Evrysdi

Indicated For

Spinal Muscular Atrophy (SMA)

About This Medication

# Genentech Patient Foundation Patient Guide: How to Get Evrysdi (risdiplam) at Low or No Cost Evrysdi (risdiplam) is an oral medication used to treat spinal muscular atrophy (SMA) in adults and children, helping improve motor function by targeting the SMN2 gene to increase survival motor neuron protein production. The **Genentech Patient Foundation** offers this medication **free for up to one year** to eligible patients who are uninsured or have insurance but face financial hardship with out-of-pocket costs.[1][2][4][5] ## Who Qualifies for the Program? The program targets patients in the **US or Puerto Rico** treated by a US-licensed physician, with **no citizenship or immigration status required**.[4][5] Key eligibility groups include: - **Uninsured patients** with **household income under $150,000** (some exceptions apply).[5] - **Insured patients** whose health plan covers Evrysdi but: - Out-of-pocket maximum exceeds **7.5% of yearly household income**.[5] - Cannot afford cost-sharing requirements.[1][5] It's for those without insurance coverage for Evrysdi or with **financial concerns** making the medicine unaffordable.[1][2][6] Household size is considered in income evaluations.[1] ## About Evrysdi (risdiplam) **Evrysdi** is a daily oral solution approved for SMA types 1, 2, and 3 across all ages. Unlike some SMA treatments requiring infusions, it's taken at home by mouth, mixed with liquid or soft food. Common side effects include fever, diarrhea, and rash; serious risks involve low platelets or liver issues—discuss with your doctor. Always follow prescribed dosing based on weight and age.[1][5] ## Income Eligibility Breakdown Specific Federal Poverty Level (FPL) percentages aren't publicly detailed, but the program uses **household income under $150,000** as a primary threshold for uninsured patients, adjusted for household size and financial need. Insured patients qualify if costs exceed 7.5% of income.[1][5] Contact a Foundation Specialist at (888) 941-3331 for personalized assessment.[7] | Household Size | Example Max Income (Uninsured, approx.) | Insured Consideration | |---------------|-----------------------------------------|----------------------| | 1 | Under $150,000 | OOP >7.5% income[5] | | 2 | Under $150,000 (adjusted) | OOP >7.5% income[5] | | 3+ | Under $150,000 (adjusted by size)[1] | OOP >7.5% income[5] | *Notes: Exact thresholds vary; call for details. Income proof required.*[1][5] ## Insurance Requirements - **Uninsured**: Primary group; no coverage needed.[1][2] - **Commercial insurance**: Eligible if unaffordable; separate co-pay assistance available via Genentech Access Solutions.[1][2] - **Medicare/Public insurance**: Can apply if unable to afford costs, but confirm plan doesn't prohibit assistance. No proof of denial/appeal needed.[5][7] ## Step-by-Step Application Process 1. **Discuss with your doctor**: Confirm Evrysdi is prescribed and medically necessary.[1] 2. **Complete Patient Consent Form**: Fill out online (English/Spanish) at GenentechPatientFoundation.com or download/print. Include personal info, household size, insurance status, income, and shipment choice (home/practice).[1][2][3] 3. **Doctor completes Prescriber Foundation Form**: Page 2 includes diagnosis (e.g., SMA ICD code), treatment start, prescription (e-prescribe to MedVantx NPI-1235371535 or attach written).[1][2] 4. **Submit both forms**: - **Online**: Via My Patient Solutions (doctor's account).[2] - **Fax**: (833) 999-4363.[1][2][3] - **Text photo**: (650) 877-1111.[2][3] - Evrysdi-specific: Use apply page at https://www.evrysdi.com/financial-support/apply.html.[provided] 5. **Gather documents**: Proof of income (tax returns/pay stubs), residency (utility bill), prescription, insurance info (if applicable).[provided][1] Both forms required; processing starts upon receipt.[2] ## Timeline and Delivery - **Processing**: Within **5 business days**; patient and prescriber contacted with outcome.[2] - **Approval notification**: Phone call discusses next steps.[1][3] - **Delivery**: Shipped free to **patient's home**, doctor's office, or treatment site via foundation pharmacy. Options: upfront shipments or product replacement for prescriber inventory.[1][provided] - **Duration**: Up to **1 year** of free medicine; reauthorization needed.[1][4][provided] ## Alternatives if Denied - **Appeal internally**: Contact Foundation Specialist (888) 941-3331 for guidance.[7] - **Co-pay programs**: Genentech Access Solutions for commercial insurance.[2] - **Other assistance**: State programs, SMA Foundation, or patient advocacy groups. Explore Medicaid expansion or marketplace plans.[6] - **No biosimilars** for Evrysdi currently.[provided] ## Refills and Reauthorization Annual reapplication required. Prescriber attests ongoing need; resubmit forms.[1][provided] ## Important Disclaimer This guide summarizes publicly available info as of 2026; eligibility/rules change. Not medical/financial advice—consult your doctor and call (888) 941-3331. Genentech may update criteria. Program for US/Puerto Rico residents only.

Program information last verified: March 25, 2026