DAXXIFY

Indicated For

Cervical dystonia

About This Medication

# DAXXIFY Patient Assistance Program Patient Guide: How to Get DAXXIFY (daxibotulinumtoxinA-lanm) at Low or No Cost DAXXIFY (daxibotulinumtoxinA-lanm) Patient Assistance Program, offered by Revance Therapeutics, Inc., helps **eligible, commercially insured patients** access this prescription treatment at low or no cost through physician office delivery.[4] This guide explains qualifications, the drug, application steps, and more in simple terms. ## About DAXXIFY **DAXXIFY** is an injectable prescription medicine (botulinum toxin type A) FDA-approved for two main uses in adults: temporarily improving moderate to severe frown lines (glabellar lines) between the eyebrows and treating cervical dystonia (neck muscle spasms).[5][6] Unlike other neurotoxins, it's powered by a stabilizing peptide, offering fast results—often within 2 days—and lasting smoothness for many up to 6 months.[1][8] For **frown lines**, 74% of patients saw at least a 2-grade improvement by week 4, with over 50% maintaining no or minor lines until 6 months.[1][8] For **cervical dystonia**, it's physician-administered to relax overactive neck muscles.[4] It's not for spasticity, children, pregnant women, or other unapproved uses.[5][6] Common side effects include injection site reactions; serious risks like toxin spread require immediate medical help if breathing, speech, or swallowing issues occur.[5] Always discuss with your doctor if DAXXIFY fits your needs—potency isn't interchangeable with other botulinum toxins.[5] ## Who Qualifies? This program targets **commercially insured patients** (private insurance, not government plans like Medicare/Medicaid).[4] It's ideal for those facing high out-of-pocket costs for DAXXIFY treatments. Uninsured patients may qualify via a separate track mentioned for cervical dystonia.[4] No specific income thresholds are listed, making it broadly accessible for insured individuals whose plans don't fully cover the drug.[4] **Key eligibility:** - Prescription for DAXXIFY from a participating provider. - Commercial insurance. - U.S. resident (program operated by Revance Therapeutics, Inc.).[3][4] ## Income Eligibility Breakdown No strict income limits apply, as this is primarily insurance-based aid.[4] However, for context in patient assistance programs, eligibility often considers household income relative to Federal Poverty Level (FPL). Since none are specified here, the table below shows general benchmarks used in similar programs (not DAXXIFY-specific—confirm with program): | Household Size | Up to 400% FPL (Example Threshold) | Annual Income Example (2026 est.) | |---------------|------------------------------------|-----------------------------------| | 1 | $60,000 | Eligible if insured | | 2 | $81,000 | Eligible if insured | | 3 | $102,000 | Eligible if insured | | 4 | $123,000 | Eligible if insured | | +1 each | +$21,000 | Eligible if insured | *Note: DAXXIFY has no published FPL caps; focus is commercial insurance. Call 1-855-329-3294 for your situation.*[4] ## Insurance Requirements **Commercially insured patients** are eligible—government insurance like Medicare typically disqualifies.[4] Provide proof like an Explanation of Benefits (EOB) or receipt showing coverage gaps.[4] Programs like this bridge copays or deductibles for DAXXIFY. Participating providers handle billing with codes like CPT 64616 for cervical dystonia.[4] Check if your doctor's office participates.[3][7] ## Step-by-Step Application Process Applications use **multiple methods**—phone is key.[4] Here's how: 1. **Get Prescribed:** Visit your doctor for DAXXIFY. Confirm they participate (many aesthetics or neurology offices do).[3][4][7] 2. **Gather Documents:** Prepare **enrollment form** (from doctor or program) and **receipt/EOB** proving treatment/insurance.[4] 3. **Apply:** Call **1-855-329-3294** to start enrollment. Provide patient details, insurance info, and documents. Online options may exist for savings IDs (e.g., for cervical dystonia).[2][4] 4. **Submit:** Fax/mail forms as directed. Program reviews eligibility. 5. **Approval:** If approved, medication ships to **physician's office** for administration.[4] **Tips:** Act fast—some offers have deadlines (e.g., past rebates ended March 31).[1][3] Your provider may scan QR codes or guide rebate enrollment.[3] ## Timeline and Delivery **Processing time** isn't specified—expect 1-2 weeks typical for similar programs, but call for updates.[4] Once approved, DAXXIFY delivers directly to your **physician's office**—no home shipment.[4] Treatments happen there; results start in 2 days, last months.[1][8] Refills/reauthorizations may need doctor resubmission (details via phone).[4] ## Alternatives if Denied - **Appeal:** Resubmit with more docs or doctor letter. - **Savings Programs:** Check DAXXIFY Radiant Rewards for rebates (up to $50 off, if eligible—ends March 31, 2026).[1][3] - **Other Aid:** Revance site for uninsured cervical dystonia access.[4] General copay cards via NeedyMeds/PAN Foundation. - **Competitors:** Other neurotoxins like Botox/Dysport if appropriate. - **Provider Discounts:** Ask about in-office offers.[7] Contact 1-855-329-3294 for denial reasons/next steps. ## Disclaimer This guide is for informational purposes, based on available program data as of 2026—not official advice.[4] Eligibility, terms change; verify with Revance at 1-855-329-3294. Not for emergencies—call 911 if needed. DAXXIFY has risks; review full prescribing info.[5] Consult your doctor/insurer. Revance not liable for guide use.

Program information last verified: March 30, 2026