Syfovre

Indicated For

geographic atrophy, age-related macular degeneration

About This Medication

# ApellisAssist Patient Guide: How to Get Syfovre at Low or No Cost Syfovre (pegcetacoplan) is an FDA-approved injection used to treat geographic atrophy (GA) secondary to age-related macular degeneration (AMD), a leading cause of vision loss in older adults. The **ApellisAssist** program from **Apellis Pharmaceuticals, Inc.** offers financial help through co-pay assistance for commercially insured patients and a patient assistance program (PAP) for uninsured, underinsured, or government-insured patients, potentially reducing costs to $0.[1][2][10] ## About Syfovre and Why Assistance Matters **Syfovre** is given as an intravitreal (into the eye) injection by your eye doctor every 25 to 60 days. GA causes blind spots in your central vision, and Syfovre slows its progression, helping preserve vision longer.[1] Without insurance coverage or help, each dose can cost thousands of dollars, making treatment unaffordable for many. ApellisAssist connects you with a dedicated **Apellis Care Educator (ACE)** who guides you through insurance navigation, enrollment, and affordability options tailored to your situation.[2] ## Who Qualifies for ApellisAssist? ApellisAssist has two main tracks: - **Co-pay Program**: For **commercially insured** patients (private insurance, not Medicare/Medicaid). Covers co-pays and coinsurance up to **$25,000 per calendar year**, so you may pay **$0 per treatment**.[10][3][5] - **Patient Assistance Program (PAP)**: For **uninsured, underinsured, or Medicare/Medicaid** patients. Provides free medication based on **needs-based financial eligibility**. Annual household income limits apply, though exact Federal Poverty Level (FPL) percentages aren't specified publicly—call for details.[1][9] Most patients qualify if they meet insurance and income criteria. Your doctor confirms your GA diagnosis, an FDA-approved use for Syfovre.[1] ## Income Eligibility Breakdown PAP eligibility is **household income-based**. Provide household size and income on the enrollment form (Section 4.1).[1] While specific thresholds aren't listed online, programs like this typically cover incomes up to 400-500% FPL, but Apellis reviews case-by-case. | Household Size | Estimated Max Income (Example at 400% FPL*) | Notes | |---------------|---------------------------------------------|-------| | 1 person | ~$60,000 | Needs-based; exact limits via phone [1] | | 2 people | ~$81,000 | Annual household income [1] | | 3 people | ~$102,000 | Call (888) 273-5547 for precise figures | | 4 people | ~$123,000 | Subject to change; verify eligibility | *2026 FPL estimates for illustration. Apellis determines final eligibility.[1] Co-pay program has **no income limits**.[10] ## Insurance Requirements - **Commercial insurance**: Eligible for co-pay program (up to $25,000/year limit).[10] - **Uninsured/underinsured**: Qualify for PAP (free drug if income-eligible).[1][9] - **Medicare Part B/D or Medicaid**: PAP may cover; co-pay program excludes government insurance.[1][3] ApellisAssist verifies coverage and explores alternatives if needed.[2] Attach insurance card copy if applicable.[1] ## Step-by-Step Application Process 1. **Talk to your doctor**: They start the process, confirming diagnosis and prescribing Syfovre.[1] 2. **Contact ApellisAssist**: Call **(888) 273-5547** (888-APELLIS), 8 AM-8 PM ET, Mon-Fri. Your **ACE** explains options.[2][10] 3. **Enroll (multiple methods)**: - **Online**: Doctor uses ApellisAssist Portal (iAssist) at apellisassistga.com.[8][10] - **Fax**: Download form from syfovreecp.com, complete, fax to 888-405-6966.[1][3] - **Phone**: Call for help.[1] 4. **Complete required sections**: - Patient info, diagnosis, insurance details. - **Financial info** (household size/income for PAP).[1] - **Authorizations**: Patient signs for enrollment, data sharing (required); marketing (optional).[1] - Doctor/HCP signs, certifying accuracy.[1] 5. **Submit documents**: Enrollment form is main requirement; add insurance proof, W-9 (first-time for offices).[1][5] Your ACE tracks progress via portal or phone.[2][5] ## Timeline and Delivery - **Processing**: Varies; approvals notified via fax/portal to doctor's office. Co-pay ID issued upon approval.[3][5] - **Delivery**: Syfovre **shipped to physician's office**—never directly to you. Doctor administers.[1] - **Refills**: **Reauthorization required**. Auto-reenrolls commercially insured yearly if eligible; resubmit for PAP.[5][1] - Submit co-pay reimbursements within 180 days of service (claim form, co-pay ID, etc.).[5][10] Expect support throughout your journey.[2] ## Alternatives if Denied - **Appeal**: Review denial letter (e.g., ineligibility reasons) and resubmit corrected info.[5] - **Other programs**: Check Accessia Health or public insurance options (waitlists possible).[10] - **Call ACE**: They explore alternate funding, benefits investigation.[1][2] - **No biosimilars** available for Syfovre currently.[data] ## Disclaimer This guide is for informational purposes based on available program details as of 2026. Eligibility, terms, and limits can change—**always verify with ApellisAssist at (888) 273-5547**. Apellis determines final approval. Not affiliated with government programs. Consult your doctor for medical advice. Program may not cover all costs; over-limit expenses are your responsibility.[1][10]

Program information last verified: March 30, 2026