Monoferric

Indicated For

iron deficiency anemia

About This Medication

# Monoferric Patient Solutions Patient Assistance Program Patient Guide: How to Get Monoferric at Low or No Cost Monoferric (ferric derisomaltose) is an intravenous iron replacement therapy used to treat iron deficiency anemia (IDA) in adults when oral iron is ineffective or not tolerated. The **Monoferric Patient Solutions Patient Assistance Program** from **Pharmacosmos Therapeutics Inc.** helps eligible uninsured or underinsured patients access **Monoferric** at low or no cost through free product shipment or copay support. ## About Monoferric **Monoferric** is administered by a healthcare professional in a single or divided dose, depending on your iron needs, offering a convenient alternative to frequent oral iron supplements or multiple infusions. It replenishes iron stores quickly to improve hemoglobin levels and reduce fatigue associated with IDA, which can result from conditions like chronic kidney disease, inflammatory bowel disease, or heavy menstrual bleeding. Always consult your doctor to confirm if Monoferric is right for you, as it may cause side effects like allergic reactions, low blood pressure, or nausea. ## Who Qualifies for the Program? This program supports **uninsured or underinsured patients** aged 18 and older who need Monoferric for IDA treatment. It includes two main tracks: - **Patient Assistance Program (PAP)**: Free Monoferric shipped directly to eligible patients without insurance coverage or with high out-of-pocket costs. - **Copay Assistance Program**: Reduces copays to as little as $0 for patients with commercial insurance. **Key exclusions**: - Patients enrolled in **Medicaid, Medicare, or other federal/state healthcare programs** are not eligible. - Insurers prohibiting copay assistance (check your plan) disqualify copay support. - Must be 18+ years old. ## Income Eligibility Specific income thresholds (e.g., Federal Poverty Level percentages) are **not publicly detailed** for this program. Eligibility focuses on uninsured/underinsured status rather than strict income limits, but Pharmacosmos may request financial verification. Contact the program at (800) 992-9022 for personalized assessment. Here's a general overview: | Household Size | Income Threshold | Notes | |---------------|------------------|-------| | Individual | Not specified | Uninsured/underinsured prioritized | | Couple | Not specified | Proof may be requested | | Family of 3 | Not specified | Call for details | | Family of 4 | Not specified | Flexible review process | *Table based on available program data; thresholds subject to change.* ## Insurance Requirements - **Uninsured/Underinsured**: Eligible for free product via PAP. - **Commercial Insurance**: Eligible for copay cards/assistance (patients pay as little as $0). Submit an **Explanation of Benefits (EOB)** within 120 days of service for retroactive claims (up to 90 days post-program changes). - **Medicare/Medicaid/Federal Programs**: **Not eligible**—program explicitly excludes patients whose claims are covered, paid, or reimbursed by these. Enrollment is annual (calendar year); reenroll as needed. Avoid if your plan bans manufacturer copay help. ## Step-by-Step Application Process 1. **Discuss with Your Doctor**: Confirm Monoferric prescription and program eligibility. Your healthcare provider (HCP) must complete part of the form. 2. **Gather Documents**: - **Patient Support Enrollment Form** (download at https://monoferric-patient-solutions.com/pdf/Monoferric_Patient_Solutions_Enrollment_Form.pdf). - **EOB** for copay assistance (from commercial insurer, showing out-of-pocket costs). - Proof of income/residency if requested (U.S. residents only). 3. **Submit Application** (multiple methods): - **Online**: Via Monoferric Patient Solutions portal. - **Phone**: Call (800) 992-9022 (Mon–Fri, 8 AM–8 PM ET) for help. - **Fax/Mail**: Follow form instructions; HCP submits EOB. 4. **Program Review**: Team verifies eligibility, benefits, and documents. They offer benefits investigation and prior authorization help. 5. **Approval Notification**: Receive confirmation; copay card issued digitally or by mail. ## Timeline and Delivery Processing time varies but aims for prompt access. Free Monoferric ships directly to you or your provider for PAP. Copay support activates immediately upon approval for infusions. Reauthorization is **required** annually or per treatment course—your HCP resubmits as needed. Expect support for appeals, coding, and reimbursement. ## If Denied or Alternatives - **Appeal**: Program provides sample appeal letters and medical necessity support. Resubmit with additional docs. - **Alternatives**: - Other IV irons: **No biosimilars** listed for Monoferric. - General PAP databases like RxAssist.org for Pharmacosmos programs. - State assistance, hospital charity care, or generic oral irons (if tolerated). - Contact (800) 992-9022 for case managers. ## Additional Support - **Provider Portal**: HCPs access billing guides, claims help at monoferricpatientsolutionsportal.com. - **Field Reimbursement Managers**: In-person office support. - **Resources**: Benefits verification, sample forms at monoferric-patient-solutions.com. ## Disclaimer This guide is for informational purposes based on publicly available data as of program details. Eligibility, terms, and availability can change; Pharmacosmos reserves rights to verify info, request docs, or modify/discontinue. Not legal/financial advice—consult your HCP, insurer, or program directly at (800) 992-9022. Patients must meet all criteria; federal law prohibits assistance for government-insured. Pharmacosmos Therapeutics Inc. not liable for third-party info.

Program information last verified: March 30, 2026