Glassia

Indicated For

Alpha-1 Antitrypsin Deficiency with Emphysema

About This Medication

# 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.

Program information last verified: March 30, 2026