Lumakras

Indicated For

KRAS G12C-mutated NSCLC

About This Medication

# Getting Financial Help for Lumakras (sotorasib) ## About This Guide Lumakras (sotorasib) is a prescription medication used to treat a specific type of lung cancer called KRAS G12C-mutated non-small cell lung cancer (NSCLC). This guide explains how to access financial assistance to help pay for your medication. ## Important Note About Manufacturer Assistance Amgen, the manufacturer of Lumakras, does not currently have an active patient assistance program (PAP) that provides free or reduced-cost medication directly. However, there are several other resources available to help make your medication more affordable. ## What is Lumakras? Lumakras is a targeted cancer therapy that works by blocking a specific mutation called KRAS G12C found in some lung cancer cells. It's designed to slow or stop the growth of cancer in patients with this mutation. Your doctor has prescribed this medication because testing showed your cancer has this specific genetic change. ## Available Financial Resources ### 1. **Amgen Support Plus Copay Savings Card** Amgen offers a copay savings program to help reduce out-of-pocket costs: - **Website**: https://www.amgensupportplus.com/copay - **Eligibility**: Most patients with commercial or Medicare insurance - **Savings**: Can reduce your copay to as little as $0-$50 per month (varies by plan) - **How to Use**: - Visit the website and complete the enrollment form - Provide insurance information - Receive your card electronically or by mail - Present at the pharmacy when filling your prescription ### 2. **Insurance Coverage and Appeals** Your health insurance plan may cover Lumakras. To maximize coverage: - Contact your insurance company's patient support line - Ask if Lumakras is on your formulary (covered drug list) - Request coverage for your specific cancer type (KRAS G12C-mutated NSCLC) - If denied, ask about the appeals process—your doctor can provide medical justification - Most cancer medications are covered by Medicare Part D and commercial plans ### 3. **State and Federal Assistance Programs** Depending on your state and income level, you may qualify for: - **State Pharmaceutical Assistance Programs (SPAP)**: Each state offers programs for uninsured or underinsured residents - **Medicare Extra Help**: If you're on Medicare with limited income - **Medicaid**: For low-income patients - **Ryan White Program**: For HIV patients also taking this medication ### 4. **Non-Profit Organizations** Several non-profits help cancer patients access medications: - **NeedyMeds.org**: Searchable database of assistance programs - **CancerCare**: Provides financial assistance and support services - **Patient Advocate Foundation**: Helps with medication access and appeals - **American Cancer Society**: Resources and local assistance programs - **Lung Cancer Alliance**: Specific support for lung cancer patients ### 5. **Pharmacy Discount Programs** - **GoodRx, RxSaver, and similar platforms**: May offer discounted prices - **Wholesale clubs**: Some offer discounted medication programs ## Income Eligibility While Amgen does not have an active PAP, other assistance programs have income limits. General guidelines for state and federal programs: | Household Size | Typical Income Limit | |---|---| | 1 person | $1,500-$2,000/month | | 2 people | $2,000-$2,700/month | | 3 people | $2,500-$3,400/month | | 4 people | $3,000-$4,100/month | | 5 people | $3,500-$4,800/month | | 6+ people | Add $500-$700 per person | *Note: Income limits vary significantly by program and state. Even if you exceed these amounts, you may still qualify for copay assistance or insurance appeals.* ## Insurance Requirements - The Amgen copay savings card works with most commercial insurance plans and Medicare - If uninsured, you're eligible for state PAP programs - If underinsured, both copay cards and state programs may apply - Some programs require that you've been denied coverage before applying ## How to Apply for Assistance ### Step 1: Check Insurance Coverage - Call your insurance company and confirm Lumakras is covered for your diagnosis - Ask about prior authorization requirements - Request a coverage letter from your insurer ### Step 2: Enroll in the Copay Savings Card - Visit https://www.amgensupportplus.com/copay - Complete the online enrollment - Verify your insurance information - Download or receive your card by mail ### Step 3: Use Additional Resources - Visit NeedyMeds.org and search for programs in your state - Contact your state's pharmaceutical assistance program - Reach out to non-profit organizations listed above ### Step 4: Appeal if Needed - If insurance denies coverage, ask your oncology team to submit a medical necessity letter - File a formal appeal with your insurance company - Include documentation of your KRAS G12C mutation - Request expedited review due to cancer diagnosis ### Step 5: Work with Your Pharmacy - Inform your pharmacist that you're using financial assistance - They can help coordinate benefits and programs - They may know of additional local resources ## Timeline and Delivery Financial assistance programs typically work as follows: - **Copay card enrollment**: 1-3 business days - **Insurance coverage decision**: 3-15 business days (faster with expedited review) - **State PAP processing**: 4-8 weeks typical - **Medication delivery**: Varies by program and pharmacy (usually 3-7 business days for in-stock medications) Your doctor may provide samples while you're waiting for coverage to be approved. ## What Happens If You're Denied Assistance If you're denied coverage or assistance: 1. **Ask why**: Get a written explanation of the denial 2. **Appeal**: Most denials can be appealed, especially if your doctor provides medical justification 3. **Try other programs**: You may qualify for different assistance programs 4. **Contact patient advocates**: Organizations like Patient Advocate Foundation can help fight denials 5. **Talk to your doctor**: They may have samples or know of other resources ## Reauthorization and Refills - Once approved, copay cards typically work for all refills - Insurance coverage usually continues as long as the medication is working - Your doctor may need to provide periodic updates to your insurance company - Ask your pharmacy about automatic refill programs ## Important Reminders - **Never skip doses**: Speak to your doctor immediately if cost is preventing you from taking your medication - **Update information**: Notify programs of any changes in income or insurance - **Multiple resources**: You may qualify for several programs at once - **No cost to apply**: Legitimate assistance programs never charge application fees - **Time is important**: Start the application process as soon as you receive your prescription ## Contact Your Care Team Your oncology team wants you to have access to your medication. Don't hesitate to ask: - Your oncologist about samples - Your nurse about financial resources - Your social worker about community programs - Your pharmacist about price options ## Legal Disclaimer This guide provides general information about financial assistance options for Lumakras. Program eligibility, benefits, and requirements change frequently. Always verify current information directly with programs and providers. This guide does not constitute medical or financial advice. Consult with your healthcare provider and insurance company regarding your specific situation. Amgen and other entities mentioned do not endorse this guide; it is provided for informational purposes only.

Program information last verified: March 25, 2026