Kesimpta

Indicated For

relapsing multiple sclerosis

About This Medication

# Alongside KESIMPTA Patient Guide: How to Get Kesimpta (ofatumumab) at Low or No Cost KESIMPTA (ofatumumab) is a prescription medication used to treat relapsing forms of multiple sclerosis (MS) in adults. **Alongside KESIMPTA**, offered by Novartis, provides free support services, copay assistance, and free medication options to help eligible patients access treatment at little or no cost.[1][2][8] ## About Kesimpta **Kesimpta** is a self-administered injection given monthly at home after initial doses. It works by targeting specific immune cells to reduce MS relapses, disability progression, and brain lesions. The list price is about **$10,094 per treatment**, but most insured patients pay less, and assistance programs can make it **$0 out-of-pocket** for many.[1][7] Enrolling in Alongside KESIMPTA pairs you with a **dedicated Patient Access Coordinator** who helps with insurance navigation, payment options, home delivery, and ongoing support via calls, texts, or emails.[1][2][3] ## Who Qualifies? Alongside KESIMPTA has multiple components for different situations: - **Access Card (Copay Assistance)**: For patients with **commercial insurance** (not Medicare, Medicaid, etc.). Covers up to **$18,000 per year** in copays, deductibles, or coinsurance, often reducing costs to **$0**. Limited to $9,000 if your plan uses a 'copay maximizer.' Funding exhausts when limit is reached.[2][8][10] - **Bridge Program**: Free Kesimpta for up to **12 months** if you have commercial insurance but get a **prior authorization (PA) denial**. Helps while appealing coverage.[2][8][9][10] - **Novartis Patient Assistance Foundation (NPAF)**: Free medication for **uninsured, underinsured, or some Medicare patients** meeting **income criteria** (typically up to 400-500% of Federal Poverty Level, but call to confirm). Requires proof of income and no other federal coverage where prohibited.[8][10] **Not eligible** if enrolled in government programs like Medicare Part D, Medicaid, VA, or TRICARE for copay help.[2][8] ## Income Eligibility Breakdown Specific income thresholds aren't publicly listed online but are based on Federal Poverty Guidelines (FPL). NPAF generally qualifies households up to **400% FPL** (e.g., ~$60,000 for individual, ~$80,000 for couple in 2026; exact varies by state/family size). Call **1-800-277-2254** for your situation.[8] | Household Size | Estimated 400% FPL Threshold (2026, continental US) | Notes | |---------------|---------------------------------------------------|-------| | 1 (Individual) | ~$60,240 | Approximate; confirm with program[8] | | 2 (Couple) | ~$81,760 | Varies by location[8] | | 3 | ~$103,280 | NPAF may adjust[8] | | 4 | ~$124,800 | Call for exact eligibility[8] | **Copay programs have no income limits** but require commercial insurance.[2] ## Insurance Requirements - **Commercial/Private Insurance**: Eligible for Access Card ($0 copay) and Bridge Program.[2][10] - **Medicare/Medicaid**: Copay assistance unavailable; try NPAF if income-qualified.[2][8] - **Uninsured**: NPAF for free drug if income-eligible.[8] Your Coordinator verifies benefits and helps with **prior authorizations (PAs)** or appeals, common for MS drugs like Kesimpta.[3][10] ## Step-by-Step Application 1. **Get Prescribed**: Ask your doctor for Kesimpta. They may start the process.[3] 2. **Enroll in Alongside KESIMPTA**: - Visit **start.kesimpta.com** or call **1-855-KESIMPTA (1-855-537-4678)**, Mon-Fri 8:30am-8pm ET.[2] - Sign up for **Access Card** online (quick digital enrollment).[2] 3. **For NPAF/Bridge**: - Doctor completes **Kesimpta Start Form** (via AcariaHealth or Novartis).[9] - Apply at **pap.novartis.com** or call **1-800-277-2254**.[8][10] 4. **Submit Documents**: Upload/ fax proof of income (tax returns, paystubs), insurance card, prescription, ID.[8] 5. **Get Coordinator**: They'll handle verification, PA help, and approval.[1][3] ## Timeline and Delivery - **Copay Card**: Instant activation upon enrollment; use at pharmacy.[2] - **Bridge/NPAF Approval**: 2-4 weeks typically; expedited possible.[10] - **Delivery**: **Home delivery** of free meds via specialty pharmacy (e.g., AcariaHealth). Includes auto-injector training resources.[1][9] Once approved, expect monthly shipments. Coordinator follows up.[1] ## Alternatives if Denied - **Appeal Insurance**: Coordinator assists; up to 180 days internal, then external review.[10] - **Bridge Program** during appeals.[2] - **Other MS Assistance**: PAN Foundation (up to $5,000/year, panfoundation.org), National MS Society resources.[10] - **NeedyMeds/Medicine Assistance Tool** for more options.[7] - **Biosimilars**: None currently available for Kesimpta.[ ] ## Disclaimer This guide is for informational purposes based on publicly available data as of 2026. **Eligibility, benefits, and terms can change**. Always verify with Novartis at 1-855-537-4678 or your healthcare provider. Not a substitute for medical/insurance advice. Novartis reserves rights to modify/discontinue programs. See full Kesimpta prescribing info for risks.[1][2]

Program information last verified: March 30, 2026