Omnitrope

Novartis Patient Assistance Foundation (NPAF) Patient Guide: How to Get Omnitrope at Low or No Cost

About Omnitrope

Omnitrope (somatropin) is an injectable growth hormone medication manufactured by Novartis. It is prescribed to treat growth hormone deficiency in children and adults. For many patients, the cost of this medication can be a significant financial burden. The Novartis Patient Assistance Foundation (NPAF) exists to help eligible patients access Omnitrope at no cost when they cannot afford it.

Who Qualifies for NPAF Assistance

To receive free Omnitrope through NPAF, you must meet all of the following eligibility requirements:

• Reside in the United States or a US Territory
• Be treated by a licensed US healthcare provider on an outpatient basis
• Meet the income guidelines for your household size (see income table below)
• Not have insurance that restricts or conditions coverage based on participation in free goods programs
• Be uninsured, underinsured, or have government insurance (such as Medicare or Medicaid)

NPAF does not provide medication to individuals with insurance associated with alternate funding programs that condition or restrict coverage based on applying to NPAF or other free medication programs.

Income Eligibility Requirements

NPAF bases its income limits on the Federal Poverty Level Guidelines, which are adjusted annually. Your household income cannot exceed the limits shown in the table below for your household size. Income limits vary depending on the specific Novartis medication prescribed.

Important: These income limits are subject to change annually as the Federal Poverty Level Guidelines are updated. Contact NPAF or visit their website to confirm current income limits before applying.

Insurance Requirements

You are eligible for NPAF assistance if you:

• Have no prescription drug coverage (uninsured)
• Have limited prescription drug coverage (underinsured)
• Have government insurance such as Medicare or Medicaid

You are not eligible if you have private insurance that would be affected by your participation in NPAF, or if your insurance plan conditions or restricts coverage based on applying to free medication programs.

How to Apply for Omnitrope Through NPAF

Step 1: Check Your Eligibility

Before starting the application, verify that you meet all eligibility requirements, including income guidelines and residency. You can check your eligibility on the NPAF website.

Step 2: Complete Your Application

You and your healthcare provider (HCP) will each need to complete your section of the application. Only the patient, their legal guardian, or their caregiver may enroll the patient in the program. Healthcare providers, specialty pharmacies, and pharmacy benefit managers cannot enroll patients on your behalf.

Step 3: Submit Required Documentation

You will need to submit:

• Proof of income: The first two pages of your household tax return to confirm your annual income
• Any additional documentation requested by NPAF to verify your eligibility
• Evidence of Extra Help denial if deemed necessary by NPAF

Make sure all required documentation is included with your application. If your application is incomplete, you will receive a letter with instructions on what additional information is needed.

Step 4: Receive Your Decision

NPAF will review your application and send you a letter with the outcome within 4 weeks of submission. If you have opted in to receive text messages, you will also receive a notification via text.

Timeline and Medication Delivery

• Application review time: You will receive a decision letter within 4 weeks of submitting a complete application
• Delivery method: Medication is shipped to your healthcare provider's office
• Automatic re-enrollment: Patients are automatically re-enrolled at the start of each year, so you will not need to reapply annually if your circumstances remain the same

What If Your Application Is Denied?

If your application for NPAF assistance is denied, you have several options:

1. Review the denial reason: The letter you receive will explain why you were not approved. Common reasons include income exceeding limits or incomplete documentation.

2. Appeal the decision: If you believe the decision was made in error, contact NPAF to discuss your options.

3. Explore alternative programs: Novartis offers other patient support programs, including:

   • Co-Pay Savings Program: If you have insurance, you may be eligible to pay as little as $0 out-of-pocket through a co-pay card
   • Omnitrope Save As You Grow Program: Eligible patients with private insurance (but no public insurance) may save up to $250 per month for up to 12 months
   • Self-Pay Program: A comprehensive cash pay option for patients who do not qualify for other programs

4. Contact other assistance resources: Organizations like the Partnership for Prescription Assistance (PPA) can help you search for additional drug coverage options.

Important Terms and Conditions

• NPAF is an independent, 501(c)(3) non-profit organization
• NPAF reserves the right to modify or discontinue the program at any time
• NPAF may verify the accuracy of all enrollment information you submit
• You must submit all required documentation to be considered for assistance
• Only patients, legal guardians, or caregivers may enroll in the program—healthcare providers and pharmacies cannot enroll you

Contact Information

For more information about NPAF and to begin your application:

• Phone: 1-800-277-2254
• Website: Visit the NPAF website to check eligibility and access the application

Disclaimer

This guide provides general information about the Novartis Patient Assistance Foundation program for Omnitrope. Program eligibility, income limits, required documentation, and other terms are subject to change. Always verify current program details with NPAF directly before applying. This information is not a guarantee of assistance or approval. Your healthcare provider can also provide guidance on whether you may qualify for this program.