Revuforj

Indicated For

Relapsed or refractory acute myeloid leukemia (AML) with KMT2A rearrangement or NPM1 mutation

About This Medication

# SyndAccess Patient Assistance Program (PAP) Patient Guide: How to Get Revuforj (revumenib) at Low or No Cost The **SyndAccess Patient Assistance Program (PAP)** from **Syndax Pharmaceuticals** helps uninsured, underinsured, or financially strained patients access **Revuforj (revumenib)**, a targeted therapy for certain relapsed or refractory leukemias, at little or no cost.[1][2][3] This guide explains eligibility, application steps, and support options in simple terms to empower you or your loved one. ## About Revuforj (revumenib) **Revuforj** is an oral prescription medication approved for adults and children 1 year and older with specific types of acute leukemia that has returned (relapsed) or not responded (refractory) to prior treatments.[3][7][9] It targets two key genetic changes: - Acute leukemia with a **KMT2A translocation** (a gene rearrangement). - Acute myeloid leukemia (**AML**) with an **NPM1 mutation**, when no other good treatment options remain.[3] Revuforj works by blocking a protein that cancer cells need to grow, helping to fight the leukemia.[3] It's taken as tablets, typically **110 mg or 160 mg twice daily** for a 28-day cycle.[2] Common doses include 110 mg x 30 tablets or 160 mg x 30 tablets.[2] **Important Safety Note**: Revuforj has a **Boxed Warning** for differentiation syndrome, a serious reaction that can occur as early as 3 days after starting treatment. Symptoms include fever, shortness of breath, and fluid buildup—seek emergency care immediately if they appear. It may also cause heart rhythm changes or harm an unborn baby, so discuss risks with your doctor.[7] Always follow your healthcare provider's instructions and report side effects to the FDA at 1-800-FDA-1088.[7] ## Who Qualifies for SyndAccess PAP? The SyndAccess program offers **two main tracks**: 1. **Copay Program**: For **commercially insured patients** (private insurance). Pay as little as **$0 per prescription** with **no income restrictions**.[1][4][5][6] 2. **Patient Assistance Program (PAP)**: For **uninsured, underinsured, or those in financial hardship**. This may include Medicare Part D patients facing high costs, denied coverage after appeals, or those not yet enrolled in Part D. Financial need is assessed case-by-case; **no strict income limits** are published—contact the program for details.[1][2][5][8] **Key Exclusions**: Not available for Medicare, Medicaid, TRICARE, VA, or other government-funded programs (except limited PAP for Medicare hardship).[2][5][8] You must be a **US resident** (including territories).[1][2] ## Income Eligibility Breakdown Unlike many programs with fixed Federal Poverty Level (FPL) cutoffs, SyndAccess **does not specify public income thresholds**. Eligibility focuses on financial hardship, insurance status, and individual review.[1][2][8] Here's a summary: | Household Size | Income Threshold | Notes | |---------------|------------------|-------| | Individual | Not specified | Case-by-case for uninsured/underinsured; copay has no limits[1][2] | | Couple | Not specified | Contact for assessment[1][2] | | Family of 3 | Not specified | Financial hardship key factor[1][2] | | Family of 4+ | Not specified | Proof of income required[1][2] | **Tip**: Even if income is above typical FPL (e.g., 400-500%), you may qualify if costs create hardship. Call **(888) 567-7963** for a free screening.[1][5] ## Insurance Requirements - **Commercial/Private Insurance**: Eligible for **Copay Program** ($0 copay possible).[4][6] - **Uninsured/Underinsured**: PAP provides free or low-cost medication.[5][8] - **Medicare/Medicaid/TRICARE/VA**: **Excluded** from copay; PAP may help Medicare Part D patients with hardship or denials.[2][5][8] SyndAccess offers **free insurance verification**, prior authorization (PA) help, and appeals support via dedicated nurses.[1][2][5] ## Step-by-Step Application Process 1. **Talk to Your Doctor**: Get a valid prescription for Revuforj. Your healthcare provider (HCP) must sign the enrollment form.[2] 2. **Contact SyndAccess**: Call **(888) 567-7963** (Mon-Fri, 8 AM-8 PM ET) or visit **syndaccess.com**. Nurses screen eligibility and guide you.[1][5] 3. **Download/Request Form**: Use the [SyndAccess Enrollment Form](https://revuforjhcp.com/wp-content/themes/revuforj/pdf/SyndAccess-Enrollment-Form.pdf).[2] 4. **Gather Documents**: - Proof of residency (e.g., utility bill) - Proof of income (e.g., tax returns, pay stubs) - Insurance info (if any) - Prescription - HCP signature[1][2] 5. **Submit**: Fax, mail, or upload via multiple methods (program supports various).[1] HCP can submit on your behalf. 6. **Quick Start/Bridge**: Get medication while approval processes (e.g., PA).[2][5] **Pro Tip**: Enroll early—nurses provide personalized case management.[8] ## Timeline and Delivery Processing time varies; expect **days to weeks** depending on verification. Bridge programs start treatment fast.[2][5] Medication ships free via **specialty pharmacy** to your home or doctor's office.[1] **Reauthorization**: **Required annually** or if circumstances change (e.g., new insurance). Renew eligibility each calendar year.[2] ## Alternatives if Denied or Ineligible - **Independent Foundations**: SyndAccess connects you to third-party programs.[2] - **NeedyMeds.org** or **RxAssist.org**: Search PAP databases.[5] - **State Programs**: Check for leukemia-specific aid. - **Generic/Biosimilars**: None available yet.[1] - **Clinical Trials**: Ask your doctor about Revuforj studies. Contact SyndAccess—they screen for copay, PAP, or external options.[2][5] ## Disclaimer This guide is for informational purposes based on publicly available data as of 2026. Program terms can change; **always verify with SyndAccess at (888) 567-7963 or syndaccess.com**.[1][2] Not medical advice—consult your healthcare provider. Syndax may modify/cancel programs without notice.[2] Eligibility not guaranteed.

Program information last verified: March 30, 2026