XEMBIFY

Indicated For

Primary Humoral Immunodeficiency Disease (PIDD)

About This Medication

# Xembify Connexions Patient Assistance Program (PAP) Patient Guide: How to Get XEMBIFY at Low or No Cost XEMBIFY (immune globulin subcutaneous human-klhw) is a prescription medication used to treat **Primary Immunodeficiency Disease (PIDD or PI)** in patients 2 years and older by providing immune globulin through subcutaneous (under the skin) injections. The **Xembify Connexions Patient Assistance Program (PAP)** from Grifols helps eligible uninsured patients get XEMBIFY at no cost, while offering copay assistance up to $10,000 per year for those with commercial insurance. ## About XEMBIFY XEMBIFY is a **20% subcutaneous immunoglobulin (SCIg)** solution, the first of its kind approved for treatment-naïve patients without needing prior intravenous therapy. It supports weekly or biweekly dosing for flexibility and is administered at home via subcutaneous infusion. This treatment replaces antibodies your body lacks due to PI, helping prevent infections. It's FDA-approved for patients 2 years and older with PI, a group of over 300 disorders weakening the immune system.[10][6] **Key benefits** include high tolerability, no need for IV access, and expanded labeling for direct SCIg start and biweekly options based on phase 4 trial data showing comparable Ig levels.[6] Always follow your doctor's instructions, as it's for subcutaneous use only.[9] ## Who Qualifies for the Program? The Xembify Connexions PAP targets **uninsured patients** with a valid prescription for on-label PI treatment who lack financial resources to pay for XEMBIFY. You must be a **US citizen or legal US resident** (excluding Puerto Rico and territories).[4] A healthcare provider must confirm the prescription is for PI (specific ICD codes apply) and supervise your treatment plan.[4][3] For **commercially insured patients**, the copay program offers $0 copay potential with up to **$10,000 annual assistance** covering deductibles, copays, and coinsurance—no monthly caps or infusion limits. Government-insured (Medicare, Medicaid, etc.) patients are ineligible for copay aid.[1][2][3] ## Income Eligibility Specific income thresholds (e.g., Federal Poverty Level percentages) are **not publicly disclosed**. Eligibility depends on financial need, verified by Grifols. Contact a **Xembify Connexions Case Manager** at (844) 699-3624 for personalized assessment.[1][2] | Household Size | Income Threshold | Notes | |---------------|------------------|-------| | Individual | Not disclosed | Speak with case manager for eligibility review | | Couple | Not disclosed | Financial resources assessed case-by-case | | Family of 3 | Not disclosed | Uninsured patients only for PAP | | Family of 4+ | Not disclosed | Proof of income and no insurance required | This table reflects available info; approval isn't guaranteed by income alone.[4] ## Insurance Requirements - **PAP (free drug)**: For **uninsured** patients only—no prescription insurance, including public programs. Provide proof of no coverage.[4] - **Copay Assistance**: **Commercial insurance** required that covers XEMBIFY and permits assistance. Ineligible if on Medicare, Medicaid, Medigap, VA, etc. Disclose assistance to your insurer per their rules.[3][7] Over 90% of commercial plans cover XEMBIFY. Xembify Connexions helps with prior authorizations and pharmacy coordination.[1] ## Step-by-Step Application Process 1. **Get a Prescription**: Ask your doctor for XEMBIFY for PI treatment. They must complete sections of the PAP form, attesting to on-label use and your treatment plan.[4] 2. **Contact Xembify Connexions**: Call **(844) 699-3624** to speak with a Case Manager. They'll guide you and connect you to a specialty pharmacy.[1][2] 3. **Download and Complete Forms**: Use the PAP Consent Form (available online). Fill in patient info, sign for eligibility verification, and have your doctor sign.[4] 4. **Gather Documents**: - PAP application form - Valid prescription - Proof of no insurance (e.g., denial letter) - Patient consent signature[4] 5. **Submit**: Multiple methods—fax, mail, or via Case Manager. They'll verify eligibility.[2] 6. **Enroll in Support**: Get nursing help from specialty pharmacy and free Patient Starter Kit (infusion supplies).[2][8] Applications are reviewed by Grifols; they reserve rights to modify/terminate.[4][7] ## Timeline and Delivery Processing time varies; contact Case Manager for updates—no fixed timeline listed. Once approved, XEMBIFY **ships directly to you via specialty pharmacy**.[2] Refills/reauthorization needed periodically—your doctor resubmits prescriptions.[4] Copay cards activate quickly via Medmonk portal for insured patients.[3] ## Alternatives if Denied or Ineligible - **Copay Program** (if commercially insured): Up to $10,000/year.[1] - **Specialty Pharmacy Assistance**: Xembify Connexions coordinates nurses and billing support.[1] - **Other IG Options**: Discuss biosimilars or alternatives like other SCIg/IVIg with your doctor (none listed as direct biosimilars here). - **State Programs**: Check local Medicaid or charity foundations for PI patients. - **Appeal**: Resubmit with more docs or call for reasons.[2] Reauthorization is required; maintain compliance.[4] ## Disclaimer This guide is for informational purposes based on publicly available data as of 2025. **Not medical advice**—consult your doctor. Program terms subject to change; Grifols may amend/terminate anytime without notice. Eligibility not guaranteed. See full Prescribing Info for XEMBIFY safety.[1][4][7] For latest, call (844) 699-3624 or visit xembify.com.

Program information last verified: March 30, 2026