Leukine

Indicated For

neutrophil recovery after BMT, acute myelogenous leukemia

About This Medication

# LeukineDirect Patient Assistance Program: How to Get Leukine at Low or No Cost ## About This Program The **LeukineDirect Patient Assistance Program**, administered by Partner Therapeutics, Inc., helps eligible patients access Leukine (sargramostim) at reduced or no cost. Leukine is a prescription medication used to shorten recovery time after chemotherapy in adult patients 55 and older with acute myeloid leukemia (AML) and to mobilize blood-forming cells for transplantation.[1] If you've been prescribed Leukine but are concerned about cost, this program may help you get your medication without financial hardship. ## Who Qualifies for This Program You may be eligible for LeukineDirect if you meet these criteria: - **Income requirement**: Your household income is at or below **500% of the Federal Poverty Level (FPL)**[1] - **Insurance status**: You are uninsured, underinsured, or have Medicare Part D coverage (evaluated case-by-case)[6] - **Program eligibility**: You are ineligible for federal or state assistance programs[6] - **Prescription requirement**: You have a valid prescription from your healthcare provider for Leukine ### Income Eligibility Breakdown The 500% FPL threshold means your household income can be significantly higher than the poverty line. Here's what this means for different household sizes in 2026: | Household Size | 100% FPL | 500% FPL | |---|---|---| | Individual | ~$15,000 | ~$75,000 | | Couple | ~$20,000 | ~$100,000 | | Family of 3 | ~$25,000 | ~$125,000 | | Family of 4 | ~$31,000 | ~$155,000 | *Note: These are approximate 2026 figures. Actual FPL amounts are updated annually by the U.S. Department of Health and Human Services.* ## Insurance Requirements Your insurance status affects your eligibility: - **Uninsured patients**: Generally eligible - **Underinsured patients**: Generally eligible (you have insurance but high out-of-pocket costs) - **Medicare Part D patients**: Evaluated case-by-case for eligibility - **Medicaid patients**: May be eligible depending on your state's program - **Federal/state program recipients**: You are **not eligible** if you receive assistance through federal or state programs If you have private insurance, the program will not pay claims that your insurance denies.[4] ## How to Apply: Step-by-Step ### Step 1: Gather Required Documents Before starting your application, collect the following: - **Proof of income** (choose one):[1] - Previous year's 1040 tax form - Social Security Retirement statement - Supplemental Social Security Income (SSI) documentation - SSA 1099 form from the previous year - Unemployment award letter - Other income documentation - **Medical information**: - Your ICD-10 diagnosis code - Your height and weight - Any known drug allergies - **Insurance information** (if applicable) - **HIPAA Authorization**: You'll sign this to allow the program to access your medical information ### Step 2: Complete the Application Form You can obtain the application form by: - **Calling the LeukineDirect Reimbursement Hotline**: (877) 353-8546[1] - **Mailing address**: PO Box 501848, San Diego, CA 92150-1848[1] - **Fax**: 855-881-6864[1] The application requires signatures from both you (the patient) and your prescribing healthcare provider.[1] All required fields must be completed, or your application will be delayed.[1] ### Step 3: Submit Your Application You can submit your completed application by: - **Fax**: 855-881-6864 - **Mail**: PO Box 501848, San Diego, CA 92150-1848 - **Phone assistance**: Call (877) 353-8546 for help **Program hours**: Monday through Friday, 9:00 AM – 5:00 PM Eastern Time[1] ### Step 4: Receive Your Medication Once approved, your medication will be **shipped directly to your healthcare provider's office**.[6] Your provider will then dispense it to you according to your treatment plan. ## Timeline and What to Expect While the search results do not specify an exact approval timeline, applications are processed after all required documentation is received.[1] Incomplete applications will be delayed, so ensure all fields are filled out and all documents are included. Your approval lasts for **one year** from the date you are approved into the program.[1] After one year, you will need to reauthorize your enrollment to continue receiving assistance. ## What Happens If Your Application Is Denied If your application is denied, you have options: - **Contact the program**: Call (877) 353-8546 to understand why you were denied and whether you can appeal - **Verify your information**: Ensure all income documentation and medical information is accurate and current - **Explore alternatives**: Ask your healthcare provider about other financial assistance options or discuss whether a different treatment approach might be more affordable - **Reapply**: If your circumstances change (such as a change in income or insurance status), you may reapply ## Important Disclaimers - Partner Therapeutics reserves the right to request additional documentation to confirm your eligibility at any time.[1] - Once your health information is disclosed to the program, it may no longer be protected by federal or state privacy laws.[1] - The program does not guarantee that insurance claims will be reimbursed, and Partner Therapeutics does not reimburse for claims denied by payers.[4] - Your healthcare provider makes all final decisions about whether Leukine is appropriate for your condition. ## Questions? Contact LeukineDirect **Phone**: (877) 353-8546 (PTx Assist) **Hours**: Monday – Friday, 9:00 AM – 5:00 PM Eastern Time **Fax**: 855-881-6864 **Mailing Address**: PO Box 501848, San Diego, CA 92150-1848 The LeukineDirect team is ready to help you navigate the application process and answer questions about your eligibility.

Program information last verified: March 30, 2026