Glassia

Takeda Patient Support Co-Pay Assistance Program Patient Guide: How to Get GLASSIA at Low or No Cost

About GLASSIA

GLASSIA is a medication containing human Alpha-1 Proteinase Inhibitor (Alpha-1-PI) used to treat adults with lung disease (emphysema) caused by severe Alpha-1 antitrypsin deficiency (AATD)[2]. People with AATD produce little to no Alpha-1 antitrypsin protein, so GLASSIA works to increase Alpha-1 protein levels in the blood and lungs[4]. The medication is administered as a weekly intravenous infusion at a dose of 60 mg/kg body weight[9].

About the Takeda Patient Support Co-Pay Assistance Program

The Takeda Patient Support Co-Pay Assistance Program is designed to help eligible patients afford their prescribed GLASSIA treatment[1]. The program can cover up to 100% of your out-of-pocket costs[1]. This is a manufacturer-sponsored patient assistance program run by Takeda, the pharmaceutical company that produces GLASSIA.

Who Qualifies

To be eligible for the Takeda Patient Support Co-Pay Assistance Program, you must meet the following requirements[4]:

• Be enrolled in Takeda Patient Support
• Have commercial insurance
• Meet additional terms and conditions (contact the program for specific details)

Important Note: The co-pay assistance program is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by certain payers[7]. Additionally, some patient assistance programs exclude Medicare enrollees, so it's important to review the program's specific rules carefully[8].

How to Apply

The application process involves three main steps[4]:

Step 1: Work with Your Healthcare Provider Your healthcare provider will complete the GLASSIA Start Form for your prescribed Alpha-1 therapy.

Step 2: Sign the Authorization You will sign the Patient Authorization section of the Start Form.

Step 3: Eligibility Confirmation and Support Takeda Patient Support will confirm your eligibility, and your dedicated support specialist will contact you.

Submitting Your Application

The completed Start Form should be submitted to Takeda Patient Support by fax at 1-844-755-5751[7]. You can also call Takeda Patient Support directly at 1-866-888-0660, Monday through Friday, 8:30 AM to 8 PM ET, to speak with a support specialist[3][6].

What Happens After You Apply

Once your application is received, a Patient Support Specialist will[7]:

• Assess your eligibility for co-pay support
• Provide information about third-party financial assistance programs if necessary
• Set up Takeda-provided self-administration training services if requested by your healthcare provider
• Help navigate the health insurance process
• Direct you to community support resources and education
• Work with your specialty pharmacy or site of care to help you receive GLASSIA
• Arrange for a trained nursing professional to teach you or a caregiver how to infuse your treatment at home, if requested

Additional Support Services

Beyond financial assistance, Takeda Patient Support offers comprehensive services including[4]:

• Working with your specialty pharmacy to help you receive GLASSIA
• Arranging home infusion training with a trained nursing professional
• Navigating the health insurance process
• Directing you to community support resources and education
• Providing tips and timely information throughout your GLASSIA treatment

What to Do If Your Application Is Denied

If you are not eligible for the co-pay assistance program, the Patient Support Specialist can provide information about third-party financial assistance programs that may be available to you[7]. Additionally, patient assistance programs (PAPs) offer free or low-cost medications to uninsured consumers as well as people with low incomes and others who can't afford prescriptions[8]. These programs are usually run by pharmaceutical companies or nonprofit organizations.

Important Disclaimers

• The Takeda Patient Support Co-Pay Assistance Program is subject to change and Takeda may rescind, revoke, or amend the program at any time without notice[7]
• This program is not valid for prescriptions eligible to be reimbursed by certain payers[7]
• Some patient assistance programs exclude Medicare enrollees[8]
• Clinical data on long-term effects of treatment with GLASSIA are not available[10]
• No randomized, controlled trials have demonstrated effects of Alpha-1-PI augmentation therapy on pulmonary exacerbations or emphysema progression[10]

Contact Information

For more information about the Takeda Patient Support Co-Pay Assistance Program or to get started:

Phone: 1-866-888-0660 Hours: Monday through Friday, 8:30 AM to 8 PM ET Fax: 1-844-755-5751 (for submitting the Start Form)

Takeda Patient Support specialists are available to answer your questions and help guide you through the enrollment process.