ILUVIEN

Indicated For

Diabetic Macular Edema (DME), Chronic Non-Infectious Uveitis affecting the Posterior Segment (NIU-PS)

About This Medication

# ILUVIEN Patient Assistance Program Patient Guide: How to Get ILUVIEN at Low or No Cost ILUVIEN (fluocinolone acetonide intravitreal implant) is a prescription eye implant used to treat **diabetic macular edema (DME)** and **chronic non-infectious uveitis affecting the posterior segment of the eye (NIU-PS)**. The **ILUVIEN Patient Assistance Program (PAP)** from Alimera Sciences provides **ILUVIEN free of charge** to eligible patients who are uninsured or lack coverage for the medication, helping those with financial need access this important treatment. ## About ILUVIEN ILUVIEN is a tiny, sustained-release implant injected into the eye by an ophthalmologist. It slowly releases **fluocinolone acetonide**, a corticosteroid, over up to **3 years** to reduce inflammation and swelling in the retina. For **DME**, it helps improve vision in people with diabetes whose macular edema persists despite other treatments. For **NIU-PS**, it manages chronic inflammation in the back of the eye. **Key benefits** include long-lasting effects from a single injection, potentially reducing the need for frequent treatments or eye drops. However, it may increase the risk of cataracts or elevated eye pressure, so regular monitoring by your doctor is essential. Always discuss risks, benefits, and alternatives with your eye specialist.[1][7] ## Who Qualifies for the Program? The program is designed for patients facing financial barriers to ILUVIEN. **Basic eligibility** includes: - Residency in the **US or Puerto Rico**. - **Uninsured** or **lack coverage for ILUVIEN** (your insurance denies it or doesn't cover it). - **Financial need** demonstrated by household income (typically assessed case-by-case). - A valid prescription for ILUVIEN per FDA labeling for DME or NIU-PS. **Important**: Medicare, Medicaid, or other government insurance patients are generally **not eligible**. The program targets those without adequate private coverage.[1][4][8] ## Income Eligibility Breakdown Financial need is required, with proof such as tax returns, 1099s, W-2s, pay stubs, or employer letters. While exact thresholds aren't publicly fixed, older program details suggest eligibility up to **500% of the Federal Poverty Level (FPL)**. Current applications are reviewed individually—call (844) 445-8843 for your situation. Here's a sample **2026 FPL table** (based on 2025 HHS guidelines; check HHS.gov for updates) to estimate if you're near 500% FPL: | Household Size | 100% FPL | 400% FPL | 500% FPL | |----------------|----------|----------|----------| | 1 person | $15,060 | $60,240 | $75,300 | | 2 people | $20,440 | $81,760 | $102,200| | 3 people | $25,820 | $103,280| $129,100| | 4 people | $31,200 | $124,800| $156,000| *Add ~$5,380 per additional person for 100% FPL.* Even if above these, submit proof—exceptions may apply based on total financial picture.[4][5] ## Insurance Requirements You must be **uninsured** or **rendered uninsured** for ILUVIEN (e.g., insurance denies coverage). Provide documentation like denial letters. **Commercially insured** patients may qualify for the separate **ILUVIEN CoPay Program** (caps out-of-pocket at $25), but PAP is for no coverage scenarios. Government beneficiaries (Medicare/Medicaid) are ineligible.[1][3][8] ## Step-by-Step Application Process 1. **Talk to your eye doctor**: Confirm ILUVIEN is right for you and get a prescription. They'll help complete the application. 2. **Gather documents**: - **Proof of income**: Recent tax returns, 1099s, W-2s, pay stubs (last 3 months), or employer letter stating salary. - **Proof of no insurance/coverage denial**: Insurance cards (if any), denial letters, or statements. - **Completed PAP application**: Download from hcp.iluvien.com or call for one. Both patient and physician **must sign**.[2][8] 3. **Submit by fax**: Fax **both pages** of the completed form to **1-844-501-7161**. Call **(844) 445-8843** (Option 3) for help or questions.[1][2] 4. **Wait for review**: Processed in about **5 business days**.[8] 5. **Approval notification**: If approved, you and your doctor get a letter to schedule the injection.[3] **Pro tip**: Work with your doctor's office or Alimera's Field Reimbursement Managers for support.[1] ## Timeline and Delivery - **Application review**: ~**5 days**. - **Delivery**: If approved, ILUVIEN ships **free to your physician's office** via specialty pharmacies like Besse Medical or McKesson. Your doctor handles the in-office injection procedure (separate costs may apply).[8] Total time from application to treatment: 1-2 weeks, depending on scheduling. ## Alternatives if Denied or Ineligible - **ILUVIEN CoPay Program**: For commercial insurance; reduces copays to $25 max. Call (844) 445-8843, Option 3.[1][3] - **Patient foundations**: AccessPlus can connect you (income/diagnosis-based).[4] - **Other options**: Generic steroids, other implants (e.g., Ozurdex), or laser therapy—discuss with your doctor. - **Reapply**: Fix issues (e.g., more docs) and resubmit. - **State programs**: Check for local assistance. Contact AccessPlus for personalized guidance.[1] ## Important Disclaimer This guide is for informational purposes based on publicly available program details as of 2026. **Alimera Sciences reserves the right to change, modify, or cancel the program anytime** without notice. Eligibility isn't guaranteed; decisions are at Alimera's discretion. This is **not medical advice**—consult your physician for treatment decisions. Program doesn't cover injection fees, office visits, or unrelated costs. Verify details by calling (844) 445-8843.[2][8] *Word count: ~950*

Program information last verified: March 30, 2026