OPZELURA

Indicated For

Mild to moderate atopic dermatitis (eczema), nonsegmental vitiligo

About This Medication

# IncyteCARES for OPZELURA Patient Assistance Program Patient Guide: How to Get OPZELURA at Low or No Cost OPZELURA (ruxolitinib) is a prescription topical cream used to treat mild to moderate **atopic dermatitis (eczema)** in patients 12 years and older whose skin has not adequately responded to other topical treatments, or for **nonsegmental vitiligo** in patients 12 years and older.[2][1] The **IncyteCARES for OPZELURA Patient Assistance Program**, offered by **Incyte**, provides this medication **at no cost** to eligible patients who are uninsured or have Medicare Part D coverage but cannot afford their copays.[2][1] ## Who Qualifies for the Program? This program is designed for U.S. residents (including Puerto Rico) facing financial barriers to accessing OPZELURA.[1] To qualify, you must meet these key criteria: - Have a **valid prescription** for OPZELURA from your doctor for approved uses: mild to moderate eczema or nonsegmental vitiligo.[2] - Be **uninsured** (no prescription insurance) or have **Medicare Part D** coverage but unable to afford out-of-pocket costs.[2][1] - Your **adjusted annual household income** must be **≤400% of the Federal Poverty Level (FPL)**.[2] **Important exclusions for Medicare Part D patients:** You cannot be enrolled in Medicaid, Medicare Part D Low-Income Subsidy (LIS), Veterans Affairs (VA), Department of Defense (DoD), TRICARE, or any State Pharmaceutical Assistance Program (SPAP). However, if you have LIS and your plan denies coverage after prior authorization (PA) and appeal, you may still qualify.[2] If you live in **Alaska or Hawaii** or have a household larger than 5 members, call 1-800-583-6964 for specific guidelines, as standard tables may not apply.[2] ## About OPZELURA OPZELURA is a **topical JAK inhibitor cream** applied directly to affected skin areas. For eczema, apply twice daily to reduce itch and inflammation. For vitiligo, it helps repigment skin over time. It's for patients 12+ years old. Always follow your doctor's instructions, as it's not for oral use or other conditions. Common side effects include acne, itching, or redness at the application site—discuss risks with your healthcare provider (HCP).[2][4] This program ensures access without cost barriers for those who qualify.[1] ## Income Eligibility Breakdown Eligibility is based on **household size** and **adjusted gross income** ≤**400% FPL**. 'Adjusted' means after allowable deductions like medical expenses. Income levels update annually; the table below uses **2025 FPL guidelines** (call for 2026 updates).[2] | Household Size | Max Annual Income (400% FPL) | |----------------|------------------------------| | 1 | $60,240 | | 2 | $81,760 | | 3 | $103,280 | | 4 | $124,800 | | 5 | $146,320 | *For larger households, Alaska/Hawaii, or questions, contact IncyteCARES at (800) 583-6964.[2] Provide proof like tax returns to verify.[1]* ## Insurance Requirements - **Uninsured:** No prescription coverage needed—fully eligible if income qualifies.[2][1] - **Medicare Part D:** Must show inability to pay copays. Your doctor submits PA; if denied, appeal first. Not for those on excluded government programs.[2] - **Other insurance:** Program targets uninsured/underinsured; commercial plans may have separate savings cards.[4] 'Uninsured' means no prescription insurance; check with your plan or doctor if unsure.[2] ## Step-by-Step Application Process 1. **Talk to your doctor:** They must write a valid OPZELURA prescription and complete the **Patient Assistance Program Enrollment Form**.[2][1] 2. **Sign and provide income proof:** You sign the form. Choose **electronic verification** (sign that section) or submit recent: Form 1040, W-2, or Social Security letter.[2] 3. **Submit:** Doctor faxes everything to **1-877-801-3840**. Or mail income docs to IncyteCARES for OPZELURA PAP, 6000 Park Lane, Pittsburgh, PA 15275.[2][1] 4. **Call for help:** (800) 583-6964, Mon-Fri 8am-8pm ET.[1][2] **Required Documents:**[1] - Valid OPZELURA prescription - Completed Enrollment Form (signed by you and HCP) - Proof of household income ## Timeline and Delivery Processing time varies; expect approval notification soon after submission—call for status.[1] If approved, **OPZELURA ships free** from the program's designated pharmacy **directly to you**.[2] - **Uninsured:** Coverage up to **12 months**; reapply after.[2] - **Medicare Part D:** Coverage for the **calendar year**; re-enroll annually.[2] **Reauthorization:** Yes, required—reauth required at end of period.[2] ## Alternatives if Denied - **Appeal denial:** Review reason; resubmit if possible.[2] - **Commercial Bridge Program:** Limited OPZELURA for PA denials while appealing.[7] - **Copay Savings Card:** For commercial insurance—ask your doctor.[4] - **Other support:** OPZELURA On Trac™ for treatment tracking, navigators.[4][6] - **State programs/NeedyMeds:** Search needymeds.org or rxassist.org for options.[5][9] - **Contact IncyteCARES:** Discuss other Incyte programs.[8] No biosimilar alternatives available.[program details] ## Disclaimer This guide is for informational purposes based on available program details as of latest updates. Eligibility, terms, and FPL change; always verify with IncyteCARES at (800) 583-6964 or official site. Not medical/financial advice—consult your HCP and advisor. Program can change anytime; void where prohibited.[2][1] (Word count: 1028)

Program information last verified: March 25, 2026