your authorized representative) and your healthcare provider must complete the enrollment form. Required information includes: - Your full name and date of birth - Contact information (phone and email) - Insurance information (front and back copies of your insurance card) - Your authorized representative's name and relationship to you (if applicable) - Your healthcare provider's prescriber information and certification **Step 3: Submit Your Application** Once completed, submit your enrollment form by: - **Faxing** to 1-877-209-6227, or - **Mailing** to PO Box 5490, Louisville, KY 40255, or - **Emailing** to ymabsconnect@pharmacord.com Make sure to include copies of both the front and back of your insurance card with your submission. **Step 4: Speak with a Case Manager** After you've enrolled, a Y-mAbs Connect case manager will contact you. You can also proactively reach out to a case manager by calling 1-833-339-6227 (option 2) Monday through Friday, 8 AM to 8 PM ET. Case managers can: - Help you understand your insurance benefits and out-of-pocket costs - Provide information about prior authorization requirements - Discuss appeals if your insurance denies coverage - Identify additional financial assistance programs you may qualify for - Provide information about travel support and lodging assistance through third-party organizations ## Timeline and Medication Delivery While specific processing times are not publicly listed, the Y-mAbs Connect team works to process applications promptly. Once approved, DANYELZA will be shipped either directly to you or to your physician's office, depending on what's arranged with your case manager. For the Co-Pay Program, your enrollment period lasts 12 months from your enrollment date. You'll need to submit your Explanation of Benefits (EOB) and claim forms to Y-mAbs Connect to receive copay assistance. ## What Happens If Your Application Is Denied If you're denied assistance through the Y-mAbs Connect program, your case manager can help you explore other options: - Information about third-party organizations that may provide financial support - Assistance with insurance appeals if your coverage was denied - Guidance on other resources available to help with treatment costs Don't hesitate to ask your case manager about alternative assistance programs—there may be other options available to you. ## Reauthorization and Refills The Y-mAbs Connect program requires reauthorization. This means you'll need to renew your enrollment to continue receiving assistance. Your case manager will provide guidance on the reauthorization process and timeline before your current enrollment period expires. For the Co-Pay Program specifically, each enrollment period lasts 12 months from your enrollment date. After 12 months, you'll need to re-enroll to continue receiving copay assistance. ## Important Disclaimers - Y-mAbs Therapeutics, Inc. reserves the right to modify or discontinue this program at any time without notice. - The copay assistance benefit applies only to the copay for a DANYELZA infusion, not to related procedures, services, or hospital stays. - Third-party organizations mentioned for travel support are not affiliated with Y-mAbs Therapeutics, Inc., and their eligibility requirements may vary. - All information in this guide is current as of the date provided but may change. Always verify current program details by contacting Y-mAbs Connect directly. ## Contact Information **Y-mAbs Connect Support Line:** 1-833-339-6227 (option 2 for case managers) **Hours:** Monday through Friday, 8 AM to 8 PM ET **Fax:** 1-877-209-6227 **Email:** ymabsconnect@pharmacord.com **Mailing Address:** PO Box 5490, Louisville, KY 40255 **Website:** ymabsconnect.com

Program information last verified: March 30, 2026