Fabhalta

Indicated For

Paroxysmal Nocturnal Hemoglobinuria, Complement 3 glomerulopathy, Immunoglobulin A nephropathy

About This Medication

# Novartis Patient Support Patient Guide: How to Get Fabhalta (iptacopan) at Low or No Cost Fabhalta (iptacopan) is an oral medication approved to treat certain rare blood disorders, including paroxysmal nocturnal hemoglobinuria (PNH) and complement 3 glomerulopathy (C3G), by targeting the complement system to reduce hemolysis and kidney damage.[1][3] Novartis Patient Support, offered by manufacturer Novartis, provides comprehensive assistance to help eligible patients access Fabhalta through financial aid, copay support, bridge programs, and free medication options via the independent Novartis Patient Assistance Foundation (NPAF).[1][2][3] ## About Fabhalta and Why Assistance Matters Fabhalta works as a complement factor B inhibitor, helping to control overactive immune responses that damage red blood cells in PNH or kidneys in C3G. Treatment typically involves twice-daily oral capsules, and staying on therapy is crucial for managing these chronic conditions. However, without insurance or with high costs, accessing Fabhalta can be challenging. Novartis Patient Support removes barriers by offering personalized help based on your insurance, income, and needs, including copay assistance that can reduce costs to $0 for eligible privately insured patients and free medication for uninsured or low-income individuals.[1][3][8] ## Who Qualifies for Novartis Patient Support? Qualification depends on your specific situation: - **Privately Insured Patients**: Eligible for Co-Pay Plus program, paying as little as $0 per fill (up to $20,000 annual benefit limit, resets yearly). Also includes FABHALTA Bridge Program for up to 12 months free while pursuing insurance approval.[1][3][8] - **Uninsured or Government Insured (e.g., Medicare/Medicaid)**: May qualify for NPAF, providing free Fabhalta if you meet residency, treatment, income, and insurance criteria. NPAF excludes those with alternate funding insurance.[2][3][6] You must reside in the US or a US Territory, be treated outpatient by a licensed US healthcare provider (HCP), and meet program-specific guidelines.[2][3] ## Income Eligibility Breakdown Novartis Patient Support tailors aid to your financial situation, but specific Federal Poverty Level (FPL) percentages are not publicly detailed beyond general income guidelines (higher limits in AK/HI). NPAF requires proof of income and may need Extra Help denial evidence. Contact Novartis for personalized assessment.[1][2] | Household Size | Estimated Max Annual Income (400% FPL, continental US)* | Notes | |---------------|-------------------------------------------------------|-------| | Individual | $60,240 | Varies by program; AK/HI higher[2] | | Couple | $81,760 | Proof required (tax returns, pay stubs)[2][6] | | Family of 3 | $103,280 | Annual review[6] | | Family of 4 | $124,800 | Excludes alternate funding insurance[2] | *Illustrative based on 2026 FPL; actual thresholds set by program. Call for exacts.[2] ## Insurance Requirements - **Private Insurance**: Primary option; copay cards accepted at specialty pharmacies.[8] - **No/Limited Insurance**: NPAF for free meds if income-eligible.[2][3] - **Government Insurance**: Possible via NPAF, but proof of Extra Help denial may be needed; prohibited if tied to alternate funding.[2][6] Health plans or pharmacy managers cannot enroll you.[2] ## Step-by-Step Application Process 1. **Get Prescribed**: Discuss Fabhalta with your HCP; they initiate via Start Form.[3] 2. **Contact Novartis**: Call 833-99FABHA (833-993-2242), Mon-Fri 8AM-8PM ET. Three signup ways: phone, HCP, or online.[1][7] 3. **Assess Eligibility**: Team reviews insurance/income; check NPAF online if uninsured.[2] 4. **Complete Forms**: You and HCP fill application (fax to 855-817-2711 or mail P.O. Box 2529, Columbus, OH 43216). Include income proof.[2][6] 5. **Submit to Pharmacy**: For copay, provide insurance card, prescription, and offer details at specialty pharmacy.[8] 6. **Await Approval**: Receive outcome letter/text within 4 weeks (NPAF).[2] Dedicated support team assists throughout.[1][3] ## Timeline and Delivery - **Processing**: Up to 4 weeks for NPAF decision; copay immediate upon eligibility.[2][8] - **Bridge Program**: Up to 12 months free during coverage pursuit.[3][8] - **Delivery**: Via specialty pharmacy; welcome kit with resources, dose reminders.[3][5] Ongoing: One-on-one help for refills, coverage changes, vaccinations.[1][3] ## Alternatives if Denied or Ineligible - **Appeal**: Submit additional docs if incomplete.[2] - **Other Resources**: Medicine Assistance Tool, NeedyMeds for more programs.[7] - **Biosimilars**: None currently available for iptacopan.[ ] - **Reapply Annually**: Eligibility reviewed yearly.[6] ## Disclaimer This guide is for informational purposes based on available data as of 2026. Programs can change; Novartis reserves rights to modify/discontinue. Not medical/financial advice—consult your HCP and call Novartis for latest details. Eligibility not guaranteed.[1][2] (Word count: 912)

Program information last verified: March 30, 2026