HEMLIBRA

Indicated For

Hemophilia A with or without factor VIII inhibitors

About This Medication

# HEMLIBRA Co-pay Assistance Program Patient Guide: How to Get HEMLIBRA (emicizumab-kxwh) at Low or No Cost HEMLIBRA (emicizumab-kxwh) is a prescription medication used to prevent or reduce bleeding episodes in people with hemophilia A, and the **HEMLIBRA Co-pay Assistance Program** from Genentech helps eligible commercially insured patients lower their out-of-pocket costs for this drug, offering up to **$15,000 per calendar year** in co-pay assistance.[1][2][3] This guide explains everything you need to know about qualifying, applying, and using the program to make HEMLIBRA more affordable. ## About HEMLIBRA (emicizumab-kxwh) **HEMLIBRA** is a bispecific monoclonal antibody that replaces the function of factor VIII, a clotting protein missing or deficient in people with **hemophilia A**. It's given as a subcutaneous (under-the-skin) injection, typically weekly, every two weeks, or monthly, depending on your doctor's plan. The FDA has approved it for routine prophylaxis to prevent or reduce the frequency of bleeding episodes in adults and children with hemophilia A, with or without factor VIII inhibitors.[2][7] Unlike traditional factor treatments, HEMLIBRA mimics the natural clotting process more continuously, potentially offering fewer injections and better protection. If you've been prescribed HEMLIBRA, high costs shouldn't stop you from getting it. Genentech's program targets the financial barriers many face with specialty medications like this one, which can have high co-pays or coinsurance even with insurance.[1][5] ## Who Qualifies for the Program? The **HEMLIBRA Co-pay Assistance Program** is designed for **commercially insured patients**—those with private insurance from an employer, marketplace plan, or other non-government coverage.[1][2][8] Key eligibility points include: - A valid prescription for HEMLIBRA for an **FDA-approved indication** (hemophilia A prophylaxis).[1][2][3] - **Commercial (private or non-governmental) insurance** covering HEMLIBRA. Government programs like **Medicare, Medicaid, TRICARE, VA, or any federal/state-funded plans** are **not eligible**.[2][4][5] - At least 18 years old, or have a legal guardian who is.[7] - Willingness to meet program terms, including no use where prohibited by law or your insurer.[2] **Important**: This is **not** a free drug program—it's co-pay help only. Benefits cap at **$15,000 per calendar year**, resetting January 1. After that, you pay full out-of-pocket.[2][3][10] The program covers **drug costs only**, not administration fees, office visits, or other meds.[2] If you're uninsured or government-insured, see the **Genentech Patient Foundation** (GPF) for free medicine options. GPF has separate rules: insured patients without coverage for HEMLIBRA or uninsured must meet income thresholds (which vary).[4] Contact Genentech Access at (877) GENENTECH for referrals.[4] ## Income Eligibility Breakdown The Co-pay Program itself **does not have strict income limits**—it's primarily for commercially insured patients regardless of income, as long as you meet other criteria.[1][3] However, if you don't qualify for co-pay help (e.g., uninsured), the **Genentech Patient Foundation** steps in with income-based free medicine. Specific FPL (Federal Poverty Level) thresholds aren't fixed here and differ for insured vs. uninsured: | Household Size | Insured (Coverage but Can't Afford) | Uninsured | |---|---|---| | Individual | Up to 400-500% FPL (varies) | Up to 250-400% FPL |[4] | Couple/Family of 3-4 | Scaled by household size; contact for details | Scaled by household |[4] **Notes**: Always verify current thresholds by calling Genentech, as they can change. Co-pay program focuses on insurance type over income.[1][2][4] ## Insurance Requirements **Commercial insurance is required** for the Co-pay Program—no government plans allowed.[2][5][8] Your plan must cover HEMLIBRA; the program reduces your co-pay/coinsurance to **as low as $0** per fill, up to the annual cap.[3][10] If your insurer has accumulator programs (that don't count assistance toward deductibles), a per-fill cap may apply.[2] **Medicare/Medicaid patients**: Ineligible for co-pay help. Try independent foundations or GPF (income-based).[2][4][9] ## Step-by-Step Application Process Applying is straightforward and mostly **online** via the tool at [https://www.hemlibra.com/financial-support/tool.html](https://www.hemlibra.com/financial-support/tool.html) or **HEMLIBRACopay.com**.[1][6] Here's how: 1. **Check Eligibility**: Confirm commercial insurance and FDA-approved prescription.[1][2] 2. **Gather Documents**: - Patient health insurance info (card, policy details).[provided] - Treatment info (diagnosis, prescription).[provided] - Prescription for HEMLIBRA.[provided] - Prescriber-completed enrollment form (download from site).[provided] 3. **Enroll Online or by Phone**: - Visit **HEMLIBRACopay.com** or call **(844) HEM-COPAY (844-436-2672)**, 9am-8pm ET, Mon-Fri (holidays excluded).[1][6] - Fill out the form; your doctor may need to sign.[6] 4. **Submit**: Upload docs online or mail/fax as instructed.[provided] 5. **Approval**: Expect quick processing (details in FAQ).[1] 6. **Use Benefit**: Get card/ID for **participating pharmacies, doctor's offices, or hospitals**.[provided] Your prescriber can help with the form—many sites have HCP portals.[4] ## Timeline and Delivery Processing time isn't specified but is typically fast for co-pay cards (often instant approval online).[1][6] Once approved, use immediately at participating locations—no home delivery mentioned; it's **pharmacy/physician/hospital pickup**.[provided] **Reauthorization is required** annually or upon benefit cap/reset (Jan 1).[provided][2] Refills auto-process if eligible. ## Alternatives if Denied or Ineligible - **Government-insured/uninsured**: Genentech Patient Foundation (call (877) 436-3683).[4] - **Independent foundations**: Genentech refers to orgs like those for bleeding disorders (e.g., check NBDF list).[2][7][9] - **Other options**: Patient Access Network, HealthWell Foundation (search independently).[2] - **Appeal**: Contact program if denied—verify docs/insurance.[1] - No **biosimilars** noted for emicizumab.[provided] ## Disclaimer This guide is for informational purposes only and based on publicly available data as of latest updates. Program details, eligibility, and benefits can change; **always visit HEMLIBRACopay.com or call (844) 436-2672 for current terms**.[1][2] Genentech reserves rights to modify/discontinue. Not legal/financial advice—consult your doctor/insurer. Eligibility criteria and limits apply; not for government-reimbursed prescriptions.[2][4]

Program information last verified: March 30, 2026