Kepivance

Indicated For

severe oral mucositis in patients with hematologic malignancies receiving myelotoxic therapy requiring hematopoietic stem cell support

About This Medication

# Kepivance Patient Assistance Program Patient Guide: How to Get Kepivance (palifermin) at Low or No Cost Kepivance (palifermin) is a supportive care medication that helps prevent and reduce severe **oral mucositis**—painful mouth sores and inflammation—in cancer patients undergoing high-dose chemotherapy, radiation, and stem cell transplants.[3][8][9] This guide explains the **Kepivance Patient Assistance Program** from Swedish Orphan Biovitrum, which provides the drug at low or no cost to eligible uninsured patients meeting income requirements.[5] ## About Kepivance (palifermin) **Kepivance** is not a cancer treatment but a supportive therapy. It is a lab-made version of keratinocyte growth factor (KGF), a natural protein that promotes growth and healing of cells in the mouth, skin, stomach, and intestines.[8][9] Severe **oral mucositis** affects up to most patients receiving myelotoxic (bone marrow-damaging) therapy for hematologic malignancies (blood cancers) before autologous hematopoietic stem cell transplantation (HSCT). This leads to painful ulcers, difficulty eating, drinking, speaking, or swallowing, often requiring feeding tubes or hospitalization.[3][8] **How it works**: Kepivance stimulates epithelial cell proliferation and mucosal thickening, reducing mucositis incidence, duration, and severity. Studies show benefits in HSCT, head/neck cancer chemoradiotherapy, and other mucotoxic chemotherapies like doxorubicin or fluorouracil.[3] It improves patient-reported symptoms and daily functioning.[3] **Administration**: Given as an IV infusion (into a vein), typically 3 doses before transplant/therapy and 3 doses after. Never on the same day as chemotherapy/radiation. Lines are rinsed with saline to avoid heparin interactions.[8] Common side effects include mouth tingling, swelling (edema), fever, rash, or elevated blood enzymes. Report new/worsening swelling to your doctor.[8] **FDA approval**: For decreasing severe oral mucositis in patients with hematologic malignancies receiving myelotoxic therapy with HSCT.[3][9] ## Who Qualifies for the Program? The program targets **uninsured** US residents or legal entrants with a qualifying medical condition (severe mucositis risk from cancer therapy).[5] You must meet undisclosed income guidelines—call (866) 547-0644 to check eligibility.[5] **Key requirements**: - US resident/legal entrant - Uninsured (no private insurance, Medicare, Medicaid, etc.)[5][4] - Income within program limits (not publicly specified; case-by-case review)[5] - Prescription for Kepivance for approved use (e.g., HSCT prep)[3][5] - Medically appropriate diagnosis[5] This program provides **one treatment course**: 3 vials pre-bone marrow transplant + 3 vials post-transplant.[5] It also offers reimbursement assistance.[5] ## Income Eligibility Breakdown Specific income thresholds are **not publicly disclosed** by Swedish Orphan Biovitrum. Eligibility is determined individually based on household income, size, and other factors.[5] Programs like this often align with **400% of the Federal Poverty Level (FPL)** or similar, but confirmation requires contacting the program.[5] | Household Size | Estimated Threshold Example (400% FPL, 2026)* | Notes | |---------------|------------------------------------------------|-------| | 1 person | ~$60,000 annually | Not confirmed; call to verify[5] | | 2 people | ~$81,000 annually | Household income reviewed[5] | | 3 people | ~$102,000 annually | Proof required[5] | | 4 people | ~$123,000 annually | Varies by location/circumstances[5] | *Illustrative only—actual limits undisclosed. Always call (866) 547-0644 for your situation.[5] Provide recent pay stubs, tax returns, etc. ## Insurance Requirements **Patients must be uninsured**—no coverage from private insurance, Medicare, Medicaid, or other programs.[5] Some PAPs exclude Medicare entirely, so confirm.[4] If insured, explore copay cards or other savings first (e.g., Swedish Orphan Biovitrum copay options), but this PAP is for uninsured only.[5][6] Attach any insurance info (even if none) to prove status.[5] ## Step-by-Step Application Process Applications are **phone-based**—no online form.[5] 1. **Call the program**: Dial **(866) 547-0644** (English/Spanish available).[5] Patient or doctor can request form faxed to office. 2. **Complete patient section**: Fill income details, sign, attach **proof of income** (pay stubs, tax return, SSI/SSDI letter), **insurance info** (statement of no coverage), and personal info.[5] 3. **Doctor completes**: Physician fills diagnosis/use section, signs, attaches **prescription**.[5] 4. **Fax back**: Use fax (866) 549-7219 or as instructed.[5] 5. **Approval wait**: Processing time not specified—expect weeks; follow up by phone.[5] 6. **Receive supply**: Ships to doctor/pharmacy/home (varies); covers prescribed amount.[5] **Tips**: Start early—before transplant. Have documents ready. Spanish apps available.[5] ## Timeline and Delivery **Processing time**: Not specified—call for updates.[5] Approval may take days to weeks based on similar programs. **Delivery**: Varies—often to prescriber's office, pharmacy, or home.[5] One-time supply for treatment course (6 vials).[5] **Refills/reauthorization**: Not detailed; contact program as needs arise.[5] ## Alternatives if Denied or Ineligible - **Other PAPs**: Prescription Hope offers Kepivance for $70/month (pre-qualify).[1] RxAssist/RxHope list options.[2][5] - **Copay assistance**: Swedish Orphan Biovitrum copay cards for insured.[6] - **Medicare tools**: Payment plans, 90-day supplies, low-income subsidies (if eligible).[4] - **State programs**: Check state pharmaceutical assistance via Dept. of Aging.[4] - **Generic/biosimilars**: None available.[program data] - **Doctor advocacy**: Ask oncologist for samples or hospital funds. - **Reapply**: Fix issues (e.g., income proof) and resubmit. ## Important Disclaimer This guide is for informational purposes only and based on publicly available data as of 2026.[5][7] Program details can change—**always verify directly** at (866) 547-0644.[5] Not medical/financial advice. Consult your doctor for treatment suitability. Eligibility not guaranteed. Manufacturer not affiliated with this guide.

Program information last verified: March 30, 2026