Dysport

Indicated For

spasticity, cervical dystonia

About This Medication

# **IPSEN CARES Patient Assistance Program** Patient Guide: How to Get **Dysport** (abobotulinumtoxinA) at Low or No Cost This guide explains the **IPSEN CARES Patient Assistance Program (PAP)**, which provides **Dysport** free to eligible patients facing financial hardship. Dysport is an injectable prescription medicine used to treat muscle spasms and stiffness in adults and children with conditions like cervical dystonia, upper/lower limb spasticity, or increased muscle stiffness in pediatric cerebral palsy patients aged 2+.[1][9] ## **Who Qualifies for the Program?** The program targets patients with **financial hardship** who meet specific criteria. You must: - Be a **U.S. resident** (including territories). - Have a **valid prescription** for Dysport from a licensed U.S. healthcare provider. - Be **uninsured or functionally uninsured** (insurance doesn't cover Dysport or leaves high out-of-pocket costs).[1][8] - Demonstrate **financial need** through proof of hardship, such as low income or other financial documents.[1] **Note:** Medicare, Medicaid, VA, DoD, TRICARE, or other government program participants are typically ineligible for this free drug program, though other IPSEN CARES support like copay help may apply separately for commercial insurance.[3][5] ## **About Dysport (abobotulinumtoxinA)** **Dysport** is a botulinum toxin type A injection that temporarily relaxes overactive muscles. It's FDA-approved for: - **Cervical dystonia** (neck muscle spasms in adults). - **Spasticity** in adults (upper/lower limbs). - **Pediatric lower limb spasticity** in children aged 2+ with cerebral palsy. Treatments are given by healthcare professionals every 3-4 months. Common side effects include injection site pain, fatigue, headache, or dry mouth—discuss risks with your doctor. Always follow your prescriber's instructions.[1][9] ## **Income Eligibility Breakdown** Specific income limits (like Federal Poverty Level percentages) aren't publicly detailed; eligibility is based on **financial hardship** and IPSEN CARES review. No fixed thresholds for individuals, couples, or families are listed.[1] | Household Size | Income Threshold | Notes | |---------------|------------------|-------| | Individual | Not specified | Assessed case-by-case for financial hardship. | | Couple | Not specified | Proof of income/finances required. | | Family of 3 | Not specified | Contact program for personalized review. | | Family of 4+ | Not specified | Financial eligibility criteria applied. | **Key Point:** Submit proof of financial hardship (e.g., tax returns, pay stubs) for evaluation. Call (866) 435-5677 for guidance.[1] ## **Insurance Requirements** You must be **uninsured or functionally uninsured**. This means: - No coverage for Dysport under your plan. - High out-of-pocket costs making it unaffordable. Patients with **commercial insurance** may qualify for separate copay programs (as low as $0), but PAP is for those without viable coverage. Government insurance (Medicare Part B/D, Medicaid) usually disqualifies you from free drug.[3][5][8] ## **Step-by-Step Application Process** Applying is straightforward with **multiple methods**. Work with your healthcare provider (HCP). 1. **Discuss with Your Doctor:** Confirm Dysport prescription and PAP eligibility. Your HCP completes prescriber sections.[1][4] 2. **Complete Enrollment Form:** Fill **Patient Information**, **Insurance Info**, and **PAP section**. Options: - **Online:** Visit https://www.ipsencares.com/dysport-patient-support/dys-us-006064-patient-assistance-program.[1] - **Download & Fax:** Print form, complete, fax to 1-888-525-2416 (pages 1-3+ required).[4][7] - **At Doctor's Office:** Fill together, submit electronically or fax.[3] 3. **Gather Documents:** - Completed enrollment form. - Prescription. - Prescriber attestation (HCP signature confirming medical need).[1][4] - Proof of financial hardship (e.g., income docs).[1] 4. **Submit:** Fax, upload online, or mail. IPSEN CARES reviews within **1 business day**.[1][4] 5. **Follow-Up:** Patient Access Specialist contacts you and HCP.[1] **Phone Support:** (866) 435-5677, Mon-Fri 8am-8pm ET.[1] ## **Timeline and Delivery** - **Processing:** 1 business day for review and contact.[1][4] - **Approval:** If eligible, Dysport ships **directly to your healthcare provider** (not home).[1] - **Treatment:** Receive at provider's office. Expect quick turnaround—enroll early to avoid delays. ## **Alternatives if Denied** - **Copay Program:** For commercial insurance (not government), pay $0 if eligible. Enroll separately.[3][5] - **Other Support:** IPSEN CARES offers nurse support, prior auth help, education.[9] - **External Programs:** Check NeedyMeds, PAN Foundation, or state assistance. - **Appeal:** Contact IPSEN CARES to discuss denial reasons and resubmit docs. - **Generic/Biosimilars:** None listed for Dysport.[1] ## **Disclaimer** This guide is for informational purposes based on available program details as of latest info. Eligibility isn't guaranteed—IPSEN CARES makes final decisions. Consult your doctor and call (866) 435-5677 for personalized advice. Program terms can change; visit ipsencares.com for updates. Not medical advice—discuss Dysport suitability with your HCP. Ipsen not liable for application errors.

Program information last verified: March 30, 2026