EMPAVELI

Indicated For

Paroxysmal Nocturnal Hemoglobinuria (PNH), C3G/primary IC-MPGN

About This Medication

# ApellisAssist Patient Assistance Program Patient Guide: How to Get EMPAVELI (pegcetacoplan) at Low or No Cost EMPAVELI (pegcetacoplan) is a prescription medication used to treat adults with **paroxysmal nocturnal hemoglobinuria (PNH)**, a rare blood disorder that destroys red blood cells.[6] The **ApellisAssist Patient Assistance Program** from Apellis Pharmaceuticals helps **uninsured or underinsured patients** access EMPAVELI at low or no cost through financial aid, support services, and free medication options for eligible individuals.[1][7][9] ## About EMPAVELI and Who It's For **EMPAVELI** works as a complement inhibitor to reduce the destruction of red blood cells in PNH patients, helping manage symptoms like fatigue, anemia, and blood clots.[3][6] It's given as a **subcutaneous injection** (under the skin) twice weekly at home after training.[8] Treatment requires enrollment in the **EMPAVELI REMS** program due to serious infection risks, including meningitis—patients must be vaccinated against certain bacteria and carry a Patient Safety Card.[2][5][10] This guide focuses on the **Patient Assistance Program (PAP)** within ApellisAssist, ideal for those struggling with costs. ApellisAssist also offers copay help for commercially insured patients ($0 copay possible) and a Trial Offer Program (8 weeks free for new PNH patients).[1][5] Always consult your doctor to see if EMPAVELI is right for you. ## Who Qualifies for the Program? The program targets **uninsured or underinsured patients** facing financial hardship.[1][7][9] You're likely eligible if: - You have no insurance or insurance doesn't cover EMPAVELI fully. - You have a valid prescription for EMPAVELI. - You reside in the US (proof required). - You meet income guidelines (specific Federal Poverty Level (FPL) thresholds not publicly detailed; call to confirm).[7] **Income Eligibility Breakdown** | Household Size | Annual Income Threshold (Estimated; Call for Exact FPL %)* | |----------------|---------------------------------------------------------| | 1 (Individual) | Contact program (e.g., ~400-500% FPL typical for PAPs) | | 2 (Couple) | Contact program | | 3 | Contact program | | 4+ | Contact program; increases per additional member | *Notes: Thresholds based on FPL; not explicitly listed online. Programs like this often cover up to 400-500% FPL for uninsured/underinsured. Verify via phone as eligibility varies.[7] ## Insurance Requirements **Uninsured or underinsured** patients qualify—no government insurance like Medicare/Medicaid typically, as programs prohibit reimbursement from federal programs.[5][7] Commercially insured? Use the Copay Program instead.[1] ApellisAssist verifies benefits and explores options.[2] Medicare patients may not qualify for free drug but check copay aid.[4] ## Step-by-Step Application Process 1. **Talk to Your Doctor**: Get a prescription and have them complete the Healthcare Provider form. Discuss REMS enrollment and vaccinations first.[2][10] 2. **Call ApellisAssist**: Dial **(866) 692-7527** (8 AM-8 PM ET, Mon-Fri) to start. They'll screen eligibility and guide you.[1] 3. **Gather Documents**: - **Proof of income** (tax returns, pay stubs, W-2s). - **Proof of residency** (utility bill, lease). - **Prescription** for EMPAVELI. - **Healthcare provider form** (signed by prescriber).[7] 4. **Submit Application**: Multiple methods—phone, fax (1-888-754-1285), or forms like Start/Trial forms. No online portal listed; staff assists.[1][6] 5. **Benefits Investigation**: Team checks insurance and approves aid.[2] 6. **Approval**: If approved, medication ships free.[9] ApellisAssist provides extras: Care Coordinators for delivery, Apellis Care Educators (ACE) for injection training (in-person/virtual), CareKit with supplies, and education.[8] ## Timeline and Delivery Processing time varies (not specified; typically 1-4 weeks for PAPs). Trial Offer ships 8-week supply quickly post-approval.[5] **Delivery**: Shipped to your home or doctor's office via PANTHERx Rare Pharmacy. Schedule with Care Coordinator; includes self-administration devices and ancillaries.[8] Refills require **reauthorization**—your doctor resubmits periodically.[7] ## Alternatives if Denied or Ineligible - **Copay Program**: For commercial insurance; $0 copay.[1] - **Trial Offer**: 8 weeks free for new PNH patients—no income check.[5] - **Other PAPs**: Search rxassist.org for generics or foundations.[7] - **Patient Access Network (PAN) Foundation** or similar for rare diseases. - **Appeal**: Call to discuss denial reasons and resubmit.[1] - **State programs** or hospital charity care. No biosimilars available.[7] ## Important Safety and Next Steps **Risks**: Serious infections—complete vaccinations, watch for meningitis symptoms (fever, headache, stiff neck). Carry Safety Card 2 months post-treatment.[8] Self-administer correctly after ACE training. **Disclaimer**: This guide is for informational purposes based on available sources as of 2026. Eligibility, terms, and availability can change. Contact ApellisAssist at (866) 692-7527 for personalized advice. Not medical advice—consult your healthcare provider. Apellis Pharmaceuticals not liable for misuse.[1][7] *Word count: 950*

Program information last verified: March 30, 2026