ORGOVYX

Indicated For

advanced prostate cancer

About This Medication

# Sumitomo Pharma America Patient Assistance Program Patient Guide: How to Get ORGOVYX at Low or No Cost ORGOVYX (relugolix) is an oral prescription medication approved by the FDA for treating **advanced prostate cancer** in adult men. The **Sumitomo Pharma America Patient Assistance Program** (PAP) offers this medication **at no cost** to eligible patients facing financial hardship, helping ensure access despite high costs or limited insurance coverage.[1][2][4][5] ## About ORGOVYX ORGOVYX is the first and only **oral gonadotropin-releasing hormone (GnRH) receptor antagonist** for advanced prostate cancer. It works by blocking the GnRH receptor, which lowers testosterone production—a key driver of prostate cancer growth. Taken as daily tablets, it provides a convenient alternative to injections. It's prescribed for adults and is not approved for women or children.[2][9] **Common side effects** include hot flushes (54%), musculoskeletal pain (30%), fatigue (26%), constipation (12%), and diarrhea (12%). Androgen deprivation therapy like ORGOVYX may prolong the QT interval, so discuss heart risks with your doctor. Always review full prescribing information with your healthcare provider.[9] ## Who Qualifies for the Program? This program targets patients with **unmet financial need**. Key requirements include: - A valid prescription for ORGOVYX for an **FDA-approved indication** (advanced prostate cancer). - Residence in the US or US territories. - **Uninsured, underinsured, or government-insured** (Medicare, Medicaid) with inadequate coverage for ORGOVYX. - Inability to afford the medication, with **no other financial support** available (e.g., not eligible for Medicare Extra Help or state Medicaid).[1][4][5][10] The program does **not have fixed income thresholds** like Federal Poverty Level (FPL) percentages. Instead, eligibility is based on a **case-by-case assessment of financial need**, with **annual reevaluation** required. Patients must demonstrate they cannot pay for the drug after exhausting other options.[1][4][5] | Household Size | Income Threshold | Notes | |---------------|------------------|-------| | Individual | Case-by-case | Assessed for unmet need; no specific FPL limit. | | Couple | Case-by-case | Annual reevaluation required. | | Family of 3 | Case-by-case | Must show inability to afford despite insurance. | | Family of 4+ | Case-by-case | Government insured may qualify for full-year coverage. |[1][4][5][10] ## Insurance Requirements The PAP is designed for those whose insurance doesn't fully cover ORGOVYX: - **Uninsured**: Fully eligible if financially needy. - **Underinsured**: Qualify if coverage is inadequate (e.g., high copays/deductibles). - **Medicare/Medicaid/Government insured**: Eligible if they meet financial criteria; program notifies plans and provides free drug for the coverage year.[1][4][5][8][10] Note: Separate **Copay Assistance Program** exists for **commercially insured** patients (as low as $10/month, up to $10,000/year max), but it's **not for government insurance**. The PAP fills the gap for others.[3][6] ## Step-by-Step Application Process 1. **Discuss with your doctor**: Confirm ORGOVYX is right for you and ask them to complete the enrollment form. 2. **Download the form**: Get the **ORGOVYX Support Program enrollment form** from your doctor's office, the HCP site, or by calling (833) 674-6899.[3][5] 3. **Complete the form**: Patient and prescriber fill it out together, attesting to eligibility and FDA-approved use. Include proof of financial need if requested.[1][5] 4. **Fax the form**: Send to the designated fax (1-844-826-8875 per some resources; confirm via phone).[3][5] 5. **Call for support**: Dial **(833) 674-6899** (Mon-Fri, 8 AM-8 PM ET) for help enrolling, benefits investigation, or prior authorizations. The Support Program contacts you post-submission.[2][5] 6. **Await approval**: Program reviews for eligibility. E-prescriptions to Mercalis Pharmacy can streamline.[3][5] **Required documents**: - ORGOVYX Support Program enrollment form (completed by patient and prescriber). - Additional proof of income/need may be requested (e.g., tax returns, pay stubs).[1][5] ## Timeline and Delivery Processing time varies but expect contact soon after faxing. Approved patients get **free ORGOVYX shipped directly to their home**. Government-insured get coverage-year supply; others up to **12 months**, pending reevaluation. **Reauthorization** is required annually or as needed.[1][5][10] The ORGOVYX Support Program triages prescriptions to your pharmacy and confirms shipments.[5] ## If Denied or Alternatives If denied, appeal via the Support Program—they assist with prior authorizations or claims. Explore: - **Copay program** if commercially insured.[3] - **State programs**, Medicare Extra Help, or other PAPs. - **No biosimilars** available for ORGOVYX. Contact (833) 674-6899 for personalized guidance.[2][5] ## Important Disclaimer This guide is for informational purposes only and based on publicly available program details as of latest knowledge. Eligibility, terms, and availability can change—**always verify directly with Sumitomo Pharma America at (833) 674-6899 or applyorgovyxpap.com**. Not medical advice; consult your doctor. Program not valid where prohibited by law. Sumitomo reserves rights to modify/amend.[1][5][10] (Word count: 942)

Program information last verified: March 29, 2026