ZEVTERA

Indicated For

Staphylococcus aureus bloodstream infections (SAB), acute bacterial skin and skin structure infections (ABSSSI), community-acquired bacterial pneumonia (CABP)

About This Medication

# ZEVTERA Patient Guide: How to Get ZEVTERA at Low or No Cost ZEVTERA (ceftobiprole medocaril sodium) is a hospital-administered antibiotic used to treat serious bacterial infections, and while La Jolla Pharmaceutical Company (through Innoviva Specialty Therapeutics) does not currently offer a dedicated patient assistance program, several pathways exist to reduce or eliminate costs for eligible patients[1][2][3][6]. This guide explains eligibility options, application steps, and alternatives to help you access this important medication affordably. ## About ZEVTERA **ZEVTERA** is an advanced-generation cephalosporin antibiotic approved by the FDA in April 2024 for treating specific serious infections in adults and children[2][3][5]. It targets **Staphylococcus aureus bloodstream infections (SAB)**, including right-sided endocarditis caused by methicillin-susceptible (MSSA) or methicillin-resistant (MRSA) strains—the first new therapy for MRSA-related SAB in nearly 20 years[2]. It is also indicated for **acute bacterial skin and skin structure infections (ABSSSI)** and **community-acquired bacterial pneumonia (CABP)** in adults and pediatric patients aged 3 months to under 18 years[3]. Administered intravenously in hospitals, typical adult dosing is 667 mg every 6-8 hours depending on the infection and treatment phase (e.g., every 6 hours on Days 1-8 for SAB, then every 8 hours)[3]. ZEVTERA combats infections proven or strongly suspected to be caused by susceptible bacteria, filling a critical gap in treating resistant strains like MRSA[1][2]. As a newer drug, it may carry high costs, but assistance options can help[6]. ## Who Qualifies for Assistance? No manufacturer-sponsored patient assistance program (PAP) with specific income thresholds is listed for ZEVTERA from La Jolla Pharmaceutical Company[1][3]. However, patients may qualify through third-party programs, government aid, or hospital resources. Key pathways include: - **Patient Advocate Foundation (PAF) Co-Pay Relief Program**: Helps underinsured patients cover co-pays, co-insurance, and deductibles for ZEVTERA[6]. - **State Medicaid Programs**: Often cover full costs for low-income patients; eligibility varies by state[6]. - **Manufacturer Inquiry**: Contact La Jolla or Innoviva to ask about unlisted expanded access or compassionate use[1][6][7]. - **Hospital or Distributor Support**: ZEVTERA is distributed via specialty pharmacies like Cardinal Health and McKesson, which may offer billing assistance[1]. Qualification generally requires U.S. residency, a valid prescription for an FDA-approved indication, and proof of financial need. Medicare Part D or commercial insurance patients may access co-pay help if income-qualified[6]. ## Income Eligibility Breakdown Specific income limits are not defined by a ZEVTERA PAP, but common benchmarks from similar programs like PAF apply. Assistance often targets incomes at or below **300-400% of the Federal Poverty Level (FPL)**, adjusted for household size and Cost of Living Index (COLI)[6]. Here's a table of approximate 2026 FPL guidelines (based on standard U.S. HHS updates; verify current figures at healthcare.gov): | Household Size | 300% FPL | 400% FPL | |----------------|----------|----------| | 1 (Individual) | $45,180 | $60,240 | | 2 (Couple) | $61,320 | $81,760 | | 3 | $77,460 | $103,280| | 4 | $93,600 | $124,800| *Add ~$16,140 (300%) or ~$21,520 (400%) per additional person. These are estimates; PAF considers household size and COLI[6]. Medicaid thresholds are typically lower (100-138% FPL by state). Always confirm with the program.* ## Insurance Requirements Most assistance requires some insurance coverage; fully uninsured patients should pursue Medicaid first[6]. - **Commercial Insurance**: PAF covers co-pays/deductibles if income ≤400% FPL and you have ZEVTERA coverage[6]. - **Medicare**: Part D enrollees may qualify for PAF if income-eligible; Extra Help (LIS) provides low-income subsidies (apply via SSA.gov)[6]. Medicare does not cover drugs like ZEVTERA if administered in-hospital (Part A), but outpatient use may fall under Part D. - **No Insurance**: Apply for Medicaid or state programs; contact manufacturer for potential free drug[6]. Hospitals often bill insurance directly; discuss prior authorization with your provider[1]. ## Step-by-Step Application Process 1. **Get Your Prescription**: Ensure your doctor prescribes ZEVTERA for an approved use (SAB, ABSSSI, CABP)[3]. Discuss hospital administration, as it's IV-only[1]. 2. **Check Insurance Coverage**: Contact your insurer for prior auth and cost estimates. 3. **Apply for PAF Co-Pay Relief**: - Visit copays.org or call 866-512-3861[6]. - Submit proof of insurance, income (tax returns, pay stubs), diagnosis, and treatment plan. - Approval grants direct payments to providers. 4. **Explore Medicaid/State Aid**: - Go to healthcare.gov or your state Medicaid site; select your state for application[6]. - Provide income docs, ID, and prescription. 5. **Contact Manufacturer/Distributors**: - Call La Jolla (via zevtera.com) or distributors (e.g., Cardinal: 1-866-677-4844)[1]. - Ask: 'Do you offer PAP, compassionate use, or free drug for uninsured patients?' 6. **Hospital Financial Aid**: Request charity care or payment plans from your facility. ## Timeline and Delivery Processing varies: - **PAF**: 1-2 weeks post-submission[6]. - **Medicaid**: 45 days max for standard, 15 days expedited[6]. - **Manufacturer**: Case-by-case, potentially days if urgent. ZEVTERA is delivered to hospitals via distributors (e.g., McKesson: 1-800-482-6700); patients don't receive it at home[1]. Expect hospital infusion; track via your care team. ## Alternatives if Denied - **Appeal Denials**: Resubmit with more docs or appeal to Medicaid/insurer. - **Other Coupons/Discounts**: Use sites like nowpatient.com for up to 90% off via cards (limited for hospital drugs)[6]. - **Biosimilars/Alternatives**: None listed for ZEVTERA; discuss generics like vancomycin for MRSA with your doctor[3]. - **NeedyMeds/PAN Foundation**: Check for co-pay aid (866-512-3861)[6]. - **Clinical Trials**: Inquire via zevtera.com for research access[1]. ## Disclaimer This guide is for informational purposes only and not medical/financial advice. Eligibility, availability, and terms change; verify with programs directly. ZEVTERA is prescription-only—consult your healthcare provider. La Jolla/Innoviva details current as of latest data; no guaranteed PAP exists[1][3][6]. 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Program information last verified: March 30, 2026