Qalsody

Indicated For

Amyotrophic Lateral Sclerosis (ALS), SOD1-ALS

About This Medication

# Biogen Support Services Patient Guide: How to Get QALSODY (tofersen) at Low or No Cost ## About QALSODY (tofersen) QALSODY is a prescription medicine used to treat adults with amyotrophic lateral sclerosis (ALS) who have a mutation in the superoxide dismutase 1 (SOD1) gene. It is the first and only FDA-approved treatment to target a genetic cause of ALS. The medication is administered as an injection and requires loading doses followed by ongoing maintenance treatment. ## Who Qualifies for Biogen Support Services Biogen Support Services is available to US residents who have been prescribed QALSODY by their healthcare provider. The program is designed to help patients, regardless of their insurance status, access their medication and navigate treatment barriers. You may be eligible for financial assistance if you are: - **Commercially insured** and meet income requirements for the Biogen Copay Program - **Government insured** (Medicare, Medicaid) and eligible for alternative assistance programs - **Uninsured or underinsured** and need help accessing medication ## Income Eligibility Biogen Support Services does not publicly disclose specific income thresholds for QALSODY assistance. However, the program evaluates eligibility on a case-by-case basis. To determine your specific eligibility, you should contact Biogen Support Services directly at **1-877-725-7639** (Monday–Friday, 8:30 AM to 8:00 PM ET) with information about your household income and insurance status. ## Insurance Requirements Biogen works with patients across all insurance types: | Insurance Type | What Biogen Can Help With | |---|---| | Commercial Insurance | Copay assistance through the Biogen Copay Program (potentially $0/month); prior authorization support; benefits investigation | | Medicare/Medicaid | Eligibility review for alternative government programs; navigation of coverage options | | Uninsured/Underinsured | Research of charitable assistance; connection to other financial resources; free medication for eligible patients | **Important Note:** Patients covered by Medicare, Medicaid, the VA/DoD, or other federal plans are generally not eligible for the Biogen Copay Program but may qualify for other assistance options. ## How to Apply: Step-by-Step Process ### Step 1: Work with Your Healthcare Provider Your doctor will need to complete the QALSODY Start Form, which includes: - Your medical information and diagnosis confirmation - Prescription details for QALSODY treatment - Authorization for Biogen to communicate with your insurance company - Your consent to enroll in Biogen Support Services ### Step 2: Gather Required Documents You and your healthcare provider will need to provide: - Copies of both sides of your insurance card - Copies of your pharmacy benefit card (if available) - Completed Start Form with all required sections filled out - Prescriber authorization and signature ### Step 3: Submit Your Application Your healthcare provider will submit the completed Start Form to Biogen by: - Fax to the designated Biogen number, or - Email to StartForm@biogen.com Alternatively, if your provider uses direct buy procurement, they will submit the form to enroll you in Biogen Support Services while handling medication procurement through their usual process. ### Step 4: Connect with Your Lead Case Manager Once Biogen receives your Start Form, you will be assigned a **Lead Case Manager (LCM)** who will: - Contact you to confirm enrollment - Help navigate the treatment initiation process - Investigate your insurance benefits and coverage options - Explain your medication costs and copay assistance eligibility - Guide you through prior authorization if needed - Support you throughout your treatment journey ## Timeline and Medication Delivery The exact processing timeline is not publicly specified by Biogen. However, the process typically moves quickly once your Start Form is submitted. Your Lead Case Manager will contact you promptly after enrollment to begin the benefits investigation and treatment initiation. Medication delivery depends on your procurement method: - **Specialty Pharmacy:** Biogen coordinates with a specialty pharmacy to fill and deliver your prescription - **Direct Buy:** Your healthcare provider handles procurement through their usual process QALSODY treatment begins with **3 loading doses administered at 14-day intervals**, followed by **maintenance doses every 28 days thereafter**. ## What Biogen Support Services Provides Beyond financial assistance, Biogen Support Services offers: - Product education about QALSODY and how it works - Insurance benefits investigations to understand your coverage - Prior authorization support and appeal assistance - Guidance on navigating the healthcare system - Connection to additional resources and support - Dedicated case management throughout your treatment ## If Your Application Is Denied If you are denied financial assistance or insurance coverage, your Lead Case Manager can: - Help you understand the reason for denial - Provide a sample appeal letter to submit to your insurance company - Explore alternative financial assistance options - Research charitable organizations that may help cover costs - Discuss other potential solutions to remove barriers to treatment ## Reauthorization and Ongoing Support Once enrolled in Biogen Support Services, your Lead Case Manager will continue to support you as long as you are taking QALSODY. They will help manage any changes to your insurance, assist with prescription refills, and address any new barriers to access that arise during your treatment. ## Important Disclaimers - Biogen Support Services is intended for US residents only - Eligibility for financial assistance programs is subject to federal and state laws - Income limits, copay caps, and program terms may change - This guide provides general information and is not a substitute for professional medical or financial advice - Contact Biogen Support Services directly for personalized eligibility determination ## Contact Information **Biogen Support Services** - **Phone:** 1-877-725-7639 - **Hours:** Monday–Friday, 8:30 AM to 8:00 PM ET - **Email:** StartForm@biogen.com (for application submission) Your healthcare provider can also help you get started by completing the QALSODY Start Form and submitting it to Biogen.

Program information last verified: March 25, 2026