YORVIPATH

Ascendis Patient Assistance Program Patient Guide: How to Get YORVIPATH at Low or No Cost

About YORVIPATH

YORVIPATH (palopegteriparatide) is a prescription medication used to treat chronic hypoparathyroidism. It works by replacing parathyroid hormone that your body isn't producing in sufficient quantities. YORVIPATH is administered as a subcutaneous injection, and your healthcare provider will help determine if it's the right treatment for your condition.

About the Ascendis Patient Assistance Program

The Ascendis Patient Assistance Program (A.P.A.P), also known as the Ascendis Signature Access Program (A·S·A·P), is designed to help eligible patients access YORVIPATH at reduced or no cost. This program provides comprehensive support beyond just medication assistance, including insurance verification, device training, and reimbursement support.

Who Qualifies for This Program?

You may be eligible for the Ascendis Patient Assistance Program if you meet these criteria:

• You are uninsured or underinsured and cannot afford your medication
• You have a valid prescription from a licensed healthcare provider in the United States or a U.S. territory
• You are being treated for an approved indication of chronic hypoparathyroidism
• You meet income eligibility requirements (specific thresholds are not publicly disclosed but are evaluated on a case-by-case basis)
• You have not previously received reimbursement for YORVIPATH through this program

Important Insurance Restrictions

If you have any of the following types of coverage, you generally cannot use the co-pay assistance program, though you may still qualify for other support services:

• Medicaid (unless you have applied and been denied enrollment, including exhaustion of all appeals)
• Medicare (unless you are Medicare-eligible without Part D coverage and have applied for and been denied Extra Help/Low Income Subsidy)
• Veterans Affairs (VA) prescription benefits (unless you have applied and been denied enrollment)
• Military coverage (DOD, TRICARE, or Medigap)

If you have Medicare and no Part D coverage, you can apply for Extra Help/Low Income Subsidy by contacting the Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778) or visiting ssa.gov/benefits/medicare/prescriptionhelp/.

Income Eligibility

While Ascendis Pharma does not publicly disclose specific income thresholds, the program evaluates your financial situation to determine eligibility. Income verification will be required as part of your application. Your income and insurance status will be periodically reconfirmed, and changes in either may affect your continued eligibility.

How to Apply

Step 1: Get a Prescription

Your healthcare provider must write a prescription for YORVIPATH for an approved indication. Your provider will also need to complete the A·S·A·P Enrollment Form.

Step 2: Submit Your Enrollment Form

Your healthcare provider's office will submit the completed A·S·A·P Enrollment Form to Ascendis by:

• Email: info@ascendissupport.com
• Fax: 1-888-436-0193

If you fax your paperwork, you will receive a fax confirmation with a case ID. If you do not receive this confirmation fax, Ascendis did not receive your initial submission.

Step 3: Gather Required Documentation

Have the following documents ready:

• Valid prescription from your licensed healthcare provider
• Income verification (such as recent tax returns, pay stubs, or benefit statements)
• Insurance documentation (copies of front and back of medical and pharmacy insurance cards, or documentation of being uninsured)
• Proof of identity

Step 4: Receive Your Welcome Call

You can expect a welcome call from your A·S·A·P Case Manager within 2-3 business days. Important: Save the A·S·A·P phone number 1-844-442-7236 and answer calls from this number to confirm shipping details and avoid delays.

Step 5: Insurance Verification and Authorization

Your A·S·A·P representative will verify your insurance coverage and eligibility. If you have insurance, they will work with your insurance company to obtain authorization. If authorization is denied, A·S·A·P can provide appeal assistance.

Step 6: Receive Your Medication

Once approved, your prescription will be sent to one of Ascendis's specialty pharmacy partners:

• Orsini Specialty Pharmacy: 1-888-204-7802 (Fax: 1-877-471-8175)
• PANTHERx Rare Pharmacy: 1-888-379-1821 (Fax: 1-877-914-0604)

Your medication will be shipped directly to your home. You may receive calls from these pharmacies to confirm shipping details.

Timeline and Delivery

You can expect your welcome call from A·S·A·P within 2-3 business days of enrollment. The exact timeline from enrollment to medication delivery depends on insurance authorization (if applicable) and pharmacy processing. Your A·S·A·P Case Manager will keep you informed throughout the process.

YORVIPATH is delivered via specialty pharmacy to your home address.

What If Your Application Is Denied?

If you are denied enrollment in the Ascendis Patient Assistance Program, you may reapply if you experience a change in circumstances that affects your eligibility. Changes might include:

• Loss of insurance coverage
• Significant decrease in income
• Change in employment status
• Approval or denial of other assistance programs (such as Medicaid or Medicare Extra Help)

Contact your A·S·A·P Case Manager or call 1-844-442-7236 to discuss your options.

Reauthorization and Ongoing Support

Your income and insurance eligibility will be periodically reconfirmed. If your insurance status or income changes, you may be deemed no longer eligible for the program. You must notify Ascendis immediately of any changes to ensure uninterrupted access to your medication.

Important Disclaimers

• By enrolling in the A.P.A.P., you certify that you meet the eligibility criteria and will comply with all terms and conditions. You agree not to seek reimbursement for any benefit received through this program.
• Ascendis Pharma reserves the right to rescind, revoke, or amend the A.P.A.P without notice at any time.
• Ascendis Pharma, in its sole discretion, can determine your participation in the program.
• This program is intended to provide assistance for patients using YORVIPATH for its approved indications only.
• Terms and conditions may change at any time.

Contact Information

Ascendis Patient Assistance Program

• Phone: 1-844-442-7236
• Email: info@ascendissupport.com

Specialty Pharmacies

• Orsini Specialty Pharmacy: 1-888-204-7802
• PANTHERx Rare Pharmacy: 1-888-379-1821