Piqray

Novartis Patient Assistance Foundation (NPAF) Patient Guide: How to Get Piqray (Alpelisib) at Low or No Cost

About This Program

The Novartis Patient Assistance Foundation (NPAF) is a program designed to help uninsured and underinsured patients access Piqray (alpelisib) at no cost or reduced cost. Piqray is a prescription medication used to treat certain types of breast cancer. If you're struggling to afford this medication, NPAF may be able to help you get the treatment you need.

Who Qualifies for NPAF?

To be eligible for the Novartis Patient Assistance Foundation program, you must meet all of the following requirements[3][6]:

• Reside in the United States or a U.S. Territory
• Have limited or no prescription insurance coverage — This includes being uninsured or having government insurance (such as Medicare or Medicaid) without alternate funding programs
• Meet income guidelines — Your household income must not exceed 400% of the Federal Poverty Level (FPL), adjusted for your household size[6]
• Have a valid prescription — Your doctor must prescribe Piqray for you
• Receive outpatient treatment — You must be treated by a licensed U.S. healthcare provider on an outpatient basis

Income Eligibility Breakdown

NPAF uses a sliding scale based on the Federal Poverty Level and your household size. The program accepts patients with household incomes up to 400% of the FPL. To determine if you qualify, you'll need to know your household size (as reported on your tax return) and your total household income.

Note: These figures are approximate and based on 2024 Federal Poverty Level guidelines. Income limits may vary by year. Contact NPAF for current thresholds.

Insurance Requirements

NPAF is designed for patients who are uninsured or have government insurance without alternate funding programs[6]. If you have private insurance, you may not qualify for NPAF. However, if your insurance denies coverage or requires a Prior Authorization that is denied, you may still be eligible. If you have insurance, you must submit proof of your insurance status and any denial letters[2].

Step-by-Step Application Process

Step 1: Check Your Eligibility

Visit www.PAP.Novartis.com or call NPAF at 1-800-277-2254 to review detailed eligibility requirements for Piqray and confirm you may qualify[6].

Step 2: Gather Required Documentation

Before starting your application, collect the following documents[2][6]:

• Proof of Income: Copies of the first two pages of your most recent federal income tax return (Form 1040). If you are not required to file taxes, contact NPAF directly for alternative documentation options[2]
• Insurance Information: Copies of the front and back of all insurance cards (primary, secondary, and prescription insurance)[2]
• Valid Prescription: Your doctor must provide a valid prescription for Piqray
• Prior Authorization Documentation (if applicable): If your insurance requires or has denied a Prior Authorization, include copies of the PA and/or appeal outcome[2]

Step 3: Complete the Application

You and your healthcare provider must each complete your sections of the NPAF application form[1]. The application includes:

• Patient Section: Your personal information, household size, income details, insurance information, and authorization for NPAF to access your health information
• Healthcare Provider Section: Your doctor's information, prescription details, and medical authorization

Ensure all fields are completed accurately. Incomplete applications will result in processing delays or denial[3].

Step 4: Submit Your Application

Submit your completed application and all supporting documents via:

• Fax: 1-855-817-2711
• Mail: NPAF, PO Box 2529, Columbus, OH 43216[6]

You can also call NPAF at 1-800-277-2254 for assistance with the application process[4].

Timeline and Medication Delivery

Application Decision Timeline: You will receive a decision letter within approximately 4 weeks of submitting your complete application[1][6].

Medication Delivery: If approved, your Piqray will be shipped directly to you or your physician's office, depending on what you arrange with NPAF[6].

Text Message Updates (Optional): If you opt in, you may receive text message updates about your application status[1].

What Happens If Your Application Is Denied?

If your application is denied, you will receive a letter explaining the reason. Common reasons for denial include[1]:

• Incomplete application or missing documentation
• Income exceeding program limits
• Having private insurance with adequate coverage
• Not meeting other eligibility criteria

If your application is denied, contact NPAF at 1-800-277-2254 to discuss your options. You may be able to reapply if your circumstances change.

Reauthorization and Refills

NPAF requires reauthorization to continue receiving assistance[6]. This means you will need to reapply periodically to maintain your benefits. NPAF will notify you when reauthorization is required. Be prepared to submit updated income documentation and insurance information.

Important Reminders

• Only you, your legal guardian, or your caregiver may enroll you in the program. Health plans, specialty pharmacies, and pharmacy benefit managers cannot enroll you[1]
• NPAF reserves the right to verify the accuracy of all information you submit[1]
• Your signature is required to participate in the program and allow NPAF to process your application[3]
• Keep copies of all documents you submit for your records

Contact Information

Novartis Patient Assistance Foundation

• Phone: 1-800-277-2254 (Monday-Friday, 9:00 AM-6:00 PM EST)
• Fax: 1-855-817-2711
• Mailing Address: NPAF, PO Box 2529, Columbus, OH 43216
• Website: www.PAP.Novartis.com

Disclaimer

This guide provides general information about the Novartis Patient Assistance Foundation program. Program eligibility, requirements, and benefits may change at any time. For the most current and accurate information, visit www.PAP.Novartis.com or contact NPAF directly. This guide is not a guarantee of program enrollment or medication assistance. Always consult with your healthcare provider about your treatment options and financial assistance programs.