HYMPAVZI

Pfizer Patient Assistance Program for HYMPAVZI Patient Guide: How to Get HYMPAVZI at Low or No Cost

About HYMPAVZI

HYMPAVZI (marstacimab-hncq) is a prescription medication used for routine prophylaxis to prevent or reduce bleeding episodes in patients 12 years of age and older with certain bleeding disorders. It is administered as a once-weekly subcutaneous injection and has demonstrated significant reductions in treated bleeds compared to traditional factor-based treatments.[1][5]

Who Qualifies for Assistance

Pfizer offers multiple financial assistance programs for eligible HYMPAVZI patients:

Eligibility Requirements:

• You must be 18 years of age or older, or be a caregiver (18+) of a HYMPAVZI patient[1]
• You must have a valid prescription from your healthcare provider for an FDA-approved indication[1]
• You must be a U.S. resident (certain programs exclude Massachusetts, Michigan, Minnesota, and Rhode Island)[1]

Insurance Requirements and Program Options

Pfizer offers different assistance programs based on your insurance status:

Important Insurance Restrictions: You are NOT eligible for co-pay assistance if you are enrolled in Medicare, Medicaid, TRICARE, Veterans Affairs health care, state prescription drug assistance programs, or Puerto Rico's Government Health Insurance Plan.[1]

How to Apply

Step 1: Contact Pfizer Hemophilia Connect

Call 1-888-733-2030 Monday through Friday, 8:00 AM to 6:00 PM EST to speak with a Patient Case Manager who will:

• Verify your insurance coverage
• Determine which assistance program you qualify for
• Answer questions about the enrollment process
• Provide educational resources[1][2][7]

Alternatively, you can have your healthcare provider enroll you in the program.

Step 2: Register for Your Program

For the Co-Pay Savings Program, you can register directly on HYMPAVZI.com.[2] For the Voucher Program, you will need to complete an enrollment form available on the HYMPAVZI Resources page.[2]

Step 3: Receive Your Benefits

Once enrolled:

• Co-Pay Program: Your co-pay card will be provided, allowing you to pay as little as $0 per prescription fill[2]
• Interim Care Rx: Eligible patients receive up to 12 months of HYMPAVZI at no cost, shipped directly to you while insurance benefits are being processed[1]
• Voucher Program: You receive a free one-time, 4-week supply with no obligation to continue[1]

Timeline and Delivery

Processing times vary by program. The Interim Care Rx program is designed to provide medication quickly while your insurance benefits are being adjudicated, with direct shipment to your home.[1] For specific timeline information, contact Pfizer Hemophilia Connect at the number above.

Medication is shipped directly to patients through designated pharmacy partners.[1]

What Happens After Your Benefits Are Approved

Once your insurance benefits are approved and activated, you transition from assistance programs to your regular insurance coverage. At that point, you will be responsible for your standard co-pays and deductibles as outlined in your insurance plan.[1]

If you reach your annual maximum benefit through insurance, you may be responsible for remaining monthly out-of-pocket costs, though you may be eligible to re-enroll in assistance programs depending on your circumstances.

If Your Application Is Denied

If you are denied assistance, contact Pfizer Hemophilia Connect immediately at 1-888-733-2030. A Patient Case Manager can:

• Review the reason for denial
• Explore alternative assistance programs you may qualify for
• Work with your healthcare provider to address any coverage issues
• Provide information about other financial resources

Important Disclaimers

• Interim Care Rx is not health insurance and is available only to commercially insured patients with an FDA-approved indication for HYMPAVZI[1]
• Terms and conditions apply to all programs; eligibility requirements must be met and maintained
• This guide provides general information; specific eligibility and benefits depend on individual circumstances and insurance plans
• Consult with your healthcare provider and insurance company for personalized information about your coverage

Contact Information

Pfizer Hemophilia Connect

• Phone: 1-888-733-2030
• Hours: Monday-Friday, 8:00 AM to 6:00 PM EST
• Website: HYMPAVZI.com

For more information about HYMPAVZI and patient resources, visit the official HYMPAVZI patient website or speak with your healthcare provider.