VUMERITY

Indicated For

Relapsing forms of multiple sclerosis

About This Medication

# Biogen Copay Program for VUMERITY Patient Guide: How to Get VUMERITY at Low or No Cost ## Introduction to VUMERITY and the Biogen Copay Program VUMERITY (diroximel fumarate) is a prescription medication approved by the FDA for treating relapsing forms of multiple sclerosis (MS) in adults. MS is a chronic condition affecting the central nervous system, causing symptoms like fatigue, numbness, vision problems, and mobility issues. VUMERITY works by reducing the immune system's attack on the protective covering of nerve fibers (myelin), helping to decrease relapses and slow disability progression. It's taken orally as two 231 mg capsules twice daily, with or without food, and is designed to have a better tolerability profile than some other MS therapies, potentially leading to fewer gastrointestinal side effects. The Biogen Copay Program for VUMERITY helps eligible patients save significantly on out-of-pocket costs. This program can cover copays, coinsurance, and deductibles, potentially reducing your costs to as low as $0 per month, up to a maximum savings limit (typically $25,000 annually, though confirm current details when applying). It's a lifeline for those facing high prescription costs, but eligibility is key. This guide walks you through everything you need to know in simple terms. ## Who Qualifies for the Program? This is a copay assistance program, not a free drug program for the uninsured. It's primarily for patients with commercial (private) insurance who need help with copay expenses. Key qualifications include: - **Diagnosis**: Prescribed VUMERITY for an FDA-approved use (relapsing MS). - **Insurance**: Must have commercial insurance. **Not eligible** if covered by government programs like Medicare (Parts A, B, D), Medicaid, Medicare Advantage, VA benefits, TRICARE, CHAMPUS, or DoD/CHAMPVA plans. - **Residency**: U.S. resident (including territories) with a valid U.S. prescription. - **Age**: 18 years or older (or as prescribed). - **Income**: No strict income thresholds are published, making it more accessible. However, program administrators may review household income during enrollment to ensure appropriate use. | Eligibility Factor | Details | Eligible? | |-------------------|---------|------------| | Commercial Insurance | Yes, required | ✅ | | Medicare/Medicaid | No | ❌ | | Uninsured | No (must have commercial coverage) | ❌ | | Income Limits | None specified; case-by-case review possible | ✅ (generally) | | U.S. Resident | Yes | ✅ | | Valid Prescription | Required | ✅ | If you're on government insurance, explore other options like Biogen's Support Services or state programs (see Alternatives section). ## Insurance Requirements Commercial insurance only—no government plans. Your plan must cover VUMERITY, but the program helps bridge high copays. Provide proof like an insurance card or explanation of benefits (EOB). If your plan changes to government coverage, you must notify the program immediately to avoid issues. ## Step-by-Step Application Process Applying is straightforward and done entirely by phone—no online forms or mailed applications needed. 1. **Get Your Prescription**: Ask your doctor for a VUMERITY prescription if it's right for you. Discuss benefits, risks (e.g., liver enzyme elevation, infection risk, PML warning), and monitoring. 2. **Gather Documents**: - Valid VUMERITY prescription (faxable by your doctor). - Proof of commercial insurance (card, policy details, or recent EOB). 3. **Call to Enroll**: Dial (800) 456-2255 (Monday–Friday, 8 AM–8 PM ET). Have your info ready: - Personal details (name, DOB, address, phone). - Insurance details (member ID, group number). - Pharmacy info (where you'll fill). - Doctor's contact. 4. **Program Review**: A representative verifies eligibility (5–10 minutes). They'll fax forms to your doctor/pharmacy if needed. 5. **Doctor Sign-Off**: Your prescriber signs and faxes back any consent forms (usually same day). 6. **Activation**: Once approved, get a copay card (digital or physical) instantly or via mail. Use at any participating pharmacy. No processing time is specified, but enrollment is often immediate upon verification. ## Timeline and Delivery - **Enrollment**: Same-day if all docs are ready. - **Copay Card**: Instant via app/text or mailed in 7–10 days. - **Medication Delivery**: Not directly shipped; fill at your pharmacy using the copay card. Savings apply per fill. - **Refills**: Automatic—no reauthorization needed. Card renews yearly or as benefits reset. Track via the program's portal or app if provided. ## Income Eligibility Breakdown Unlike needs-based programs, there's no fixed income threshold. It's copay-focused for commercially insured patients. However: | Household Size | No Strict Limit | Notes | |----------------|-----------------|--------| | 1 | No cap | Review possible | | 2 | No cap | Household income considered | | 3+ | No cap | Same | This flexibility helps middle-income families with high-deductible plans. ## Alternatives if Denied or Ineligible - **Government Insurance**: Biogen MS Support Line (1-800-456-2255) for free drug options like the VUMERITY CoPay Renewal Program (separate for Medicare). - **Patient Assistance Foundation**: PAN Foundation or HealthWell for MS drugs. - **State Programs**: Check your state's pharmaceutical assistance. - **Biosimilars/Generics**: None for VUMERITY (brand-only). - **Other MS Meds**: Programs for Tecfidera (Biogen) or generics like dimethyl fumarate. - **Appeal**: Call to discuss denial reasons and resubmit. Shop around pharmacies for lowest cash price if needed. ## Important Disclaimer This guide is for informational purposes based on publicly available data as of 2026. Program terms can change—always verify with Biogen at (800) 456-2255 or biogensupport.com. Not medical advice; consult your doctor. Biogen reserves rights to amend/terminate. Savings vary by insurance/dosage. Report side effects to FDA at 1-800-FDA-1088. (Word count: 1028)

Program information last verified: March 30, 2026