PEMGARDA

Indicated For

COVID-19 prevention in immunocompromised

About This Medication

# Invivyd Care Patient Guide: How to Get PEMGARDA (pemivibart) at Low or No Cost PEMGARDA (pemivibart) is an investigational monoclonal antibody authorized by the FDA under Emergency Use Authorization (EUA) for pre-exposure prophylaxis to help prevent COVID-19 in certain adults and adolescents aged 12 years and older weighing at least 40 kg who are unlikely to mount an adequate immune response to vaccination.[3][8] **Invivyd Care**, from manufacturer **Invivyd**, offers personalized support including financial assistance, insurance navigation, and treatment coordination to help eligible patients access PEMGARDA at low or no cost.[1][2][4][6] ## About PEMGARDA PEMGARDA works as a SARS-CoV-2 spike protein-directed attachment inhibitor, administered as a single intravenous (IV) infusion of 4500 mg, with repeat doses every 3 months as needed.[3] It is **not FDA-approved** and authorized only during the COVID-19 public health emergency.[3][4] Prescriptions must come from licensed physicians, advanced practice registered nurses, or physician assistants.[3] It's intended for individuals at increased risk, such as those who are moderately or severely immunocompromised.[3][8] Common side effects may include infusion-related reactions, but consult your healthcare provider for full risks and benefits.[8] Doses are given in a medical setting like a doctor's office, infusion clinic, or hospital.[5] ## Who Qualifies for Invivyd Care? Invivyd Care supports patients with a valid PEMGARDA prescription for pre-exposure COVID-19 prophylaxis.[1][2] Key eligibility: - Age 12 years or older and weighing at least 40 kg.[2][3] - U.S. residents, including Puerto Rico and U.S. territories.[2] - **Commercial insurance** covering some portion of PEMGARDA cost for savings card/copay support; cash-paying patients are ineligible.[2] The program provides broader support like benefits investigation and prior authorization help across insurance types, but copay assistance is commercial-insurance specific.[4][6] No specific income thresholds are listed; eligibility focuses on insurance and prescription status.[2] ## Income Eligibility Breakdown Invivyd Care does not publish federal poverty level (FPL) or strict income thresholds. Instead, financial assistance via the **Patient Savings Program** targets **commercially insured patients** with out-of-pocket cost support.[2][5] No income eligibility table is available, as qualification hinges on commercial coverage rather than income.[1][2] Contact Invivyd Care for personalized review.[4] | Eligibility Factor | Details | Notes | |--------------------|---------|-------| | **Insurance Type** | Commercial insurance covering PEMGARDA | Required for copay savings card[2] | | **Income** | Not specified | No FPL limits mentioned[1][2] | | **Residency** | U.S., Puerto Rico, territories | Program restriction[2] | | **Age/Weight** | 12+ years, ≥40 kg | EUA criteria[3] | | **Cash Pay** | Ineligible | Must have insurance coverage[2] | ## Insurance Requirements **Commercial insurance** is key for copay assistance; patients must have coverage for some PEMGARDA cost.[2] Providers bill through medical benefits (not pharmacy) since it's an IV infusion.[5] Medicare Part B claims for pre-exposure prophylaxis often don't need prior authorization.[4] Private, Managed Medicare, or Medicaid may require prior authorization or medical necessity forms.[4] Invivyd Care helps verify benefits, navigate PA, and handle appeals.[6] Government program reimbursement (e.g., federal/state) prohibits savings card use.[2] ## Step-by-Step Application Process 1. **Get Prescribed**: Discuss with your doctor if PEMGARDA fits your COVID-19 prevention needs. They must write a prescription.[3][4] 2. **Contact Invivyd Care**: Call **844-VYD-2220 (844-893-2220)** Monday-Friday, 8 a.m.–8 p.m. ET, or visit **invivydcare.com**.[4][6] Provide your prescription details. 3. **Benefits Investigation**: Program verifies your insurance coverage and estimates out-of-pocket costs.[6] 4. **Prior Authorization (if needed)**: Invivyd Care assists your provider with PA forms or appeals.[4][6] 5. **Access Savings**: For eligible commercial patients, get a **Savings Card** to reduce copay.[2] Pharmacy/provider applies it at infusion.[2] 6. **Schedule Infusion**: Program helps find sites via Infusion Center Locator and coordinates treatment.[6] 7. **Submit Documents**: Typically prescription and insurance info; no extensive list required upfront.[2][6] Applications are provider-initiated post-prescribing decision.[6] ## Timeline and Delivery Processing varies by insurance; benefits verification is quick, but PA may take days to weeks.[6] Once approved, infusions are scheduled promptly at chosen sites.[6] Initial dose: 4500 mg IV; repeats every 3 months.[3] Delivery is direct to infusion centers; patients don't handle medication.[5] Next-dose reminders provided.[6] Expect support from enrollment to treatment.[1] ## Alternatives if Denied If ineligible (e.g., no commercial insurance), explore general assistance via Medicine Assistance Tool or NeedyMeds.[5] Discuss other COVID-19 prophylactics or vaccines with your doctor. Appeal denials with Invivyd Care's advocacy.[6] Program terms can change; Invivyd may amend anytime.[2] ## Disclaimer This guide is for informational purposes based on available program details as of latest sources. **Invivyd Care eligibility, terms, and availability may change**; always verify directly at invivydcare.com or 844-893-2220.[1][2][4] PEMGARDA is EUA-only, not FDA-approved; risks/benefits per FDA Fact Sheet.[3][8] Not medical advice—consult your healthcare provider. Invivyd reserves rights to program changes without notice.[2] Word count: 962.

Program information last verified: March 30, 2026