Inrebic

Indicated For

intermediate-2 or high-risk primary or secondary (post-polycythemia vera or post-essential thrombocythemia) myelofibrosis

About This Medication

# Inrebic Patient Assistance Guide: Getting Your Medication at Low Cost ## What is the Bristol Myers Squibb Patient Assistance Foundation? The Bristol Myers Squibb Patient Assistance Foundation (BMS PAF) helps eligible patients get Inrebic (fedratinib) at reduced or no cost. If you have myelofibrosis and struggle to afford this medication, this program may help you access the treatment you need. ## Who Can Apply? You may qualify if you: - Have been prescribed Inrebic by your doctor for intermediate-2 or high-risk myelofibrosis (primary, post-polycythemia vera, or post-essential thrombocythemia) - Are uninsured or underinsured - Meet annual income limits based on your household size - Are a U.S. resident **Important:** This program does not cover patients with commercial insurance. If you have health insurance coverage, you should use that first. However, if your insurance denies coverage or has high out-of-pocket costs, contact the program to discuss your situation. ## Income Eligibility Income limits vary by household size and change annually. The program uses federal poverty guidelines as a starting point but may consider individual circumstances. Contact the BMS PAF directly at **(800) 861-0048** to learn the current income limits for your household size. The program staff can quickly tell you if you likely qualify. ## What Documents Do You Need? To apply, have these ready: 1. **Proof of Income** – Recent tax return, W-2, pay stub, or unemployment statement 2. **Proof of Residency** – Utility bill, lease, or mortgage statement with your current address 3. **Valid Prescription** – Your doctor's prescription for Inrebic 4. **Insurance Information** – Proof of uninsured or underinsured status (if applicable) Your doctor's office can help provide some of these documents. ## How to Apply: 4 Easy Steps **Step 1: Gather Your Documents** Collect proof of income, residency, and your Inrebic prescription as listed above. **Step 2: Call the BMS PAF** Contact the program at **(800) 861-0048**. A representative will answer questions about eligibility and walk you through the application process. You can apply over the phone or request an application form to complete at home. **Step 3: Submit Your Application** Return your completed application and documents by mail, phone, or online through the program website at https://www.bmspaf.org. Follow the instructions provided by the program staff. **Step 4: Wait for Approval** The program typically reviews applications and notifies you of approval status within 2-3 weeks, though this may vary. Once approved, you'll receive your medication or information about how to access it. ## Savings Options In addition to the full assistance program, a **Inrebic savings card** is available that can help reduce your out-of-pocket costs if you have insurance or partial coverage. Ask your pharmacist or call the program number above to learn more. ## Important Details **Reauthorization:** Your assistance typically lasts one year. You'll need to reapply annually to continue receiving help. **Processing Time:** Plan ahead—approval usually takes 2-3 weeks. Ask your doctor's office about providing temporary doses or delayed prescription fills if you need medication right away. **What If You're Denied?** Don't give up. If your application is denied, ask the program why and whether you can reapply. Your situation may change, or additional information could help. ## Need Help? If you have questions or need assistance: - **Call:** (800) 861-0048 - **Visit:** https://www.bmspaf.org - **Ask Your Doctor:** Your healthcare provider's office often helps patients apply for assistance programs The program staff are there to help—don't hesitate to ask questions about eligibility, the application process, or your status.

Program information last verified: March 25, 2026