Focalin XR

Novartis Patient Assistance Foundation (NPAF) Patient Guide: How to Get Focalin XR at Low or No Cost

About This Program

The Novartis Patient Assistance Foundation (NPAF) helps eligible patients access Focalin XR (dexmethylphenidate hydrochloride extended-release) at no cost or reduced cost when they cannot afford their medication. Focalin XR is a prescription stimulant medication used to treat attention-deficit/hyperactivity disorder (ADHD) in children and adults. If you struggle to pay for this medication, NPAF may be able to help you receive it for free through this patient assistance program.

Who Qualifies for NPAF Assistance

To be eligible for the Novartis Patient Assistance Foundation program, you must meet all of the following requirements:

Residency and Healthcare Provider Requirements

• You must be a resident of the United States or a U.S. Territory
• You must be treated by a licensed U.S. healthcare provider on an outpatient basis
• You must have a valid prescription for Focalin XR from your doctor

Insurance Requirements

• You must have no prescription drug coverage or be functionally underinsured
• If you have insurance with an alternate funding program, you may not be eligible
• If your insurance requires prior authorization, you must submit documentation of the denial or appeal outcome

Income Requirements

• Your household income must meet NPAF's income guidelines, which are based on the Federal Poverty Level (FPL) at 400% or less, depending on your household size
• Income thresholds vary by specific medication, so you should verify eligibility for Focalin XR on the NPAF website
• You must provide proof of your current income

Income Eligibility Breakdown

NPAF uses a sliding scale based on household size and the Federal Poverty Level. While specific income thresholds for Focalin XR are not listed in this guide, the program generally serves patients at or below 400% of the Federal Poverty Level. Your household size is determined by your most recent tax return (Form 1040).

To find the exact income limits for your household size, visit www.PAP.Novartis.com or call NPAF at 1-800-277-2254.

Step-by-Step Application Process

Step 1: Check Your Eligibility Visit www.PAP.Novartis.com to review detailed eligibility requirements for Focalin XR. You can also call NPAF at 1-800-277-2254 (Monday–Friday, 9:00 AM–6:00 PM EST) to speak with a representative about whether you may qualify.

Step 2: Gather Required Documentation Before starting your application, collect the following documents:

• Copies of the front and back of all your insurance cards (primary, secondary, and prescription insurance)
• A copy of the first two pages of your most recent federal income tax return (Form 1040) to verify your income
• If your insurance denied prior authorization for Focalin XR, include a copy of that denial letter
• Your valid prescription for Focalin XR from your healthcare provider

Step 3: Complete the Patient Application Fill out the Novartis Patient Assistance Foundation enrollment application form completely and accurately. The form includes sections for:

• Your personal information (name, address, contact details)
• Your household size (from your tax return)
• Your insurance information
• Your income information
• Your authorization for NPAF to speak with your healthcare provider about your health condition

Make sure to sign and date the patient authorization section. An incomplete form will result in processing delays or application denial.

Step 4: Have Your Healthcare Provider Complete Their Section Give your completed patient section to your doctor or healthcare provider. They must:

• Complete the Healthcare Professional Section of the application
• Provide a valid prescription for Focalin XR
• Sign and date the prescription and authorization sections
• Submit their section directly to NPAF or include it with your submission

Step 5: Submit Your Application Submit your completed application and all required documentation using one of these methods:

• Fax: 1-855-817-2711
• Mail: Novartis Patient Assistance Foundation, Inc., P.O. Box 2529, Columbus, OH 43216

Make copies of everything you submit for your records.

Timeline and Medication Delivery

Processing Time After you submit your complete application, NPAF will review it and send you a decision letter within approximately 4 weeks. You will also receive a text message notification if you have opted in to text updates.

What Happens If Your Application Is Incomplete If your application is missing information, NPAF will send you a letter explaining what additional documents or information you need to provide. Respond promptly to avoid further delays.

Medication Delivery Once your application is approved, your Focalin XR medication will be shipped directly to you. NPAF will provide instructions on how to receive your medication.

What to Do If Your Application Is Denied

If NPAF denies your application, you will receive a letter explaining the reason. Common reasons for denial include:

• Incomplete application or missing documentation
• Income exceeding program limits
• Having prescription drug insurance coverage
• Not meeting other eligibility requirements

If you believe your application was denied in error, contact NPAF at 1-800-277-2254 to discuss your options. You may be able to appeal the decision or provide additional information.

Important Reminders

• Complete accuracy is essential: Any missing information or inaccuracies can delay your application or result in denial.
• Your signature is required: You must sign and date the patient authorization section for NPAF to process your application.
• Keep copies: Save copies of all documents you submit.
• Follow up if needed: If you don't hear back within 4 weeks, contact NPAF to check on your application status.

Contact Information

Novartis Patient Assistance Foundation

• Phone: 1-800-277-2254 (Monday–Friday, 9:00 AM–6:00 PM EST)
• Fax: 1-855-817-2711
• Mailing Address: Novartis Patient Assistance Foundation, Inc., P.O. Box 2529, Columbus, OH 43216
• Website: www.PAP.Novartis.com

Disclaimer

This guide provides general information about the Novartis Patient Assistance Foundation program for Focalin XR. Program eligibility, requirements, and benefits may change. For the most current and accurate information, visit www.PAP.Novartis.com or contact NPAF directly. This guide is not a guarantee of program eligibility or approval. Always consult with your healthcare provider about your treatment options and medication needs.