Empliciti

Indicated For

Multiple myeloma

About This Medication

# How to Get Empliciti (Elotuzumab) Through the Bristol Myers Squibb Patient Assistance Foundation --- ## Who Qualifies for the Bristol Myers Squibb Patient Assistance Foundation? If you need Empliciti (elotuzumab) and cannot afford it, you may be able to get it at no cost through the **Bristol Myers Squibb Patient Assistance Foundation**. This program is designed for patients who meet income and insurance requirements. For a single-person household, your annual income must be at or below **$75,300** to qualify. On the insurance side, you generally must be uninsured or have insurance that does not cover Empliciti. Some Medicare Part D patients may also qualify under specific conditions. If you meet these criteria, this program could provide your medication free of charge, shipped directly to your prescriber's office. --- ## About Empliciti (Elotuzumab) Empliciti (elotuzumab) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat **multiple myeloma**, a type of blood cancer that affects plasma cells in the bone marrow. It belongs to a drug class called SLAMF7-directed cytolytic antibodies and is typically used in combination with other medications. Empliciti is administered by intravenous (IV) infusion, meaning it is given in a clinical setting rather than taken at home as a pill. As a specialty biologic drug, Empliciti carries a very high list price, often placing it out of reach for patients without comprehensive insurance coverage. The Bristol Myers Squibb Patient Assistance Foundation exists specifically to help bridge that gap. --- ## Income Eligibility: Full Breakdown The Bristol Myers Squibb Patient Assistance Foundation uses **500% of the Federal Poverty Level (FPL)** as its income threshold for Empliciti and other oncology products. Here is how that breaks down by household size: | Household Size | Maximum Annual Income | |---|---| | 1 person | $75,300 | | 2 persons | $102,200 | | 3 persons | $129,100 | | 4 persons | $156,000 | Your income is typically verified using your most recent federal tax return, W-2 forms, or 1099 forms. If your tax documents are not yet available, three months of recent pay stubs may be accepted in some cases. If your income is above these limits, you may not qualify for this particular program. However, you should still explore the alternatives listed later in this guide, including manufacturer savings cards and state pharmaceutical assistance programs, which use different eligibility criteria. Household size is generally defined as the number of people living in your home whose finances are considered together when filing taxes. If your situation is unusual — for example, you support dependents not listed on your return — it may be worth calling the program directly to discuss your specific circumstances. --- ## Insurance Requirements Explained Your insurance status plays a major role in whether you qualify. Here is a straightforward breakdown: - **If you are uninsured:** You are likely eligible, provided you meet the income requirements. Being fully uninsured is one of the clearest paths to approval for this program. - **If you have Medicare Part D:** You may still qualify, but only under specific financial criteria. You must also have been denied a **Low Income Subsidy (LIS/Extra Help)** from Medicare. This exception is not automatic — you will need to document the denial and meet income thresholds. - **If you have private insurance that does not cover Empliciti:** You may qualify if your plan explicitly excludes this drug or denies coverage for it. Having insurance that covers some drugs but not Empliciti can still make you eligible. - **If you have Medicaid:** Patients with full Medicaid coverage are generally not eligible for this program, as Medicaid is considered active drug coverage. Contact the program directly if your Medicaid plan has limited or restricted coverage for Empliciti. --- ## Step-by-Step: How to Apply Follow these steps to apply for free Empliciti through the Bristol Myers Squibb Patient Assistance Foundation: 1. **Gather your documents before you start.** You will need: a completed and signed application form (both the patient section and the prescriber section), proof of income (most recent tax return, W-2, or 1099), and your current prescription information. 2. **Choose your application method.** You can apply online, by phone, or by fax. - **Online:** Visit [https://www.bmsaccesssupport.bmscustomerconnect.com/patient/patient-assistance-foundation](https://www.bmsaccesssupport.bmscustomerconnect.com/patient/patient-assistance-foundation) to complete the application digitally. - **By phone:** Call **(800) 736-0003** to apply with assistance from a program representative. - **By fax:** Send your completed application and supporting documents to **(800) 736-1611**. 3. **Have your prescriber complete their section.** The application requires a signature and information from the doctor who prescribed Empliciti. Coordinate with your oncology office before submitting. 4. **Submit your income documentation** along with the completed application. Make sure documents are legible and complete to avoid delays. 5. **Wait for a decision.** Processing typically takes **2 to 3 business days** after all required documents are received. 6. **Confirm approval with your prescriber's office.** Bristol Myers Squibb will notify the prescriber. Follow up with your oncology office to confirm they have received approval before your next scheduled infusion. --- ## What to Expect: Timeline and Delivery Once your completed application and all supporting documents are submitted, a decision is typically made within **2 to 3 business days**. You will not need to pick up Empliciti at a pharmacy. Approved medication is **shipped directly to your prescriber's office** — the clinic or infusion center where you receive treatment. You do not need to do anything special at the time of delivery; your care team will handle the medication when it arrives. Keep in mind that approval is not permanent. The Bristol Myers Squibb Patient Assistance Foundation requires **annual reauthorization**. As your renewal date approaches, your prescriber's office will typically help initiate the process, but it is a good idea to track your approval date and follow up proactively to avoid a gap in your treatment. --- ## Alternatives If You Don't Qualify If you do not meet the eligibility criteria for this program, here are other options worth exploring: 1. **Biosimilars:** There are currently **no FDA-approved biosimilar alternatives** to Empliciti (elotuzumab). This option is not available at this time. 2. **Manufacturer savings card (for insured patients):** If you have private insurance that covers Empliciti, you may qualify for a savings card through the manufacturer. Visit [https://www.empliciti.com/savings-support](https://www.empliciti.com/savings-support) to learn more and see if you are eligible for cost-sharing assistance. 3. **State Pharmaceutical Assistance Programs (SPAPs):** Many states run their own programs to help residents afford expensive medications, particularly for Medicare beneficiaries. Eligibility and benefits vary by state. Contact your state's department of health or aging to ask about available programs. 4. **NeedyMeds.org:** This free, independent database at [www.NeedyMeds.org](https://www.needymeds.org) lists patient assistance programs, disease-specific funds, and other resources. It is a useful tool if you are exploring multiple options at once. --- > *This guide is for informational purposes only and does not constitute medical or legal advice. Eligibility determinations are made solely by Bristol Myers Squibb. Program terms may change — verify current requirements at [https://www.bms.com/patient-and-caregiver-support/patient-assistance-foundation.html](https://www.bms.com/patient-and-caregiver-support/patient-assistance-foundation.html) before applying.* ---

Program information last verified: February 27, 2026