Elfabrio

Indicated For

Fabry disease

About This Medication

# Chiesi Total Care Patient Guide: How to Get Elfabrio (pegunigalsidase alfa-iwxj) at Low or No Cost Elfabrio (pegunigalsidase alfa-iwxj) is an FDA-approved enzyme replacement therapy for adults with Fabry disease, a rare genetic disorder affecting lipid metabolism. The **Chiesi Total Care** program by Chiesi USA, Inc. helps eligible patients access Elfabrio through copay assistance, reducing out-of-pocket costs to as little as $0 for the medication and infusions.[5][7] ## About Elfabrio and Fabry Disease **Elfabrio** is an intravenous infusion treatment administered every two weeks to replace the deficient enzyme alpha-galactosidase A, helping to reduce substrate buildup that causes organ damage in Fabry disease. Symptoms include pain, kidney issues, heart problems, and stroke risk. Always consult your doctor for personalized advice on whether Elfabrio is right for you.[7] The Chiesi Total Care program offers comprehensive support, including a dedicated team of pharmacists, patient service coordinators, reimbursement specialists, nursing support, and patient education. They handle insurance navigation, prior authorizations, appeals, and ensure **worry-free refills** with medication shipped directly to your home or infusion site.[1][2][5][7] ## Who Qualifies for Chiesi Total Care? Eligibility focuses on insurance type rather than strict income thresholds. Key requirements include: - A **valid prescription** for an FDA-approved indication (Fabry disease in adults). - **Commercial insurance** (private plans through job, marketplace, or individual purchase). Government plans like **Medicare, Medicaid, or VA** are **not eligible** for financial copay assistance, though non-financial support may be available.[5][7] - Residency in the United States or its territories. - Enrollment in Chiesi Total Care. **Note:** No specific income thresholds are listed for Elfabrio's copay programs, making it accessible to a broad range of commercially insured patients. Independent foundations may offer additional help for uninsured or underinsured patients, but Chiesi does not control their criteria.[5] ### Income Eligibility Breakdown While Chiesi Total Care for Elfabrio does not specify income limits for copay assistance, here's a general table based on similar Chiesi programs (e.g., Revcovi). Check with the program for Elfabrio specifics, as copay cards often have no income cap for commercial insurance. | Household Size | 400% FPL Example (2026 est.) | 500% FPL Example (2026 est.) | |---------------|------------------------------|------------------------------| | 1 | $60,000 | $75,000 | | 2 | $81,000 | $101,250 | | 3 | $102,000 | $127,500 | | 4 | $123,000 | $153,750 | | +1 per person | +$21,000 | +$26,250 | *Estimates; actual FPL updates annually. Copay programs prioritize commercial insurance over income.[9] ## Insurance Requirements **Commercial insurance is required** for copay assistance. Chiesi Total Care offers two programs: - **Prescription Copay**: Covers medication costs, as low as $0. - **Infusion Program**: Covers supplies and administration (including home infusion), as low as $0. **Exclusions:** - Government-funded plans (Medicare, Medicaid, VA) ineligible for financial aid.[5][7] - Residents of MA or RI cannot access home infusion services.[7] The team assists with benefits investigations, prior authorizations, and appeals to maximize coverage.[2][7] ## Step-by-Step Application Process 1. **Get Your Prescription**: Ask your doctor for a prescription for Elfabrio for FDA-approved use. 2. **Contact Chiesi Total Care**: Call **1-833-656-1056** to start enrollment. A Patient Service Coordinator will guide you.[5] 3. **Complete Enrollment and Authorization Form**: This will be mailed to your home or available online. Sign and return with: - Valid prescription. - Proof of commercial insurance (insurance card, explanation of benefits).[7] 4. **Submit Documents**: Fax, upload, or mail as instructed. The team verifies eligibility. 5. **Benefits Investigation**: Program checks insurance coverage and identifies copay support. 6. **Approval and Start**: Once approved, medication ships to your home or infusion site. Your coordinator handles everything, including nurse education on infusions.[1][4][7] ## Timeline and Delivery Processing times vary but average around 18 days from prescription to first dose in similar programs. Expect: - Enrollment: 1-3 days after call. - Verification: 5-10 business days. - Delivery: Shipped to patient home or infusion center; home infusion available (except MA/RI).[6][7] Refills are automatic with pharmacist oversight for seamless delivery.[1][3] ## Reauthorization **Reauthorization is required**. Your doctor must renew the prescription periodically, and Chiesi Total Care assists with resubmissions to maintain coverage.[program details] ## Alternatives if Denied or Ineligible - **Appeal**: Work with reimbursement specialists for prior authorization appeals.[2] - **Independent Foundations**: Program provides info on external aid for uninsured/underinsured (Chiesi not affiliated).[5] - **Patient Assistance Program**: For those meeting financial need (if applicable), free medication possible.[9] - **Other Therapies**: Discuss biosimilars or alternatives like Fabrazyme with your doctor (none specified for Elfabrio). - **State Programs**: Check local resources for rare diseases. Contact Chiesi Total Care for personalized options. ## Important Disclaimer This guide is for informational purposes only and not a substitute for medical or financial advice. Eligibility, benefits, and terms subject to change. Program may discontinue anytime. Costs vary by insurance; maximum savings apply. Consult your healthcare provider and call **1-833-656-1056** for latest details. Chiesi USA, Inc. reserves rights. See full terms at enrollment. (Word count: 942)

Program information last verified: March 30, 2026