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Oncology

ENHERTU

Generic: fam-trastuzumab deruxtecan-nxki

Manufacturer: Daiichi Sankyo and AstraZeneca  ·  Program: ENHERTU Patient Assistance Program

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Eligibility Criteria

Insurance Requirement

Uninsured, underinsured, or Medicare patients without private or government insurance (excluding Medicare) that covers ENHERTU; not receiving other assistance

Residency

US resident or Puerto Rico

Annual income at or below a certain level for uninsured, underinsured, or Medicare patients

Program Information

Processing Time

4–8 weeks

Delivery Method

shipped to patient or physician office

Application Method

Multiple

Reauthorization

Required — annual

Typically Required Documents

ProvisionRX prepares and organizes all required documentation as part of your enrollment management. This list is provided for informational purposes.

  • proof of residency
  • proof of income
  • prescription

Indicated For

HER2-positive metastatic breast cancer, HER2-mutant non-small cell lung cancer, HER2-positive gastric cancer

About This Medication

# ENHERTU Patient Assistance Program: How to Get ENHERTU at Low or No Cost ## About ENHERTU ENHERTU (fam-trastuzumab deruxtecan-nxki) is a prescription medication manufactured by Daiichi Sankyo and AstraZeneca used to treat certain types of cancer. The medication is administered intravenously by a healthcare provider once every three weeks in a 21-day treatment cycle. Because ENHERTU can be expensive, the ENHERTU4U program offers financial assistance to help eligible patients access their treatment. ## Who Qualifies for the ENHERTU Patient Assistance Program The ENHERTU Patient Assistance Program is designed for patients who are struggling to afford their medication. You may qualify if you meet the following criteria: - You are a resident of the United States - You have a valid prescription for ENHERTU from your healthcare provider - You are uninsured, underinsured, or a Medicare patient experiencing financial difficulty - You do not have private or government insurance (excluding Medicare) that covers ENHERTU - You are not currently receiving other financial assistance to help pay for ENHERTU - Your annual household income is at or below a certain level (specific thresholds are determined on a case-by-case basis) ## Income Eligibility The ENHERTU Patient Assistance Program considers your annual household income when determining eligibility. While specific income thresholds are not publicly listed, the program evaluates applications based on financial need. Income limits are typically set at or below a certain percentage of the federal poverty level, though exact figures vary. If you are unsure whether your income qualifies, you can discuss your situation with the program representatives when you apply. There are no income requirements for the separate Patient Savings Program (described below), which serves patients with commercial insurance. ## Insurance Requirements To qualify for the Patient Assistance Program, you must meet specific insurance criteria: | Insurance Type | Eligible? | Notes | |---|---|---| | Uninsured | Yes | No health insurance coverage | | Underinsured | Yes | Insurance that doesn't cover ENHERTU or covers only part of the cost | | Medicare | Yes | Medicare patients with financial difficulty | | Medicaid | No | Government insurance that typically covers medications | | Private Insurance Covering ENHERTU | No | If your insurance covers the full cost | | Other Government Programs (VA, TRICARE, Medigap) | No | These are considered sufficient coverage | If you have commercial insurance that does not cover the full cost of ENHERTU, you may qualify for the separate **Patient Savings Program** instead, which allows eligible patients to pay as little as $0 per prescription, up to $26,000 per calendar year. ## Step-by-Step Application Process ### Step 1: Gather Required Documents Before applying, collect the following documents: - **Proof of residency**: A utility bill, lease agreement, or government-issued ID showing your current address - **Proof of income**: Recent tax returns, pay stubs, or benefit statements showing your annual household income - **Valid prescription**: Your ENHERTU prescription from your healthcare provider ### Step 2: Contact the ENHERTU4U Program Reach out to the program through one of these methods: - **Phone**: Call 1-833-ENHERTU (1-833-364-3788) - **Online**: Visit ENHERTU4U.com to start your application Program representatives can answer questions about eligibility and guide you through the application process. ### Step 3: Complete Your Application You will need to provide: - Personal and household information - Income documentation - Insurance status - Your prescription details - Proof of residency Applications are available in English and Spanish. ### Step 4: Submit Your Application Submit your completed application along with all required supporting documents. You can submit these materials by phone, mail, or through the online portal at ENHERTU4U.com. ### Step 5: Await Program Decision The program will review your application and contact you with a decision. Processing times vary, so check with the program for specific timelines. ## Timeline and Medication Delivery Once your application is approved, ENHERTU will be shipped to either your home or your physician's office, typically within 0-1 week. Your healthcare provider will administer the medication during your scheduled treatment appointments. ## What the Program Covers If approved, the ENHERTU Patient Assistance Program provides: - **Medication at no cost** to qualifying patients - **Infusion administration assistance** of up to $100 per administration (with some state exceptions) *Note: Patients who are residents of Massachusetts, Michigan, Minnesota, or Rhode Island are not eligible for infusion administration assistance.* ## Reauthorization and Refills Your assistance through the program requires **annual reauthorization**. You will need to submit a new application every 12 months with updated financial information to continue receiving assistance. Your healthcare provider can help coordinate this process with the program. ## What If Your Application Is Denied? If your application is denied, you have several options: 1. **Ask why you were denied**: Contact the program to understand the specific reason for denial 2. **Appeal the decision**: Many denials can be appealed with additional information or clarification 3. **Explore alternative programs**: The ENHERTU4U program also offers: - Patient Savings Program (for patients with commercial insurance) - Independent Foundations that may provide additional assistance - Other patient assistance resources 4. **Work with your healthcare provider**: Your doctor may be able to provide additional documentation or appeal on your behalf ## Additional Support Services Beyond financial assistance, ENHERTU4U provides: - Information about insurance coverage and common insurance terms - Downloadable Patient Authorization Forms - Access to independent foundations that may help with costs - Support navigating insurance requirements and prior authorization ## Contact Information **ENHERTU4U Support Program** - **Phone**: 1-833-ENHERTU (1-833-364-3788) - **Website**: ENHERTU4U.com - **Hours**: Available to answer questions about eligibility and the application process ## Important Disclaimer This guide provides general information about the ENHERTU Patient Assistance Program. Program eligibility, benefits, and requirements may change. For the most current and accurate information, contact the ENHERTU4U program directly or visit ENHERTU4U.com. Always consult with your healthcare provider about your treatment options and financial assistance eligibility. This information is not a guarantee of program enrollment or medication coverage.

Program information last verified: March 23, 2026

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