ZYMFENTRA

Indicated For

Crohn's disease, Ulcerative Colitis

About This Medication

# Celltrion CONNECT Patient Assistance Program Patient Guide: How to Get ZYMFENTRA (infliximab-dyyb) at Low or No Cost ZYMFENTRA (infliximab-dyyb) is a prescription biologic medicine used to treat certain inflammatory conditions like Crohn's disease and ulcerative colitis in adults. The **Celltrion CONNECT Patient Assistance Program (PAP)** helps eligible uninsured or functionally uninsured patients get **ZYMFENTRA** for free by covering the full cost of the medication.[1][2] ## About ZYMFENTRA **ZYMFENTRA** is an infliximab biosimilar, administered as a subcutaneous injection at home after initial doses. It works by blocking tumor necrosis factor (TNF), a protein that causes inflammation in autoimmune diseases. Always follow your doctor's instructions for use, dosing, and monitoring for side effects like infections or infusion reactions. This guide focuses on accessing the drug affordably through PAP—not medical advice.[1] ## Who Qualifies for the Program? The program targets patients facing financial hardship who cannot afford **ZYMFENTRA**. Key qualifications include: - **Uninsured or functionally uninsured**: No insurance coverage, or your insurance denies **ZYMFENTRA** after one level of appeal (you pay 100% out-of-pocket).[1][2][5] - **No government insurance**: Excludes Medicare, Medicaid, TRICARE, or similar programs.[1] - **Valid prescription**: From a licensed healthcare provider (HCP) for an approved use.[1][5] - **Income-based eligibility**: While specific Federal Poverty Level (FPL) thresholds aren't listed for **ZYMFENTRA**, Celltrion programs often use <400% FPL. Income is verified electronically (eIV); if that fails, provide proof like W-2s, tax returns (1040/1099), pay stubs, or benefit letters. No asset test.[3][5] - **U.S. resident**: Program serves U.S. patients only. Patients must report changes in income or insurance promptly. Enrollment lasts a **rolling 12 months** from approval, with electronic checks every 6 months.[1][3] ## Income Eligibility Breakdown Exact income limits for **ZYMFENTRA** PAP aren't specified, but similar Celltrion programs cap at **<400% FPL**. Use this table for 2026 estimates (adjust for household size; check current FPL at HHS.gov). Provide proof if eIV doesn't confirm. | Household Size | 100% FPL | 400% FPL (Typical Max) | |---------------|----------|-------------------------| | 1 | $15,060 | $60,240 | | 2 | $20,440 | $81,760 | | 3 | $25,820 | $103,280 | | 4 | $31,200 | $124,800 | | +1 per person | +$5,380 | +$21,520 | *Notes: Annual household income. Electronic verification preferred; manual proof required otherwise. Excludes government-insured patients.[3][5]* ## Insurance Requirements - **Uninsured**: No health insurance at all.[1][2] - **Functionally uninsured**: Insurance exists, but **ZYMFENTRA** is excluded (100% patient cost) after **one appeal denial**. Program assists with prior authorizations/appeals.[1][4] - **Exclusions**: Medicare, Medicaid, VA, TRICARE, or other federal programs disqualify you. Do not seek reimbursement from any plan, FSA, or HSA for PAP meds.[1][3] - Program runs **eBV** (electronic benefits verification) every 6 months.[1] ## Step-by-Step Application Process 1. **Confirm eligibility**: Discuss with your HCP. Get a valid **ZYMFENTRA** prescription.[1] 2. **Gather documents**: - Proof of no/functional uninsured status (insurance denial letter after one appeal).[1] - Income proof (if requested: W-2, tax return, 3 pay stubs, etc.).[5] - Prescription.[1] - HCP certification (income, diagnosis, consent).[1] 3. **Get the form**: Download from [Celltrion CONNECT](https://www.celltrionconnect.com/static-assets/uploads/US-ZYM-24-00045_ZYM_PAP-App__DIGI_L04.pdf).[1] 4. **Complete and submit**: - Patient, HCP sign. - Fax or mail (details on form). - Call **(877) 812-6662** (Mon-Fri 8AM-8PM ET) for help.[1] 5. **Program reviews**: Verifies info, runs eIV/eBV. May request more docs.[1] **Multiple methods**: Online form, phone, fax.[1] ## Timeline and Delivery - **Processing time**: Not specified; typically weeks. Call for status.[1] - **Approval**: Rolling 12-month period. Reauthorization needed annually.[1][5] - **Delivery**: Free **ZYMFENTRA** shipped to your home or HCP's office.[1] - Track via phone; report changes immediately.[1] ## Alternatives if Denied - **Appeal denial**: Contact program for reasons; resubmit docs.[1] - **Co-pay programs**: For commercially insured, check Celltrion CONNECT co-pay support.[4][8] - **Other assistance**: Benefits investigation, prior auth help.[1][9] - **Foundations**: Patient Access Network (PAN), HealthWell—check eligibility separately. - **Biosimilars**: No listed alternatives for **ZYMFENTRA**.[1] - Call **(877) 812-6662** for personalized options.[1] ## Important Disclaimer This guide is for informational purposes based on available program details as of 2026. Eligibility, terms, and forms can change—verify with Celltrion CONNECT at (877) 812-6662 or www.CelltrionConnect.com. Not medical/financial advice. Consult your HCP/ advisor. Program may end or modify without notice. Do not use PAP meds for reimbursement elsewhere.[1][3] (Word count: 942)

Program information last verified: March 30, 2026