OTULFI

Indicated For

plaque psoriasis, psoriatic arthritis, Crohn’s Disease, ulcerative colitis

About This Medication

# KabiCare Patient Support Program Patient Guide: How to Get OTULFI (ustekinumab-aauz) at Low or No Cost The **KabiCare Patient Support Program** from **Fresenius Kabi** helps eligible patients access **OTULFI (ustekinumab-aauz)**, an FDA-approved biosimilar to Stelara (ustekinumab), through copay assistance and patient assistance options to reduce or eliminate out-of-pocket costs.[1][2][9] ## About OTULFI (ustekinumab-aauz) **OTULFI** is a biologic medication approved by the FDA in 2025 as a biosimilar to Stelara. It works by targeting specific proteins in the immune system to reduce inflammation. It's indicated for treating: - Moderate to severe **plaque psoriasis** in adults and children 6 years and older - Active **psoriatic arthritis** in adults and children 6 years and older - **Crohn’s disease** in adults - **Ulcerative colitis** in adults[2] OTULFI is typically administered via injection, either subcutaneous (under the skin) or intravenous (into a vein) depending on the condition and dose. It's often covered under pharmacy or medical benefits. Always follow your doctor's instructions and review the full prescribing information for safety details, including potential side effects like infections or allergic reactions.[2] ## Who Qualifies for KabiCare? KabiCare offers two main types of support: **copay assistance** for commercially insured patients and **patient assistance** for uninsured or underinsured individuals. Eligibility focuses on financial need, insurance status, and residency.[1][9] - **Copay Assistance**: For patients with private commercial insurance (not government programs). Covers copays, coinsurance, or deductibles up to program maximums (per syringe/annual limits apply).[9] - **Patient Assistance Program (PAP)**: For uninsured or underinsured patients who meet income guidelines. Free or low-cost medication may be provided.[1] **Income Eligibility**: Specific thresholds (e.g., Federal Poverty Level percentages) are not publicly listed. Contact KabiCare at (833) 522-4227 for personalized eligibility details, as they assess on a case-by-case basis.[1] Here's a general breakdown based on typical programs (confirm with KabiCare): | Household Size | Estimated Max Annual Income | Notes | |---------------|-----------------------------|-------| | Individual | Contact program | Based on FPL; exact % not specified | | Couple | Contact program | Case-by-case review | | Family of 3 | Contact program | Uninsured/underinsured prioritized | | Family of 4+ | Contact program | Additional details via phone[1] | You must reside in the US or Puerto Rico, have a valid prescription for an FDA-approved use, and not seek reimbursement from government programs.[9] ## Insurance Requirements - **Eligible**: Commercial/private insurance (pharmacy or medical benefit). Program covers patient responsibility after insurance pays.[1][9] - **Not Eligible**: Medicare, Medicaid, VA, Tricare, or other federal/state programs. Government-insured patients cannot use copay assistance.[1][9] - **Uninsured/Underinsured**: May qualify for PAP; provide proof of income and lack of coverage.[1] Your pharmacy handles claims for pharmacy benefits using specific BIN/PCN details. For medical benefits, submit claims with EOB.[1] ## Step-by-Step Application Process KabiCare offers **multiple application methods** for flexibility. Work with your doctor or healthcare provider.[1] 1. **Discuss with Your Doctor**: Confirm OTULFI is right for you. Have them initiate enrollment. 2. **Choose Enrollment Method**: - **Online**: HCP portal at kabicare.us (create account).[1] - **Form**: Download PDF enrollment form and fax.[1] - **Phone**: Call (833) 522-4227.[1][5] 3. **Full Enrollment**: Includes copay program automatically if eligible.[1] 4. **For Copay Claims**: - **Pharmacy Benefit**: Pharmacy submits secondary claim (Member ID, Group 77770232, RxBin 610852, RxPCN 2001). Real-time approval.[1] - **Medical Benefit**: Fax/mail completed UB-40/CMS-1500 form + Primary EOB (itemized with NDCs and costs) to 844-877-1052 or KabiCare Copay Program, 2250 Perimeter Park Dr., Suite 300, Morrisville, NC 27560. Reimbursement in 7-10 days.[1] 5. **Required Documents**: - Completed claim form (UB-40 or CMS-1500) - Primary Explanation of Benefits (EOB)[1] 6. **Submit and Track**: Receive confirmation. Program handles refill reminders and support.[4] ## Timeline and Delivery - **Processing**: 7-10 business days for claims/reimbursement.[1] - **Pharmacy Claims**: Real-time at pharmacy. - **Delivery**: Medication via your pharmacy or provider; direct-to-patient for some reimbursements (paper check in 7-14 days, 180-day lookback).[5] - **Refills**: Program provides reminders; re-enroll or resubmit as needed (reauthorization details via program).[4] ## Alternatives if Denied or Ineligible - **Biosimilar Alternative**: Stelara (ustekinumab), the reference product. Ask about its assistance programs.[2] - **Other Options**: - PAN Foundation or similar nonprofits for immune conditions. - State programs or generic alternatives if applicable. - Appeal denial by calling KabiCare or providing updated documents. - Shop 340B pharmacies or discount cards like GoodRx.[1] If denied, contact (833) 522-4227 for reasons and next steps. ## Additional Support KabiCare offers injection training, disease education, insurance navigation, and clinical support. Visit kabicare.us or call for resources.[3][4][10] ## Disclaimer This guide is for informational purposes only and based on publicly available program details as of 2025. Eligibility, benefits, and terms can change. It does not guarantee approval. Consult your healthcare provider, pharmacist, or KabiCare directly at (833) 522-4227 or https://www.kabicare.us/hcp/program/otulfi-ustekinumab-aauz/how-to-enroll/ for the latest information. Not a substitute for medical advice. Program not for government-insured patients.[1][9]

Program information last verified: March 30, 2026