Krystexxa

Indicated For

gout

About This Medication

# Amgen By Your Side Patient Guide: How to Get Krystexxa (pegloticase) at Low or No Cost Krystexxa (pegloticase) is an IV infusion treatment for adults with uncontrolled gout who haven't responded well to oral medications. The **Amgen By Your Side** program, run by manufacturer **Amgen**, offers personalized support including co-pay assistance to make treatment affordable, potentially reducing your costs to $0 if eligible.[1][2][4] ## About Krystexxa and Uncontrolled Gout **Uncontrolled gout** happens when high uric acid levels cause painful flares, tophi (uric acid deposits under the skin), or ongoing joint damage despite trying oral urate-lowering therapies like allopurinol. Krystexxa works differently by converting uric acid into a harmless substance your body can easily remove, often lowering levels dramatically within weeks.[2][4] It's given every 2 weeks as an IV infusion in a doctor's office, hospital, infusion center, or sometimes at home (if approved by your healthcare provider). Treatment usually lasts at least 6 months, with monitoring for response via blood tests. **Important safety note:** Krystexxa carries risks like anaphylaxis (severe allergic reactions), infusion reactions, and issues in people with G6PD deficiency—a blood test is required before starting. Always get infusions from trained professionals ready to handle emergencies.[2][4] ## Who Qualifies for Amgen By Your Side Assistance? This program connects you with a **Patient Access Liaison (PAL)**—your dedicated guide—for insurance help, financial aid, and logistics. Key eligibility for co-pay support:[4][2] - 18+ years old with **uncontrolled gout** (serum uric acid ≥7 mg/dL, failed/intolerant to oral therapies, plus ≥1 symptom like tophi, ≥2 flares/year, or chronic joint issues). - U.S. resident. - **Commercial insurance** (not government programs like Medicare/Medicaid/VA/TRICARE—those patients may have other options via Amgen support).[2][4] Uninsured patients: Contact the program for help exploring options. Insured but ineligible for co-pay? Independent foundations may assist—your PAL can guide you.[4] ## Income Eligibility Breakdown Amgen By Your Side co-pay program doesn't list strict income thresholds like federal poverty level (FPL) limits; eligibility focuses on commercial insurance and financial need for drug/infusion costs. No specific individual, couple, or family income caps are published—decisions are case-by-case after enrollment.[4] Your PAL investigates benefits and matches aid. | Household Size | Typical Income Threshold | Notes | |---------------|-------------------------|-------| | Individual | Not specified (commercial insurance required) | Focus on out-of-pocket responsibility[4] | | Couple | Not specified | Case-by-case financial review[2] | | Family of 3 | Not specified | Uninsured: Explore foundations[4] | | Family of 4 | Not specified | Government insurance ineligible for co-pay[2] | **Pro tip:** Even higher earners with high-deductible plans often qualify for $0 co-pay on medication and infusions.[4] ## Insurance Requirements **Commercial/private insurance** is key for the co-pay program—government coverage disqualifies you from co-pay cards, but Amgen By Your Side helps with benefits investigation, prior authorizations, and appeals.[2][4] Expect prior authorization (PA) from your insurer, as Krystexxa needs proof of uncontrolled gout (labs, history). Your doctor submits PA; AmeriPharma notes approvals in 24-72 hours with help.[5] Medicare patients: Contact Amgen for non-co-pay options.[2] ## Step-by-Step Application Process 1. **Talk to your doctor:** Confirm Krystexxa fits your uncontrolled gout. Get G6PD test (must be normal) and uric acid labs.[4] 2. **Enroll in Amgen By Your Side:** Visit krystexxa.com or amgenbyyourside.com/krystexxa. Fill the PAL form—a Gout Nurse Advocate contacts you in **2 business days** to check eligibility and assign your PAL.[1][3] 3. **Doctor completes forms:** HCP portal (krystexxahcp.com) has enrollment/fax (877-633-9522) or email (GOUTABYS@amgen.com). Include DOB, G6PD results, gout diagnosis codes.[2][4] 4. **PAL helps:** They run **insurance benefits investigation**, handle PA, find infusion sites, and apply for co-pay/financial aid. Get peer mentor support from real patients.[1][2] 5. **Start treatment:** Once approved, infusions begin. PAL sends reminders and checks in.[2] Phone: 877-633-9521 for support.[4] ## Timeline and Delivery - **Enrollment to PAL:** 2 business days.[3] - **PA approval:** Often 24-72 hours with specialty pharmacy help.[5] - **First infusion:** Varies by insurance/scheduling; PAL coordinates site (office/home) and dates.[2] Delivery: Infused by professionals—no home shipping of drug. Every 2 weeks ongoing.[2] ## Alternatives if Denied or Ineligible - **Appeal:** PAL assists with insurer appeals using lab/diagnosis proof.[2] - **Foundations:** For uninsured or co-pay ineligible—Amgen connects you.[4] - **Other gout meds:** Oral options (if tolerated) or biosimilars (none listed for Krystexxa yet).[4] - **Specialty pharmacies** like AmeriPharma for extra copay aid ($55M secured).[5] ## Reauthorization and Refills Ongoing infusions need response checks (uric acid <6 mg/dL). Re-treatment after breaks requires monitoring for reactions. PAL handles reauthorizations.[2] ## Disclaimer This guide is for informational purposes based on Amgen By Your Side details as of available sources—eligibility/terms can change. Not medical/financial advice. Consult your doctor, insurer, and PAL (877-633-9521). Report co-pay use to insurer if required. Krystexxa has serious risks; discuss fully with your provider. Program excludes government insurance for co-pay.[1][2][4]

Program information last verified: March 25, 2026