VYEPTI

Indicated For

migraine prevention

About This Medication

# VYEPTI CONNECT Copay Assistance Program Patient Guide: How to Get VYEPTI at Low or No Cost ## About VYEPTI VYEPTI (eptinezumab-jjmr) is a monoclonal antibody medication manufactured by Lundbeck that is used to treat migraine. It is administered as an intravenous infusion every three months. The list price for VYEPTI is $2,004.09 per vial, but Lundbeck offers financial assistance programs to help eligible patients reduce their out-of-pocket costs. ## Who Qualifies for VYEPTI CONNECT Copay Assistance The VYEPTI CONNECT Copay Assistance Program is designed to help eligible patients with commercial insurance pay as little as $0 per infusion. To qualify, you must meet the following criteria: - You have a valid prescription for VYEPTI (up to 300 mg) for an approved indication - You have commercial insurance coverage - You are not self-pay (meaning you do not pay the entire cost out of your own pocket) - You are not enrolled in Medicare, Medicaid, Medigap, VA, DOD, or TRICARE (unless you are Medicare-eligible and enrolled in an employer-sponsored retiree health plan or prescription drug benefit program) ## Income Eligibility The VYEPTI CONNECT Copay Assistance Program does not have published income thresholds. Instead, eligibility is based on your insurance coverage type. If you have commercial insurance and meet the insurance requirements listed above, you may be eligible for the copay assistance program regardless of your household income. If you do not have commercial insurance or are uninsured, the Lundbeck Migraine Patient Assistance Program may be available to patients who have limited financial resources and do not have insurance coverage for VYEPTI. This program requires documentation of your household income and financial resources. ## Insurance Requirements | Insurance Type | Eligibility for VYEPTI CONNECT Copay Program | Alternative Assistance | |---|---|---| | Commercial Insurance | Eligible | VYEPTI CONNECT Copay Assistance Program | | Medicare | Not eligible for copay program | May qualify for Medicaid assistance or Lundbeck Migraine PAP | | Medicaid | Not eligible for copay program | May receive VYEPTI at little to no cost depending on state and household income | | TRICARE/VA | Not eligible for copay program | Coverage varies by location and military status | | Uninsured | Not eligible for copay program | Lundbeck Migraine Patient Assistance Program | | Employer-Sponsored Retiree Plan | Eligible | VYEPTI CONNECT Copay Assistance Program | ## How Much Will You Pay If you are eligible for the VYEPTI CONNECT Copay Assistance Program: - You may pay as little as **$0 per infusion** - The program covers up to **$200 in administration fees per treatment** - The program has a **calendar year maximum cap** on total assistance for all out-of-pocket expenses (medication and administration combined) - If your total out-of-pocket expenses exceed the annual cap, you will be responsible for the additional balance You should confirm your exact out-of-pocket cost with your pharmacy or healthcare provider before your treatment. ## Step-by-Step Application Process ### Step 1: Confirm Your Eligibility Review the eligibility criteria above to confirm you have commercial insurance and meet the program requirements. If you are unsure about your insurance type, contact your insurance provider or call the VYEPTI support line at 1-833-4-VYEPTI (1-833-489-3784). ### Step 2: Complete the Enrollment Form Obtain the VYEPTI CONNECT Enrollment Form from your healthcare provider or by contacting VYEPTI support. You can also email enrollment@lundbeck.com to request the form. ### Step 3: Submit Your Enrollment Complete and sign the enrollment form, then email it to **enrollment@lundbeck.com**. Alternatively, your healthcare provider or infusion center can help you enroll over the phone by calling the VYEPTI support line. ### Step 4: Receive Confirmation After enrollment, a confirmation letter will be sent to you and your prescribing physician. This letter will confirm your enrollment in the program. ### Step 5: Begin Treatment Once enrolled, you can begin receiving VYEPTI infusions with copay assistance. Your infusion provider will help coordinate your treatment and submit copay claims to the program. ## Timeline and Delivery **Enrollment Processing:** The exact processing time for enrollment is not specified in program materials. However, you should allow several business days for your enrollment to be processed after submitting your form. **Copay Claims Submission:** Copay claims must be submitted to the program within **180 days of your date of service**. Your infusion provider or healthcare provider typically handles this submission on your behalf. **Treatment Delivery:** VYEPTI is administered as an intravenous infusion every three months. You can receive your infusion at an infusion center through the VYEPTI Infusion Network or at your healthcare provider's office if they administer VYEPTI in-office. ## What If Your Application Is Denied If you are not eligible for the VYEPTI CONNECT Copay Assistance Program (for example, if you have Medicare or Medicaid), you may still qualify for other assistance: - **Medicaid patients:** You may be able to get VYEPTI at little to no cost. Out-of-pocket costs vary based on your state and household income. - **Medicare patients:** Call 1-800-MEDICARE (1-800-633-4227) to learn about your coverage options. - **Uninsured or underinsured patients:** The Lundbeck Migraine Patient Assistance Program may be available. This program requires documentation of limited financial resources. Contact the program at 1-877-228-9125 (Monday–Friday, 8 AM to 6 PM EST) or fax your application to 1-866-889-0580. - **TRICARE/VA patients:** Your coverage options vary based on your location and military status. Contact your healthcare provider for more information. ## Reauthorization and Renewal The VYEPTI CONNECT Copay Assistance Program assistance is valid through the end of the calendar year in which you enroll. If you need to continue receiving copay assistance in the following year, you will need to reapply. Contact VYEPTI support at 1-833-4-VYEPTI to learn about the reapplication process. ## Additional Support Beyond copay assistance, VYEPTI CONNECT offers additional support services: - Insurance coverage information related to VYEPTI - Benefits investigations and prior authorization assistance - Information about other Lundbeck patient support programs - Personalized support through the VYEPTI Go program For questions or assistance, contact VYEPTI support: - **Phone:** 1-833-4-VYEPTI (1-833-489-3784), Monday–Friday, 8 AM–8 PM ET - **Email:** enrollment@lundbeck.com ## Important Disclaimer This guide provides general information about the VYEPTI CONNECT Copay Assistance Program as of March 2026. Program details, eligibility criteria, and benefits are subject to change. Always verify current program details with Lundbeck or your healthcare provider before making treatment decisions. This information is not a guarantee of eligibility or assistance. Individual circumstances vary, and program approval is based on meeting all eligibility requirements.

Program information last verified: March 30, 2026