MYOBLOC

Indicated For

Cervical dystonia, Chronic sialorrhea

About This Medication

# MYOBLOC Patient Assistance Program Patient Guide: How to Get MYOBLOC at Low or No Cost MYOBLOC (rimabotulinumtoxinB) Patient Assistance Program provides **free medication** to eligible uninsured or underinsured adults with **cervical dystonia** or **chronic sialorrhea** who cannot afford treatment and meet specific criteria.[1][2][3] ## About MYOBLOC **MYOBLOC** is an injectable botulinum toxin type B medication used to treat two conditions: - **Cervical dystonia (CD)**: Abnormal head position and neck pain from involuntary muscle contractions.[10] - **Chronic sialorrhea (CS)**: Excessive drooling that impacts daily life.[1][2] Administered by a healthcare provider (HCP) via injection into affected muscles, MYOBLOC temporarily blocks nerve signals to reduce symptoms. Effects typically last about 12-13 weeks.[9][10] It's supplied in ready-to-use vials (2,500, 5,000, or 10,000 Units) with J-Code J0587 and specific ICD-10 codes: G24.3 for CD or K11.7 for CS.[1][2] **Important**: MYOBLOC is prescription-only. Discuss with your doctor if it's right for you. Common side effects include dry mouth, swallowing difficulty, and injection site pain—report serious issues to your HCP or Solstice Neurosciences at 1-888-461-2255.[10] ## Who Qualifies for the Program? This **needs-based program** from **Solstice Neurosciences, LLC** offers MYOBLOC at **no charge** to qualifying adults.[1][2][3] Key eligibility: - 18+ years old and legal US resident.[1][5] - Prescribed MYOBLOC by a licensed physician for CD or CS, with proper diagnosis codes.[1][2] - **Uninsured** (no coverage for MYOBLOC) or **underinsured** (insurance denies benefits/coverage).[1][3] - Cannot afford treatment otherwise (needs-based; income details not publicly disclosed).[3] - **Not enrolled** in government programs like Medicare, Medicaid, TRICARE, or other federal/state-funded insurance.[1][5] - Receive injections of MYOBLOC (J0587).[1][2] **Note**: Separate **MYOBLOC Co-Pay Program** helps commercially insured patients with up to **$4,000/year** for out-of-pocket costs (vials, injections, ultrasound/EMG guidance)—but excludes government insurance.[1][2][5] This guide focuses on the Patient Assistance Program (PAP).[3] ## Income Eligibility Income requirements are **not publicly disclosed**; it's a **needs-based** assessment by Solstice Neurosciences.[3] No specific thresholds (e.g., FPL percentages) are listed. Your HCP or program staff evaluate financial hardship case-by-case. | Household Size | Income Threshold | Notes | |---------------|------------------|-------| | Individual | Not disclosed | Needs-based; proof of inability to pay required[3] | | Couple | Not disclosed | Contact program for assessment[1] | | Family of 3 | Not disclosed | - | | Family of 4 | Not disclosed | - | | General | None specified | Income not primary barrier; focus on no insurance/affordability[1][2] | Call **1-888-461-2255** (Option 3, M-F 8AM-8PM ET) for personalized guidance.[1][3] ## Insurance Requirements - **Eligible**: Uninsured or underinsured (no MYOBLOC benefits from private insurance).[1][3] - **Ineligible**: Government insurance (Medicare, Medicaid, TRICARE, etc.).[1][5] - Provide insurance details (if any) on application to confirm lack of coverage.[3] ## Step-by-Step Application Process 1. **Talk to your HCP**: Confirm MYOBLOC prescription for CD/CS. They complete physician section.[1][3] 2. **Gather documents**: - Completed application (patient + physician signatures).[3] - Proof of diagnosis (e.g., medical records with ICD-10 codes).[1][2] - Insurance info (or proof of no coverage).[3] 3. **Apply** (multiple methods): - **Online**: HCP enrolls via Circle of Care Provider Portal.[3] - **Phone**: Call 1-888-461-2255 (Option 3).[1][3] - **Website**: Visit https://www.myoblochcp.com/reimbursement-program-information for forms/info.[2] 4. **Submit**: HCP faxes details or program verifies.[3] 5. **Wait for approval**: ~**12 business days**; notified if approved, details faxed to Acredo.[3] **Tip**: Start early—processing takes time. ## Timeline and Delivery - **Processing**: 12 business days.[3] - **Delivery**: Shipped **free** to your pharmacy or HCP's office via **Acredo** (specialty pharmacy).[3] - **Reauthorization**: Required for refills/ongoing treatment—resubmit periodically.[3] ## If Denied or Alternatives - **Denied?** Ask for reason (e.g., insurance issue, income). Appeal or check Co-Pay Program if commercially insured (up to $4,000/year).[1][2] - **Other options**: - **MYOBLOC Co-Pay Program** for insured patients.[5] - Generic/biosimilar: None available.[ ] - Other botulinum toxins (e.g., Botox for CD, but consult HCP).[9] - State programs, NeedyMeds, or PAN Foundation. ## Disclaimer This guide is for informational purposes only, based on publicly available data as of 2026.[1][2][3] Eligibility not guaranteed—criteria set by Solstice Neurosciences; subject to change. Not medical/financial advice. Consult your HCP and call 1-888-461-2255 for latest details. MYOBLOC has risks; see full prescribing info.[10]

Program information last verified: March 30, 2026