Tepezza

Amgen By Your Side Program Patient Guide: How to Get Tepezza (teprotumumab-trbw) at Low or No Cost

Tepezza (teprotumumab-trbw) is a prescription medication used to treat Thyroid Eye Disease (TED), a condition that causes inflammation and swelling in the muscles and tissues behind the eyes, leading to symptoms like bulging eyes, double vision, and pain. The Amgen By Your Side Program, offered by manufacturer Amgen, provides financial support to help eligible patients access Tepezza at low or no cost, primarily through co-pay assistance for commercially insured patients and free medication for qualifying uninsured individuals.[1][2][4][5][7][8]

Who Qualifies for the Program?

The Amgen By Your Side Program has two main tracks: the Commercial Co-Pay Program and the Patient Assistance Program (PAP). Eligibility focuses on insurance status rather than strict income limits.

• Commercial Co-Pay Program: For patients with commercial (private) insurance who have out-of-pocket costs for Tepezza or its infusion administration. Eligible patients may pay $0 for the medication and infusion costs. You must be a US resident (including Puerto Rico), 18 years or older, and prescribed Tepezza for its FDA-approved indication (TED, regardless of disease activity or duration).[1][2][4][5][7]

• Patient Assistance Program (PAP): For uninsured or underinsured patients who meet income-based criteria (specific thresholds not publicly detailed but needs-based). Provides Tepezza free of charge to qualified applicants. US residency required, and your doctor must confirm they are pursuing insurance coverage.[4][6][8][10]

Note: Medicare, Medicaid, or government-insured patients are generally not eligible for the co-pay program, but check with the program for PAP options.[5][8]

About Tepezza

Tepezza is the first and only FDA-approved treatment for TED in adults. It's given as an intravenous (IV) infusion every 3 weeks for a total of 8 infusions (initial dose 10 mg/kg, then 20 mg/kg). It works by blocking a protein called IGF-1R, which reduces eye bulging, double vision, and inflammation. Common side effects include muscle spasms, nausea, hair loss, hearing issues, and high blood sugar—discuss risks with your doctor. Treatment is administered at an infusion center, not at home.[1][3][4]

Income Eligibility Breakdown

This program is not primarily income-based for co-pay assistance but requires commercial insurance. The PAP track is needs-based. Here's a summary table:

Always verify current details by calling the program, as criteria can change.[4][5][8]

Insurance Requirements

• Commercial insurance is required for co-pay assistance. The program covers your share of drug and infusion costs if your plan doesn't fully cover them.[2][5][7]
• No coverage required for PAP, but your doctor must attest to pursuing insurance.[6][8]
• Medicare/Medicaid: Typically ineligible for co-pay help; explore PAP or other foundations like NORD.[5][8][10]
• A Patient Access Liaison (PAL) from Amgen By Your Side can help verify benefits, find infusion centers, and coordinate prior authorizations (common for TED treatments).[3][4]

Step-by-Step Application Process

1. Get Prescribed: Ask your ophthalmologist or endocrinologist to prescribe Tepezza and discuss if it's right for your TED (often requires prior authorization from insurance).[10]

2. Contact Amgen By Your Side: Call 1-833-5-TEPEZZA (1-833-583-7399) Monday-Friday, 8 AM-8 PM ET. A PAL will guide you and start enrollment.[4][5][6]

3. Complete Enrollment Form: Your doctor fills out the TEPEZZA Patient Enrollment Form (available online or via phone). Required fields include patient info, diagnosis code, insurance details, and signatures from patient and prescriber. Fax to 833-469-8333, email to TEPEZZAHBYS@horizontherapeutics.com, or submit online.[5][6]

4. Submit Documents: Provide insurance verification (e.g., benefits summary) and patient identification (e.g., ID, proof of residency). PAL assists.[1][4]

5. Approval and Activation: For co-pay, get a co-pay card. For PAP, approval based on eligibility review. No activation needed beyond enrollment.[5]

6. Schedule Infusion: PAL helps find and book an infusion center, coordinates ongoing appointments (8 infusions over ~24 weeks).[3][4]

Application is primarily by phone with your doctor involved—no direct patient online portal mentioned.[1]

Timeline and Delivery

• Processing Time: Not specified; expect quick review post-enrollment (days to weeks). PAL provides status updates.[3]
• Delivery: Tepezza is administered at an infusion center—not shipped home. Program covers eligible costs; infusions every 3 weeks.[2][3]
• Full Course: 8 infusions; support continues throughout.[4]

No reauthorization required per available details, but insurance may need it separately.[1]

Alternatives if Denied

• Appeal Denial: Work with your PAL to resubmit or appeal insurance prior auth.[3][10]
• Other Programs: Assistance Fund for TED, NORD grants, or state programs.[10]
• Biosimilars: None available.[1]
• Foundations: Check Patient Access Network (PAN) or HealthWell Foundation for TED.

Disclaimer

This guide is for informational purposes only and based on publicly available data as of 2026. Eligibility, terms, and benefits can change—always contact Amgen By Your Side at 1-833-583-7399 for personalized advice. Not a substitute for medical or financial counseling. Amgen does not guarantee coverage; patients remain responsible for non-eligible costs. Consult your doctor for treatment decisions.