Yupelri

Indicated For

COPD

About This Medication

# Viatris Patient Assistance Program Guide: How to Get YUPELRI at Low or No Cost ## About YUPELRI YUPELRI (revefenacin) is a prescription medication used to treat Chronic Obstructive Pulmonary Disease (COPD). It belongs to a class of drugs called anticholinergic bronchodilators, which work by relaxing the muscles around your airways to help you breathe easier. If your doctor has prescribed YUPELRI but you're concerned about the cost, the Viatris Patient Assistance Program may be able to help you obtain this medication at no cost or at a reduced price. ## What Is the Viatris Patient Assistance Program? The Viatris Patient Assistance Program is a free, confidential program offered by Viatris (the manufacturer of YUPELRI) to help uninsured and underinsured patients access their medications. Through this program, eligible patients can receive YUPELRI at little to no cost, regardless of their ability to pay. ## Who Can Apply? You may be eligible for the Viatris Patient Assistance Program if you meet the following criteria: - You are a U.S. resident - You have a valid prescription for YUPELRI from a licensed U.S. healthcare professional - You are **fully uninsured**, OR - You have health insurance but **no prescription drug coverage** (or your insurance does not cover YUPELRI) - You meet the financial need requirements based on your household income **Important Note:** If you have prescription drug insurance that covers YUPELRI, you generally cannot use this assistance program. However, you may be eligible for the YUPELRI Patient Savings Card, which offers copay assistance (see "Alternatives" section below). ## Income Eligibility Income eligibility varies based on household size and individual circumstances. The program uses flexible guidelines to assess financial need. While specific income thresholds are individualized, the program generally considers applicants with limited financial resources. During the application process, you'll provide information about your household income, and the program will determine your eligibility. If you're unsure whether you qualify, we recommend applying anyway. The program staff will review your situation and let you know if you're eligible. ## Required Documents To apply for the Viatris Patient Assistance Program, you'll need to gather the following documents: 1. **Completed PAP Application Form** — Available from the program website or by phone. Must be signed and dated. 2. **Valid Prescription** — An original or copy of your prescription from your doctor, dated within the past 12 months. 3. **Proof of Financial Need** — Examples include recent tax returns, pay stubs, bank statements, or a letter explaining your financial situation. 4. **Insurance Verification Documentation** — If you have insurance, proof that it does not cover prescription drugs or does not cover YUPELRI specifically (such as an insurance card, policy documents, or a letter from your insurance company). Make sure all documents are legible and include your name, date of birth, and contact information. ## How to Apply There are several ways to apply for the Viatris Patient Assistance Program: ### Online Application Visit the program website at https://www.viatris.com/en-us/lm/united-states/patient-assistance-program to complete and submit your application online. This is often the fastest method. ### Phone Application Call the Viatris Patient Assistance Program at **(800) 796-9526** to speak with a representative who can guide you through the application process over the phone. ### Fax Application Complete the PAP Application Form and fax it along with your supporting documents to **(877) 427-7290**. ### Mail Application You can also mail your completed application and documents to the address provided on the application form or available by calling the program. ## Application Timeline and What to Expect **Processing Time:** The program typically processes applications within **4-8 weeks**. You'll receive notification of your eligibility status by mail or phone. **Delivery:** If approved, YUPELRI will be delivered through a non-commercial pharmacy dispensing service, which means it will be shipped directly to you or your healthcare provider. You will not need to fill the prescription at a regular pharmacy. **What Happens Next:** Once approved, you'll receive instructions on how to receive your medication. The program will coordinate with your doctor's office to ensure the prescription is ready for dispensing. ## Reauthorization Your assistance is not permanent. **Annual reauthorization is required** to continue receiving YUPELRI through the program. You'll be notified when it's time to reapply. Make sure to start the reauthorization process before your current assistance expires so there's no gap in your medication supply. ## Before You Apply: Check Alternative Options Before applying to the patient assistance program, consider these alternatives: ### YUPELRI Patient Savings Card If you have insurance with prescription drug coverage, you may qualify for the **YUPELRI Patient Savings Card**, which can reduce your out-of-pocket copay costs. Visit https://www.yupelrihcp.com/access-and-coverage/yupelri-patient-savings-card for more information and to see if you're eligible. This card can save you money while using your existing insurance. ### State Pharmaceutical Assistance Programs Many states offer their own prescription assistance programs for residents. Contact your state's health department or pharmacy board to learn about programs available in your area. ### Other Resources Websites like NeedyMeds.org and Patient Advocate Foundation provide free information about additional assistance programs you may qualify for. ## What if Your Application Is Denied? If your application for the Viatris Patient Assistance Program is denied, don't lose hope. The program staff can explain why and may be able to help you explore other options, such as: - Reapplying if your circumstances have changed - Applying for the YUPELRI Patient Savings Card if you have insurance - Finding other assistance programs for which you may be eligible - Discussing lower-cost alternatives with your doctor Call **(800) 796-9526** to discuss your denial and learn about next steps. ## Privacy and Confidentiality The Viatris Patient Assistance Program keeps all your personal and medical information confidential. Your application and medical records are protected under federal privacy laws. ## Questions? If you have questions about the application process or your eligibility, contact the Viatris Patient Assistance Program: - **Phone:** (800) 796-9526 - **Fax:** (877) 427-7290 - **Website:** https://www.viatris.com/en-us/lm/united-states/patient-assistance-program The program staff are available to help answer your questions and guide you through the process. ## Legal Disclaimer This guide is for informational purposes only and does not constitute medical advice. The Viatris Patient Assistance Program is subject to change at any time. For the most current information about eligibility, requirements, and application procedures, please visit the official program website or contact the program directly. Always consult with your healthcare provider regarding your medication and treatment options. This guide does not replace official program documentation or communications from Viatris.

Program information last verified: March 25, 2026