Piqray

Indicated For

breast cancer

About This Medication

# Novartis Patient Assistance Foundation (NPAF) Patient Guide: How to Get Piqray (alpelisib) at Low or No Cost Piqray (alpelisib) is a targeted therapy used in combination with fulvestrant to treat adults with **HR-positive, HER2-negative advanced or metastatic breast cancer** that has a **PIK3CA mutation** (detected by an FDA-approved test) and is progressing after endocrine-based therapy.[2][6] This guide explains how the **Novartis Patient Assistance Foundation (NPAF)** and related programs like the **Novartis Oncology Universal Co-pay Program** can help you access Piqray at low or no cost if you're uninsured, underinsured, or facing high out-of-pocket expenses.[1][3][4] ## About Piqray and Why Access Matters **Piqray** works by inhibiting the PI3K enzyme to slow cancer cell growth in specific breast cancers. It's taken as tablets, usually 300 mg once daily with fulvestrant injections. Common side effects include **high blood sugar (hyperglycemia)**, **diarrhea**, **rash**, **nausea**, and **lung issues (pneumonitis)**—your doctor will monitor these closely and may adjust doses.[5][6] Treatment costs can exceed $15,000 per month without help, making patient assistance crucial for staying on therapy.[3][7] Novartis offers two main programs: - **NPAF**: Free medication for eligible uninsured/underinsured patients.[1][4] - **Universal Co-pay Program**: Reduces copays to $0 for eligible commercially insured patients (up to $15,000/year per product).[3][4][7] ## Who Qualifies for NPAF? To qualify for **free Piqray** through NPAF, you must:[1][4][9] - Live in the **US or a US Territory**. - Be treated by a **licensed US healthcare provider (HCP)** on an **outpatient basis**. - Have **limited or no prescription insurance** and meet **income guidelines** (specific thresholds vary; Alaska/Hawaii have higher limits—check via the eligibility tool).[1] - Not be enrolled by health plans, pharmacies, or their agents—only patients, guardians, or caregivers can apply.[1] NPAF is for those who **cannot afford** their medication. Government insurance patients may need proof of Extra Help denial.[1] ## Income Eligibility Breakdown Exact income thresholds aren't publicly listed and depend on **Federal Poverty Level (FPL)** guidelines, household size, and location (higher in AK/HI). Use the online eligibility checker for precise figures.[1][9] Here's a general example based on typical programs (always verify): | Household Size | Annual Income Limit (Contiguous US, ~400-500% FPL) | Alaska/Hawaii Adjustment | |----------------|-----------------------------------------------------|--------------------------| | 1 (Individual) | Up to ~$60,000-$75,000 | Higher by ~25-40% | | 2 (Couple) | Up to ~$80,000-$100,000 | Higher by ~25-40% | | 3 | Up to ~$100,000-$125,000 | Higher by ~25-40% | | 4 | Up to ~$120,000-$150,000 | Higher by ~25-40% | *Notes: These are estimates; actual limits require eligibility check. Income includes all household sources. Programs may change.[1][9]* ## Insurance Requirements - **NPAF**: Best for **uninsured** or **underinsured** with limited/no coverage. Medicare/Medicaid patients may qualify if they prove inability to pay and Extra Help denial.[1][4][7] - **Universal Co-pay Program**: For **commercial/private insurance** (not government insurance). Pays copays down to **$0/month**, up to **$15,000/year**.[3][4][7] - If you have insurance but high copays, start with the co-pay program. Switch to NPAF if uninsured.[8] ## Step-by-Step Application Process 1. **Check Eligibility**: Visit **pap.novartis.com** or call **1-800-282-7630** (Mon-Fri, 8 AM-8 PM ET). Use the online tool for income/insurance pre-screen.[1][4] 2. **Gather Documents**: Prepare proof of income (tax returns, pay stubs, W-2s), residency, HCP prescription, and insurance denial if applicable (e.g., Extra Help letter).[1] 3. **Complete Application**: You and your **HCP** fill out sections together. Download from pap.novartis.com or request via phone.[1] 4. **Submit**: Mail, fax, or upload as instructed. Opt-in for texts for updates.[1] 5. **Follow Up**: If incomplete, you'll get a letter/text with next steps.[1] For co-pay: Enroll at **Copay.NovartisOncology.com** or call **1-877-577-7756**—immediate savings possible.[3][4] ## Timeline and Delivery - **Processing**: Up to **4 weeks** for NPAF decision letter.[1] - **Delivery**: Free medication shipped directly to your **doctor's office** or **home** (program decides). Refills handled automatically if eligible.[1][4] - Co-pay cards activate quickly for pharmacy use.[7] ## Alternatives if Denied or Ineligible - **Appeal**: Contact Novartis support for review—provide additional docs.[1] - **Other Assistance**: Check PAN Foundation, RxAssist.org, or NeedyMeds for breast cancer funds.[9] - **Generic/Biosimilars**: None available for Piqray.[ ] - **Manufacturer Contact**: Call **1-877-577-7756** (Oncology) for bridging help or free trial if starting therapy.[2] - **State Programs**: Explore Medicaid extra help or charity care. ## Important Disclaimer This guide is for informational purposes only and based on publicly available data as of 2026. **Eligibility, terms, and availability can change**—Novartis reserves the right to modify/discontinue programs.[1] Always verify with **pap.novartis.com**, your HCP, or **1-800-282-7630**. Not a substitute for medical/financial advice. Piqray has serious risks (e.g., severe hyperglycemia—monitor blood sugar).[5][6] Discuss with your doctor.

Program information last verified: March 25, 2026