Retevmo

Indicated For

RET fusion-positive non-small cell lung cancer, thyroid cancer, other solid tumors

About This Medication

# Lilly Cares Foundation Patient Guide: How to Get Retevmo (selpercatinib) at Low or No Cost Retevmo (selpercatinib) is a targeted therapy medication used to treat certain types of lung and thyroid cancers driven by specific genetic changes called RET alterations. The **Lilly Cares Foundation** program, run by Eli Lilly and Company, provides this and other Lilly medicines **at no cost** to eligible uninsured or underinsured patients who meet income and residency rules. This guide explains everything you need to know to apply and get started.[1][2] ## Who Qualifies for Lilly Cares? To join the program, you must meet **all** these basic requirements: - Be a **permanent resident** of the United States, including Puerto Rico or U.S. Virgin Islands.[1][2] - Have a prescription for **Retevmo** from your healthcare provider.[1] - **Household income** at or below **400% of the Federal Poverty Level (FPL)**.[2] - **Insurance status**: Uninsured or underinsured, but **not** enrolled in Medicaid, full Low-Income Subsidy (LIS or “Extra Help” for Medicare), or Veterans (VA) Benefits. Specific rules apply by medication group—check the application for Retevmo details.[1][2] - Agree to program terms, including allowing review of your information.[2] **Important**: Even if you have some insurance, you may qualify if it's not government-funded as listed above. Underinsured means your coverage doesn't fully cover Retevmo costs.[1] ## About Retevmo (selpercatinib) **Retevmo** is an oral capsule taken twice daily to target **RET fusion-positive** cancers, such as: - Non-small cell lung cancer (NSCLC) with RET gene fusions. - Thyroid cancers like medullary thyroid cancer (MTC) or RET-mutant thyroid cancer. It's FDA-approved for adults and children (over 12 years in some cases) after genetic testing confirms a RET alteration. Common side effects include dry mouth, diarrhea, fatigue, high blood pressure, and liver issues—your doctor will monitor these. Always take as prescribed, with or without food, and report side effects promptly.[3] This program helps remove cost barriers so you can focus on treatment. Retevmo is typically expensive without assistance (thousands per month), but Lilly Cares covers it fully for qualifiers.[7] ## Income Eligibility Breakdown Eligibility is based on **total household income** before taxes, compared to **400% of the Federal Poverty Level (FPL)**. FPL adjusts yearly for household size and location (lower in Alaska/Hawaii). Specific dollar thresholds aren't listed in program sources, but here's a general guide using 2026 FPL estimates (check www.lillycares.com or call for exacts): | Household Size | 100% FPL (approx.) | 400% FPL Threshold (approx.) | |----------------|---------------------|------------------------------| | 1 person | $15,060 | **$60,240** | | 2 people | $20,440 | **$81,760** | | 3 people | $25,820 | **$103,280** | | 4 people | $31,200 | **$124,800** | *Add ~$5,380 per extra person for 100% FPL, then multiply by 4.* **Notes**: Include all household income (wages, Social Security, etc.). Provide proof like tax returns or pay stubs. Call (800) 545-6962 to confirm your numbers—program verifies everything.[1][2] ## Insurance Requirements - **Uninsured**: No private or public coverage? You're likely eligible if other rules fit.[1] - **Underinsured**: Have private insurance but high copays/deductibles for Retevmo? May qualify, but **cannot** have Medicaid, full Medicare Extra Help, or VA benefits.[1][2] - **Medicare Part D**: Allowed if not on full LIS/Extra Help; enrollment may end at calendar year-end.[1] - For some meds, include insurance verification docs.[2] **Pro tip**: If insured, try your plan's coverage first—Lilly Cares is for when that falls short. ## Step-by-Step Application Process Applying is straightforward with **multiple options** to reduce hassle:[1][4] 1. **Gather documents**: - **Proof of income** (e.g., last year's tax return, W-2s, pay stubs, SSI award letter). - **Proof of residency** (utility bill, lease, ID with address). - **Prescription** for Retevmo. - **Physician info** (your doctor's signature on app).[1][2] 2. **Choose method**: - **Online** (fastest): Go to lillycares.com, enter info, upload docs.[1][9] - **Download PDF**: Fill digitally or by hand at https://www.lillycares.com/assets/pdf/lilly_cares_application.pdf.[2] - **Phone help**: Call (800) 545-6962.[8] 3. **Complete form**: You fill patient sections; doctor completes prescriber section and prescription.[1] 4. **Submit**: - Online: Instant. - Mail: Lilly Cares, PO Box 501847, San Diego, CA 92150. - Fax: 1-844-431-6650.[1] 5. **Wait for decision**: By mail/text (you) and fax (doctor).[1] **Use the newest form**—old ones rejected![2] ## Timeline and Delivery - **Processing**: 3-5 business days if complete; longer if issues.[1] - **Notification**: Mail/text to you, fax to doctor. - **Enrollment**: Usually **12 months** or end of calendar year (Medicare).[1] - **Delivery**: **Shipped to your home** (pharmacy calls to schedule) or doctor's office.[1] - If >14 business days post-approval with no meds, call (800) 545-6962.[1] **Refills**: Doctor faxes new Rx to 1-844-431-6650 or calls.[1] ## If Denied or Need Alternatives - **Common denial reasons**: Income too high, Medicaid/VA/LIS enrollment, incomplete docs, outdated form.[1][2] - **Appeal**: Review denial letter; resubmit with fixes. Call for guidance.[1] - **Reapply**: Anytime if situation changes (e.g., job loss).[1] - **Alternatives**: - **Lilly Support Services** for Retevmo: Copay help, free meds for commercially insured. Fax form to 1-877-427-4030 or call 1-800-LillyRx (1-800-545-5979).[3][7] - **MyRightDose**: Dose exchange for eligible patients.[5] - **NeedyMeds** or PAN Foundation for grants. - **Medicare Extra Help** if low-income (apply via SSA.gov).[1] - Generic/biosimilar: **None available** for Retevmo.[provided] **No biosimilars** listed; discuss other RET inhibitors (e.g., pralsetinib/Gavreto) with your doctor. ## Reauthorization **Yes, required**. Reapply at enrollment end (up to 60 days early). Use newest app; doctor may need new Rx.[1] ## Disclaimer This guide is for informational purposes based on publicly available program details as of latest sources. **Eligibility, rules, and FPL can change**—always verify at www.lillycares.com, application, or by calling **(800) 545-6962**. Lilly Cares makes final decisions. Not medical/financial advice; consult your doctor/ advisor. Eli Lilly not liable for guide info. Word count: ~1050.

Program information last verified: June 7, 2024