Kovaltry

Indicated For

Hemophilia A

About This Medication

# Bayer US Patient Assistance Foundation Patient Guide: How to Get Kovaltry (octocog alfa) at Low or No Cost Kovaltry (octocog alfa) is a prescription medicine used to control and prevent bleeding episodes in people with hemophilia A, a genetic bleeding disorder where the blood does not clot properly. The **Bayer US Patient Assistance Foundation** helps eligible patients in the United States and Puerto Rico get Kovaltry at no cost if they face financial challenges, have limited or no insurance coverage for the medication, and meet income-based criteria.[1][2][3][4][5] ## About Kovaltry (octocog alfa) **Kovaltry** is an extended half-life factor VIII concentrate, a type of clotting protein replacement therapy. It is injected intravenously to treat and prevent bleeding in patients with hemophilia A, which affects about 1 in 5,000 male births. Unlike standard factor VIII products, Kovaltry's design allows for less frequent dosing in some cases, potentially improving quality of life. It is FDA-approved for routine prophylaxis, on-demand treatment, and perioperative management. Always follow your doctor's instructions for use, as dosing is personalized based on weight, bleeding risk, and activity level. Common side effects may include headache, fever, or injection site reactions—discuss risks with your healthcare provider.[5] This guide explains how the Bayer US Patient Assistance Foundation (the Foundation) can help you access Kovaltry without high costs. The program is a charitable initiative by Bayer, separate from commercial copay cards, targeting those who qualify based on need.[3][4] ## Who Qualifies? To be eligible, you must: - Live in the **United States or Puerto Rico**.[2][5] - Meet **certain income limits** based on financial need (specific federal poverty level percentages are not publicly detailed but assessed case-by-case).[1][2] - Be **uninsured or underinsured**, meaning your insurance does not cover Kovaltry or leaves you with unaffordable costs.[2][5] - Have a valid prescription from a U.S.-licensed healthcare provider.[1][2] The Foundation prioritizes patients without other payment options. You may need to show denial from state or government programs first.[5] Medicare Part D patients have extra steps (see Insurance section below).[1] ## Income Eligibility Breakdown Eligibility hinges on household income and financial need, but exact thresholds like specific Federal Poverty Level (FPL) percentages are not detailed in program materials. Applications are reviewed holistically.[1][2] Here's a general overview based on available info: | Household Size | Estimated Income Threshold | Notes | |---------------|----------------------------|--------| | Individual | Based on financial need (FPL not specified) | Assessed via proof of income; no fixed number listed. [1][2] | | Couple | Based on financial need (FPL not specified) | Household income considered. [1] | | Family of 3 | Based on financial need (FPL not specified) | Include all dependents. [2] | | Family of 4+ | Based on financial need (FPL not specified) | Larger families may have adjusted limits. [5] | **Tip**: Provide recent pay stubs, tax returns, or benefit statements. The Foundation does not publish exact FPL cutoffs (e.g., 400% FPL), unlike some programs—call 1-866-228-7723 for guidance.[1][6] ## Insurance Requirements The program is **generally for uninsured or underinsured patients**. 'Underinsured' means your plan covers Kovaltry poorly or not at all.[2][5] - **No insurance?** Eligible if other criteria met.[4] - **Commercial/employer insurance?** Eligible if Bayer meds aren't covered; however, the Foundation won't assist if your plan requires applying to a PAP as part of an alternative funding setup.[1] - **Medicare Part D/Advantage?** Possible, but patients eligible for Low-Income Subsidy (LIS/Extra Help—typically income <150% FPL for age 65+) **must provide proof of LIS denial**. Coverage starts January 1 for approved Medicare patients.[1][5][7] - **Medicaid?** Seek state assistance first; denials may be required.[5] Notify the Foundation of insurance changes.[7] ## Step-by-Step Application Process 1. **Get the form**: Download from www.patientassistance.bayer.us or call 1-866-228-7723 (Mon-Fri, 9 AM-6 PM ET).[1][2][5] 2. **Complete Patient Section** (pages 2-5): Include your name, contact, household income, insurance details. A caregiver can help.[2] 3. **Have your doctor complete/sign HCP Section** (page 6): Prescription for Kovaltry required.[1][2] 4. **Gather documents**: - Proof of income (e.g., pay stubs, 1040 form). - Proof of residency (e.g., utility bill). - Proof of prescription. - LIS denial if applicable.[1][5] 5. **Review checklist** (page 7) and make a copy.[2] 6. **Submit**: Fax to 1-866-575-6568 or mail to Bayer US Patient Assistance Foundation, P.O. Box 5670, Louisville, KY 40255. Online option via hubconnect.mckesson.com (check eligibility).[5] 7. **Wait for approval**: Applications reviewed in ~2 business days; longer if incomplete.[6] **Phone support**: 1-866-228-7723.[1] ## Timeline and Delivery - **Processing**: Usually within **2 business days**; delays if info missing.[6] - **Approval duration**: Up to 1 year; Medicare starts Jan. 1.[5][7] - **Delivery**: Medication **shipped directly to your home** at no cost.[Program details] - **Refills**: **Reauthorization required** annually or upon changes.[7] Track status by calling the helpline. ## Alternatives if Denied - **Appeal**: Contact the Foundation for reasons and resubmit missing info.[6] - **Other Bayer programs**: Copay assistance for commercially insured (not Medicare/Medicaid; up to 100% co-pay, annual reapply).[7] - **Government aid**: Apply for Extra Help (LIS), Medicaid, or state programs.[1][5] - **Hemophilia orgs**: National Hemophilia Foundation or bleeding disorder chapters offer grants. - **Generic/biosimilars**: No biosimilars listed for Kovaltry.[Program details] - **Patient Access Network (PAN) Foundation** or similar for hemophilia. ## Disclaimer This guide is for informational purposes based on publicly available data as of 2025. Eligibility, terms, and forms can change—verify at www.patientassistance.bayer.us or by calling 1-866-228-7723. Not medical/financial advice; consult your doctor and advisor. Bayer US Patient Assistance Foundation determines eligibility at its discretion. Program availability not guaranteed.[1][2][3][4][5][6][7]

Program information last verified: March 30, 2026