Xatmep

Indicated For

pediatric acute lymphoblastic leukemia (ALL), polyarticular juvenile idiopathic arthritis (pJIA)

About This Medication

# Xatmep Patient Assistance Program Patient Guide: How to Get Xatmep at Low or No Cost Xatmep (methotrexate) Oral Solution is a prescription medication used to treat certain conditions like pediatric acute lymphoblastic leukemia (ALL) and other approved uses, and the **Xatmep Patient Assistance Program** from **Azurity Pharmaceuticals, Inc.** helps eligible uninsured patients get it at no cost.[1][3][10] ## About Xatmep (Methotrexate) Oral Solution **Xatmep** is an oral liquid form of methotrexate, a folate analog metabolic inhibitor. It's specifically indicated for: - Treatment of pediatric patients with **acute lymphoblastic leukemia (ALL)** as part of multi-phase chemotherapy regimens. - Management of pediatric patients with polyarticular juvenile idiopathic arthritis (pJIA). - Other off-label or maintenance uses under medical supervision.[10] Methotrexate works by interfering with cell growth and is taken as directed by your doctor. It's available as a 2.5 mg/mL oral solution, making it easier for precise dosing, especially for children. **Important safety note**: Xatmep can cause serious side effects like liver damage, bone marrow suppression, and infections. Always follow your doctor's instructions and report side effects immediately.[8] This guide focuses on the Patient Assistance Program (PAP), which provides **free medication** to eligible patients who can't afford it due to lack of insurance or financial hardship.[1][2][3] ## Who Qualifies for the Program? The program is designed for **financially needy, uninsured patients** who meet specific criteria. Key eligibility factors include:[1][2][3][4] - **Uninsured status**: No prescription insurance coverage, including Medicaid or other public programs. - **Financial need**: Documentation required to verify income and financial hardship. Specific income thresholds (e.g., Federal Poverty Level percentages) are not publicly detailed; eligibility is determined case-by-case.[3] - **U.S. residency**: Typically for patients in the U.S. - **Valid prescription**: For a medically necessary use with ICD-10 diagnosis codes. **Note**: If you have commercial insurance, explore co-pay assistance programs like eVoucherRx or Voucher on Demand, which can reduce costs to as low as **$5** per prescription (not valid for government insurance).[4][5] For insurance delays over 48 hours, the **Azurity Solutions Bridge Drug Program** offers up to **30 days of free medication**.[1][2] ## Income Eligibility Breakdown Exact income limits are not specified publicly and require verification through the application process. The program requests proof of income to confirm financial need.[3] Here's a general overview based on similar programs (consult Azurity for your situation): | Household Size | Estimated Threshold | Notes | |---------------|---------------------|-------| | Individual | Case-by-case (e.g., <400-500% FPL) | Proof of income required; no fixed % listed[3] | | Couple | Case-by-case | Documentation verifies hardship | | Family of 3 | Case-by-case | Uninsured only | | Family of 4+ | Case-by-case | Financial need assessed | **FPL Percent**: Not specified; program emphasizes documentation over strict cutoffs.[3] Call (844) 472-2032 to discuss your household income and get pre-screened.[2] ## Insurance Requirements - **Must be uninsured** for prescription coverage, with **no Medicaid or other public insurance** (e.g., Medicare, VA, TRICARE).[3][4][5] - **Not eligible** if receiving federal/state-funded benefits for this medication. - **Commercially insured?** Use co-pay cards instead (as low as $5).[5] - **Medicaid patients**: May qualify for coverage; PAP for those needing extra support but uninsured otherwise.[4] Azurity verifies insurance via your authorization on the form.[3][9] ## Step-by-Step Application Process 1. **Talk to your doctor**: Get a prescription and prescriber statement confirming medical necessity. Include **ICD-10 codes** for primary/secondary diagnoses.[3] 2. **Gather documents**: - Proof of **insurance status** (e.g., denial letter or statement of no coverage). - **Proof of income** (e.g., tax returns, pay stubs, W-2s). - **ICD-10 codes** and prescriber signature. - **Statement of medical necessity** from prescriber.[3] 3. **Download or request form**: Get the **Patient Assistance Program and Bridge Drug Program Form** from xatmep.com or call (844) 472-2032.[3][6] 4. **Complete and sign**: Patient, prescriber, and applicant declarations required. Authorize info sharing for verification.[3] 5. **Submit**: Multiple methods available (call for fax/mail details). Phone: **(844) 472-2032**.[2][3] 6. **Wait for approval**: Azurity reviews and contacts you. Your prescriber agrees to verify ongoing use and resubmit prescriptions as needed.[3] ## Timeline and Delivery - **Processing time**: Not specified; Bridge Program acts fast for urgent needs (if insurance delay >48 hours).[1][2] - **Delivery**: Free medication shipped directly (details confirmed post-approval). Up to program supply limits.[1][3] - **Bridge Program**: Quick access to 30 days while awaiting insurance.[2] Call for status updates. ## Alternatives if Denied or Ineligible - **Bridge Program**: For insurance gaps.[1] - **Co-pay assistance**: For commercial insurance ($5 copay).[4][5] - **State programs**: Check Medicaid or local assistance. - **Other PAPs**: RxAssist.org lists options; generic methotrexate may be cheaper.[7] - **Appeal**: Provide additional docs or reapply. - **Biosimilars**: None listed for Xatmep.[program data] ## Disclaimer This guide is for informational purposes only and based on publicly available data as of 2024.[1-10] Azurity Pharmaceuticals reserves the right to **modify, discontinue, or terminate the program** anytime without notice.[3] Eligibility not guaranteed. Consult your healthcare provider and contact Azurity at (844) 472-2032 for personalized advice. Not medical advice. Always read Xatmep prescribing info for risks/benefits.

Program information last verified: March 30, 2026