Kymriah

Indicated For

Acute lymphoblastic leukemia, Diffuse large B-cell lymphoma, Follicular lymphoma

About This Medication

# KYMRIAH CARES Patient Guide: How to Get Kymriah at Low or No Cost ## About This Program KYMRIAH CARES is a patient assistance program designed and funded by Novartis to help patients access Kymriah (tisagenlecleucel), a specialized cancer treatment. This program recognizes that affording advanced therapies can be challenging and provides dedicated support to eligible patients throughout their treatment journey. ## What Is Kymriah? Kymriah is an FDA-approved cell therapy used to treat certain types of cancer, including acute lymphoblastic leukemia (ALL) in children and young adults, and diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma in adults. Because Kymriah is a personalized treatment that requires specialized manufacturing and administration at certified treatment centers, it represents a significant healthcare investment. KYMRIAH CARES exists to ensure that cost is not a barrier to accessing this potentially life-saving therapy. ## Who Qualifies for KYMRIAH CARES? To be eligible for KYMRIAH CARES, you must meet the following requirements: - **Residency**: Be a resident of the United States or Puerto Rico - **Insurance Status**: Be uninsured or underinsured (having limited insurance coverage) - **Income**: Meet specific income guidelines (needs-based eligibility) - **Valid Prescription**: Have a current prescription for Kymriah from a licensed U.S. healthcare provider - **FDA-Approved Indication**: Be prescribed Kymriah for an FDA-approved cancer indication - **Treatment Center**: Be treated at a licensed KYMRIAH Treatment Center ## Income Eligibility KYMRIAH CARES uses a needs-based approach to determine eligibility, meaning your household income is evaluated against specific guidelines. However, the exact income thresholds are not publicly listed and vary based on your individual circumstances. | Factor | Details | |--------|----------| | **Income Assessment** | Needs-based evaluation of household income | | **Household Size** | Considered in eligibility determination | | **Specific Thresholds** | Contact KYMRIAH CARES for your situation | | **Documentation** | Proof of income required with application | Because income guidelines are individualized, the best way to determine if you qualify is to contact the program directly. Many patients who think they may not qualify are surprised to find they do. ## Insurance Requirements KYMRIAH CARES is specifically designed for patients who are: - **Uninsured**: Have no health insurance coverage - **Underinsured**: Have insurance but face significant out-of-pocket costs or limited coverage for Kymriah If you have Medicare, Medicaid, or commercial insurance, you should first explore coverage through your plan. KYMRIAH CARES can help you navigate insurance options and may provide additional assistance if your insurance has limitations. ## What Does KYMRIAH CARES Cover? The program provides several types of support: - **Financial Assistance**: Help with medication costs for eligible patients - **Co-pay Assistance**: Support with insurance co-payments and deductibles - **Travel Assistance**: Income-based support for travel, lodging, and food expenses related to treatment at a certified KYMRIAH Treatment Center - **Case Management**: A dedicated KYMRIAH CARES case manager who provides personalized support throughout your entire treatment journey - **Treatment Center Location**: Help finding a KYMRIAH Certified Treatment Center near you - **Insurance Navigation**: Guidance on insurance coverage and reimbursement questions ## How to Apply: Step-by-Step ### Step 1: Gather Required Documents Before calling, have the following information ready: - Valid prescription for Kymriah from your healthcare provider - Proof of residency (utility bill, lease, or government ID) - Proof of income (recent tax return, pay stubs, or benefit statements) - Service Request Form for Patient Support (available through your treatment center or by calling the program) ### Step 2: Contact KYMRIAH CARES Call the program at **(844) 459-6742** (1-844-4KYMRIAH) **Hours**: Monday through Friday, 8:00 AM to 8:00 PM ET A KYMRIAH CARES representative will: - Answer your questions about eligibility - Explain what financial assistance you may qualify for - Guide you through the application process - Help you understand travel assistance options ### Step 3: Complete Your Application The program will provide you with an enrollment form and instructions. You'll need to: - Complete the application form with your personal and financial information - Submit required documentation (prescription, proof of residency, proof of income) - Provide information about your insurance status - Authorize the program to verify your information ### Step 4: Enrollment and Case Management Once approved, you'll be enrolled in KYMRIAH CARES and assigned a dedicated case manager. Your case manager will: - Help coordinate your treatment at a certified KYMRIAH Treatment Center - Provide ongoing support throughout your therapy - Answer questions about your benefits and assistance - Help with any issues that arise during treatment ## Timeline and Delivery **Processing Time**: The program does not publicly specify an exact processing timeline. However, because Kymriah treatment is time-sensitive for cancer patients, KYMRIAH CARES works to process applications promptly. Contact the program for specific information about expected timelines. **Delivery Method**: Kymriah is not delivered like a traditional medication. Instead, you receive treatment at an authorized KYMRIAH Treatment Center, where the therapy is administered by your healthcare team. KYMRIAH CARES can help you locate a treatment center near you. ## What If Your Application Is Denied? If your application for assistance is denied, you have options: - **Ask for Clarification**: Contact KYMRIAH CARES to understand the specific reason for denial - **Provide Additional Information**: If circumstances have changed or information was incomplete, you may reapply - **Explore Alternatives**: Your case manager can help you explore other financial resources or insurance options - **Appeal**: Ask about the program's appeal process if you believe the decision was made in error ## Reauthorization and Ongoing Support Once enrolled in KYMRIAH CARES, your case manager will provide continuous support throughout your treatment. The program does not require periodic reauthorization for most patients, but your case manager will monitor your situation and ensure you continue to receive appropriate assistance. ## Important Reminders - **Enrollment is Required**: You must be formally enrolled in KYMRIAH CARES to receive benefits - **No Activation Fee**: There is no cost to apply or enroll in the program - **Specific Sites Enroll Patients**: Information about the program is provided through authorized treatment centers and KYMRIAH CARES representatives - **Personalized Support**: Because each patient's situation is unique, the program tailors assistance to your specific needs ## Disclaimer This guide provides general information about KYMRIAH CARES based on program guidelines. Eligibility, benefits, and assistance amounts may vary based on individual circumstances, income, insurance status, and other factors. For accurate, personalized information about your specific situation, contact KYMRIAH CARES directly at (844) 459-6742. This guide is not a guarantee of eligibility or assistance. Always verify current program details with the official program representatives, as policies and benefits may change.

Program information last verified: March 25, 2026