Rydapt

Indicated For

Aggressive Systemic Mastocytosis (SM), Mast Cell Leukemia (MCL), Acute Myeloid Leukemia (AML)

About This Medication

# Novartis Patient Assistance Foundation Patient Guide: How to Get Rydapt at Low or No Cost ## About This Program The Novartis Patient Assistance Foundation (NPAF) helps eligible patients access Rydapt (midostaurin) at reduced or no cost. Rydapt is a prescription medication used to treat certain types of cancer. If you're struggling to afford this medication, this program may be able to help you get the treatment you need. ## Who Qualifies for This Program? To be eligible for NPAF assistance with Rydapt, you must meet all of the following requirements: - **U.S. Residency**: You must live in the United States or a U.S. territory - **Valid Prescription**: You must have a current prescription for Rydapt from a licensed U.S. healthcare provider - **Outpatient Treatment**: You must be receiving treatment on an outpatient basis (not hospitalized) - **Insurance Status**: You must have limited or no prescription insurance coverage, or be unable to afford your medication even with insurance - **Income Requirements**: Your household income must meet NPAF's guidelines, which are based on the Federal Poverty Level and vary by household size. Alaska and Hawaii have different income limits than other states. ## Understanding Income Eligibility NPAF uses a needs-based approach to determine eligibility. Your household income is compared against federal poverty guidelines adjusted for your household size. The program considers your total household income from all sources. | Household Size | Income Consideration | |---|---| | 1 person | Individual income limits apply | | 2 people | Couple income limits apply | | 3 people | Family of 3 limits apply | | 4+ people | Family of 4+ limits apply | *Note: Alaska and Hawaii have higher income thresholds. Contact NPAF directly at 1-800-277-2254 for specific income limits in your state.* To verify your eligibility, visit the NPAF website at pap.novartis.com and check the income requirements for Rydapt specifically. ## Insurance Requirements You are eligible for NPAF assistance if you: - Have no prescription drug insurance coverage, OR - Have prescription insurance but cannot afford your medication due to high copayments, deductibles, or coinsurance, OR - Are eligible for Medicare or Medicaid but still cannot afford your medication If your insurance requires prior authorization for Rydapt, you will need to submit documentation of any prior authorization denial or appeal outcome with your application. ## How to Apply: Step-by-Step ### Step 1: Check Your Eligibility Visit pap.novartis.com to review the specific eligibility requirements for Rydapt. This will give you an initial indication of whether you may qualify based on income and other factors. ### Step 2: Gather Required Documents Before starting your application, collect the following: - Copy of the front and back of all insurance cards (primary, secondary, and prescription insurance) - Copy of the first two pages of your most recent federal income tax return (Form 1040) to verify your household income - If you are not required to file taxes, contact NPAF directly for alternative documentation - A valid prescription for Rydapt from your healthcare provider - If applicable, documentation of any insurance prior authorization denials ### Step 3: Complete the Patient Application Fill out the NPAF patient application form completely and accurately. The form includes sections for: - Your personal information - Your household size (as shown on your tax return) - Your insurance information - Your authorization for NPAF to contact your healthcare providers and insurers Make sure all required fields are completed. Incomplete applications will result in processing delays or denial. ### Step 4: Have Your Healthcare Provider Complete Their Section Your prescribing physician must complete the healthcare provider section of the application, which includes: - Verification of your valid prescription for Rydapt - Their authorization to release your medical information - Their signature and date ### Step 5: Submit Your Application Submit your completed application and all supporting documents by either: - **Fax**: 1-855-817-2711 - **Mail**: NPAF, PO Box 2529, Columbus, OH 43216 Make sure to keep copies for your records. ## Timeline and What to Expect **Processing Time**: You will receive a decision letter within approximately 4 weeks of submitting your complete application. **Notification**: If you have opted in, you may also receive a text message with updates about your application status. **If Your Application Is Incomplete**: You will receive a letter explaining what additional information is needed and the next steps to complete your application. **Medication Delivery**: Once approved, your Rydapt will be shipped directly to you or your healthcare provider. ## What If Your Application Is Denied? If your application is denied, you have options: - Review the denial letter carefully to understand the reason - Contact NPAF at 1-800-277-2254 (Monday-Friday, 9 AM-6 PM EST) to discuss your situation - Ask about the appeals process if you believe there was an error - Explore other patient assistance resources or discuss alternative treatment options with your healthcare provider ## Reauthorization and Refills Your assistance through NPAF is not permanent. You will need to reauthorize your enrollment periodically to continue receiving assistance with Rydapt. NPAF will notify you when reauthorization is required. Be prepared to provide updated income documentation and insurance information. ## Questions? For questions about the application process, eligibility, or your application status, contact: **Novartis Patient Assistance Foundation** - **Phone**: 1-800-277-2254 - **Hours**: Monday-Friday, 9 AM-6 PM EST - **Website**: pap.novartis.com - **Mailing Address**: NPAF, PO Box 2529, Columbus, OH 43216 ## Important 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 complete information, visit pap.novartis.com or contact NPAF directly. This information is not a guarantee of eligibility or assistance. Your individual circumstances will be evaluated during the application process.

Program information last verified: March 30, 2026