Kesimpta

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]

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]