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), a rare genetic disease that causes muscle weakness and loss of motor function in infants, children, and adults. The **Genentech Patient Foundation** offers free Evrysdi to eligible patients who are uninsured, underinsured, or facing high out-of-pocket costs due to financial need.[1][2][4] ## About Evrysdi and Why Assistance Matters **Evrysdi** is a survival motor neuron-2 (SMN2) splicing modifier taken once daily by mouth, approved for SMA patients 2 months of age and older. SMA affects the motor neurons in the spinal cord, leading to progressive muscle weakness. Without treatment, it can be life-threatening, especially in younger patients. Evrysdi helps increase SMN protein production to support motor neuron function and improve survival and motor milestones.[3] The cost of Evrysdi without assistance can exceed $100,000 per year, making it unaffordable for many. The Genentech Patient Foundation bridges this gap by providing the medication at no cost to those who qualify based on income and insurance status. This program ensures ongoing access without the need for annual re-enrollment as long as eligibility is maintained.[8] ## Who Qualifies? Eligibility focuses on three main groups: - **Uninsured patients** with household income under $150,000 (some exceptions apply).[4] - **Insured patients** whose health plan covers the Genentech medicine but has an out-of-pocket maximum exceeding 7.5% of yearly household income.[4] - **Underinsured patients** unable to afford cost-sharing requirements.[4][5] The program is open to U.S. residents (including Puerto Rico) treated by a U.S.-licensed physician. No citizenship or immigration status is required. Government insurance like Medicare or Medicaid may qualify under certain financial hardship conditions, but co-pay assistance is limited to commercial insurance only.[1][4][8] ## Income Eligibility Breakdown Specific Federal Poverty Level (FPL) percentages are not publicly detailed, but guidelines emphasize household income and size. Income under $150,000 is a key benchmark for uninsured patients.[4] Use the online Confirm Financial Eligibility tool or call (888) 941-3331 for a personalized assessment.[9] | Household Size | Example Annual Income Threshold (Uninsured)* | Notes | |---------------|---------------------------------------------|-------| | 1 | Under $150,000 | Exact thresholds vary; call for details[4] | | 2 | Under $150,000 | Adjusted for household size[4][7] | | 3 | Under $150,000 | Some exceptions apply[4] | | 4+ | Under $150,000 | Provide net household income[1] | *These are illustrative based on sources; actual eligibility confirmed by Genentech. Provide adjusted gross income (AGI) or net income on forms.[5] ## Insurance Requirements - **Uninsured**: Fully eligible if income qualifies.[4] - **Commercially insured**: Eligible if out-of-pocket costs (deductible, co-pay, max) exceed 7.5% of income.[4] - **Medicare/Medicaid/Government programs**: May qualify for free medicine if financially needy and insurance doesn't cover or costs are unaffordable. Co-pay programs exclude government insurance.[1][4][8] Your insurance cannot require or manipulate eligibility for this program.[5] Foundation Specialists verify coverage.[2] ## Step-by-Step Application Process 1. **Confirm Eligibility**: Use the online tool at gene.com/patients/patient-foundation/see-if-you-qualify or call (888) 941-3331 (Mon-Fri, 6 a.m.–5 p.m. PT).[9][2] 2. **Complete Patient Consent Form**: Fill out Boxes 1 and 2 online (English/Spanish available). Include name, DOB, address, phone, email, insurance details, household size, and annual net income.[1][5] 3. **Doctor Completes Prescriber Foundation Form**: Provide your doctor's info (name, practice, address, phone). They sign Page 2.[1][4] 4. **Submit Both Forms Together**: - **Online**: Via My Patient Solutions (if doctor's office registered) or eSubmit.[1][3] - **Fax**: (833) 999-4363[1][4] - **Text**: Photo to (650) 877-1111[1] - **Phone Assistance**: (866) 422-2377 or (888) 941-3331[2] - Evrysdi-specific: Ensure patient signs page 4 of Evrysdi Start Form if applicable.[3] 5. **Wait for Review**: Processed within 5 business days. You'll be contacted with outcome.[1][7] Both forms are **required**—no action until received.[1] ## Timeline and Delivery - **Processing**: 5 business days after complete submission.[1] - **Notification**: Patient and doctor contacted by phone.[1][7] - **Delivery**: Medication shipped free directly to you via a specialty pharmacy. One year of supply provided initially, with ongoing refills if eligible—no re-enrollment needed.[8] Call Foundation Specialists for status updates.[2] ## Alternatives if Denied - **Appeal Insurance Denial**: Apply while appealing; no proof needed.[6] - **Other Assistance**: Foundation Specialists suggest local options or alternative funding.[2] - **Co-Pay Programs**: For commercial insurance (not government).[1] - **State Programs**: Inquire via (888) 941-3331 for regional help.[2] - No biosimilars available for Evrysdi. ## Important Disclaimer This guide is for informational purposes based on publicly available Genentech resources as of 2026. Eligibility, terms, and forms may change—always verify with Genentech at (888) 941-3331 or gene.com/patients/patient-foundation. Not medical advice; consult your doctor. Genentech does not guarantee approval. Program for U.S. residents only.

Program information last verified: March 30, 2026