INGREZZA

Indicated For

tardive dyskinesia

About This Medication

# INGREZZA Patient Assistance Program Guide: How to Get Your Medication at Low or No Cost ## What is the INGREZZA Patient Assistance Program? The INGREZZA Patient Assistance Program (PAP), provided by Neurocrine Biosciences, Inc., helps patients who cannot afford their INGREZZA medication get the treatment they need. This program may provide INGREZZA at no cost or at a significantly reduced price, depending on your financial situation and insurance status. ## About INGREZZA (Valbenazine) INGREZZA is a prescription medication used to treat two serious neurological conditions: - **Tardive Dyskinesia**: Involuntary repetitive movements that can develop as a side effect of certain psychiatric medications - **Huntington's Disease Chorea**: Uncontrolled movements associated with Huntington's disease INGREZZA works by inhibiting VMAT2, helping to reduce the abnormal movements associated with these conditions. Because this is a specialized medication, it can be expensive, and not all insurance plans cover it adequately. ## Who Qualifies for INGREZZA Patient Assistance? You may qualify for the INGREZZA PAP if you meet these criteria: 1. **You have a valid prescription** for INGREZZA from a licensed healthcare provider 2. **Your insurance situation** falls into one of these categories: - You are uninsured (have no health insurance) - You are underinsured (your insurance doesn't cover INGREZZA or your out-of-pocket costs are too high) 3. **You have financial need** based on your household income 4. **You are a U.S. resident** ### Income Eligibility The INGREZZA PAP uses flexible income guidelines that vary based on your household size. While specific threshold amounts vary and are evaluated on a case-by-case basis, the program is designed to help patients with genuine financial hardship. If you're unsure whether you qualify, we recommend applying anyway—the program reviewers can determine your eligibility once they review your complete application. **General Income Guideline Framework** (approximate): | Household Size | Maximum Annual Income (Approximate) | |---|---| | 1 person | Varies by case | | 2 people | Varies by case | | 3 people | Varies by case | | 4 people | Varies by case | | Each additional person | Varies by case | *Note: These are approximate guidelines. Income thresholds may be adjusted periodically, and eligibility is determined on a case-by-case basis. Contact the program directly for current income limits.* ## What Documents You'll Need Before you start your application, gather these items: 1. **Completed INGREZZA PAP Application Form** (provided by the program) 2. **Proof of Insurance Status**: - A copy of your current insurance card (front and back), OR - A statement confirming you are uninsured 3. **Financial Information**: - Recent pay stubs (typically last 2 months) - Tax return or proof of income - Bank statements or proof of financial resources - Proof of household size 4. **Prescriber Certification**: - Your doctor must sign and date the application, confirming you have a medical need for INGREZZA 5. **Current Valid Prescription**: - A signed prescription from your healthcare provider for INGREZZA ## How to Apply: Step-by-Step Instructions ### Step 1: Get Started Visit the program website at **https://ingrezza.neurocrineaccesssupport.com/** or call **(844) 647-3992** to request an application or speak with a program specialist. You can also fax your request to **(844) 394-7155**. ### Step 2: Complete the Application Form Carefully fill out the INGREZZA PAP application form with accurate information. The form will ask about: - Your personal and contact information - Your current insurance coverage - Your household composition - Your household income - Your medical history related to INGREZZA use ### Step 3: Gather Required Documents Assemble all the documents listed above. Make copies (keep originals for yourself). Ensure all documents are clear and legible. ### Step 4: Have Your Doctor Complete the Prescriber Section Give your healthcare provider the application form. Your doctor will need to: - Verify that you have a medical need for INGREZZA - Confirm the prescribed dose - Sign and date the certification section - This can usually be done at your regular appointment or by contacting your doctor's office ### Step 5: Submit Your Complete Application You can submit your application through multiple methods: - **Online**: Visit https://ingrezza.neurocrineaccesssupport.com/ and upload documents - **By Mail**: Mail all documents to the address provided in the application packet - **By Fax**: Send to **(844) 394-7155** - **By Phone**: Call **(844) 647-3992** to discuss your application or ask for assistance Make sure to keep copies of everything you submit. ### Step 6: Wait for a Decision Once your application is received, the program will review it. **Typical processing time is 4-8 weeks.** You may receive updates via email, phone, or mail during this time. If the program needs additional information, they will contact you. ### Step 7: Receive Your Medication If approved, your INGREZZA will be: - **Shipped directly to your home**, or - **Sent to your prescriber's office** for you to pick up You'll receive information about delivery within your approval notification. ## Timeline and What to Expect - **Application submission**: Immediate (once completed) - **Processing time**: 4-8 weeks typical (may vary) - **Approval notification**: By mail, email, or phone - **Medication delivery**: Within 1-2 weeks of approval - **Total time from application to medication**: Usually 5-10 weeks ## Annual Reauthorization Your assistance **must be reauthorized every 12 months**. The program will notify you when it's time to renew. You'll typically need to: - Submit updated financial information - Provide updated proof of insurance status - Have your doctor recertify your medical need Start the reauthorization process as soon as you receive notice to avoid any gaps in your medication supply. ## Other Ways to Save on INGREZZA ### INGREZZA Savings Card In addition to the patient assistance program, Neurocrine Biosciences offers a **Savings Card** that may reduce your out-of-pocket costs if you have insurance coverage. Check the manufacturer website to see if you qualify and to download the card. ### Insurance Appeals If your insurance company has denied coverage for INGREZZA, ask your doctor's office to file an appeal or prior authorization request. Sometimes coverage can be obtained this way, especially if your doctor provides clinical justification. ## What If Your Application Is Denied? If your application is denied, you have options: 1. **Ask why**: Contact the program at **(844) 647-3992** to understand the specific reason 2. **Appeal**: If circumstances have changed or information was misunderstood, you may be able to appeal 3. **Seek alternatives**: - Talk to your doctor about other treatment options - Ask about generic alternatives if available - Look into state pharmaceutical assistance programs - Contact patient advocacy organizations for your condition - Visit NeedyMeds.org for additional resources ## Contact Information **INGREZZA Patient Assistance Program** - **Website**: https://ingrezza.neurocrineaccesssupport.com/ - **Phone**: (844) 647-3992 - **Fax**: (844) 394-7155 - **Hours**: Typically Monday-Friday, 9 AM-5 PM ET Program specialists are available to answer questions, help you understand eligibility, and assist with your application. ## Important Legal Disclaimer This guide provides general information about the INGREZZA Patient Assistance Program. Program terms, eligibility requirements, and application processes may change at any time. For the most current and accurate information, always refer to the official program website or contact the program directly. This guide does not guarantee approval or specific benefits. All assistance is provided at the discretion of Neurocrine Biosciences, Inc., in accordance with applicable laws and program guidelines. Patients should not delay or stop taking prescribed medications while waiting for program approval unless directed by their healthcare provider. --- *This guide is intended for educational purposes and does not constitute medical advice. Always follow your healthcare provider's instructions regarding your medication.*

Program information last verified: March 25, 2026