Reclast

Novartis Patient Assistance Foundation Patient Guide: How to Get Reclast at Low or No Cost

About This Program

The Novartis Patient Assistance Foundation (NPAF) helps eligible patients access Reclast (zoledronic acid) at reduced or no cost when they cannot afford their medication. Reclast is an intravenous bisphosphonate used to treat osteoporosis and other bone conditions. If you have limited financial resources and meet the program's eligibility requirements, NPAF may be able to help you receive this medication.

Who Qualifies for NPAF

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

• U.S. Residency: You must be a resident of the United States or a U.S. territory
• Valid Prescription: You must have a current prescription for Reclast from a licensed U.S. healthcare provider for outpatient treatment
• Insurance Status: You must have no prescription drug insurance coverage, or your insurance does not cover Reclast, or you cannot afford the out-of-pocket costs even with insurance
• Income Eligibility: Your household income must meet NPAF's guidelines, which are based on the Federal Poverty Level and vary by household size, your state, and the specific medication
• Healthcare Provider: You must be treated on an outpatient basis by a licensed U.S. healthcare provider

Income Eligibility Guidelines

NPAF uses a sliding scale income threshold based on the Federal Poverty Level. Income limits vary depending on your household size and state of residence (Alaska and Hawaii have different thresholds). The program also considers financial hardship on a case-by-case basis.

Note: To determine your exact income eligibility, visit the NPAF website or call the program directly at (800) 833-0166. Income thresholds are reviewed and may change annually.

Insurance Requirements

NPAF is designed for patients without prescription drug coverage or those who cannot afford their medications despite having insurance. Specifically:

• If you have no prescription insurance, you may qualify
• If you have prescription insurance but it does not cover Reclast, you may qualify
• If you have insurance that covers Reclast but you cannot afford your out-of-pocket costs (copayments, coinsurance, or deductibles), you may qualify
• If you are denied Extra Help (a Medicare program that helps with prescription drug costs), you may still be eligible for NPAF

You will need to provide copies of your insurance cards (front and back) as part of your application.

How to Apply: Step-by-Step

Step 1: Check Your Eligibility

Before applying, verify that you meet the basic eligibility requirements. You can do this by calling NPAF at (800) 833-0166 or visiting their website to review income guidelines for your household size and state.

Step 2: Gather Required Documentation

Collect the following documents before starting your application:

• Proof of Income: A copy 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. Acceptable alternatives may include:
  • IRS Form 1040EZ
  • Social Security Statement (Form 1099)
  • Recent paycheck stubs
  • W-2 forms
• Insurance Information: Copies of the front and back of all insurance cards (primary, secondary, and prescription insurance)
• Prior Authorization Documentation: If your insurance requires prior authorization for Reclast and it was denied, include a copy of the denial letter or appeal outcome
• Prescription: Your healthcare provider will provide this as part of their application section

Step 3: Complete the Patient Application

Fill out the patient section of the NPAF application form completely and accurately. Include:

• Your personal information (name, date of birth, contact information)
• Your household size (as reported on your tax return)
• Your healthcare provider's information
• Authorization for NPAF to contact your healthcare providers and insurers
• Your signature and date

Important: An incomplete application will result in processing delays or denial. Make sure every required field is completed or marked "N/A" if not applicable.

Step 4: Have Your Healthcare Provider Complete Their Section

Your prescribing physician must complete the healthcare provider section of the application, which includes:

• Confirmation of your diagnosis and medical need for Reclast
• A valid prescription for Reclast
• Their signature and authorization
• Any relevant clinical information

Discuss the NPAF program with your healthcare provider and ask them to complete their portion of the application.

Step 5: Submit Your Application

Submit your completed application and all required documentation by:

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

Make sure to include copies (not originals) of all documentation. Keep a copy for your records.

Timeline and What to Expect

Processing Time: You will receive a decision letter within approximately 4 weeks of submitting a complete application.

Incomplete Applications: If your application is missing information, you will receive a letter explaining what is needed. You may also receive a text message if you have opted in to text notifications.

Approval: If approved, NPAF will provide information about how to receive your medication. Reclast will typically be shipped to your home or your healthcare provider's office.

Annual Reauthorization: Your eligibility is reviewed every year. You will need to reapply or provide updated documentation to continue receiving assistance.

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:

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

If you believe your application was denied in error, or if your financial situation has changed, you can:

• Contact NPAF at (800) 833-0166 to discuss your denial
• Reapply if your circumstances have changed
• Ask about alternative assistance programs that may be available

Alternatives If You Are Not Eligible

If you do not qualify for NPAF, consider these options:

• Manufacturer Coupons: Check if Novartis offers discount coupons for Reclast
• Medicare Extra Help: If you are a Medicare beneficiary, you may qualify for Extra Help to reduce prescription drug costs
• State Pharmaceutical Assistance Programs: Many states offer programs to help residents afford medications
• Community Health Centers: Federally qualified health centers may offer medications at reduced costs
• Generic Alternatives: Ask your healthcare provider if there are generic bisphosphonates available at lower cost
• Patient Advocacy Organizations: Organizations focused on bone health may have resources or financial assistance information

Important Reminders

• Accuracy Matters: Provide accurate information on your application. Incomplete or inaccurate applications will be delayed or denied.
• Keep Documentation: Maintain copies of all documents you submit.
• Annual Renewal: Remember that you must reapply each year to continue receiving assistance.
• Contact NPAF: If you have questions at any point in the process, call (800) 833-0166, Monday through Friday, 8:00 a.m. to 8:00 p.m. ET.

Disclaimer

This guide provides general information about the Novartis Patient Assistance Foundation program. Program eligibility, requirements, and benefits may change. For the most current and accurate information, contact NPAF directly or visit their official website. This guide is not a guarantee of eligibility or approval. Your individual circumstances will be evaluated by NPAF staff. Always consult with your healthcare provider about your treatment options and financial assistance programs.