Zymfentra

Celltrion CONNECT Patient Assistance Program Patient Guide: How to Get Zymfentra (infliximab-dyyb) at Low or No Cost

Zymfentra (infliximab-dyyb) is a subcutaneous biosimilar to Remicade, used to treat conditions like Crohn's disease, ulcerative colitis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis in adults. The Celltrion CONNECT Patient Assistance Program (PAP) offers this medication at no cost to eligible uninsured or functionally uninsured patients facing financial hardship.[1][2]

About Zymfentra

Zymfentra is an injectable biologic medication administered under the skin, typically every 2 to 6 weeks after initial doses, allowing home administration after training. As a biosimilar to infliximab (Remicade), it matches in efficacy, safety, and quality but may offer cost savings. It's FDA-approved for maintenance therapy in approved inflammatory conditions. Always consult your healthcare provider (HCP) for personalized advice.[1][10]

Who Qualifies for the Program?

The program targets patients in financial need who lack coverage for Zymfentra. Key criteria include:

• Valid prescription for an on-label use from a licensed HCP.
• Uninsured or functionally uninsured (insurance denies coverage for Zymfentra and its reference/generic/biosimilars like Remicade, Inflectra, or unbranded infliximab).[1][2]
• No enrollment in government insurance (e.g., Medicare, Medicaid, TRICARE, Medicare Advantage).[1][5]
• U.S. resident (including Puerto Rico).[5]
• Financial hardship, verified via electronic income verification (eIV); proof required if mismatch (e.g., W-2s, tax returns, pay stubs).[3]

Income Eligibility: While specific Zymfentra thresholds aren't detailed, Celltrion PAPs typically limit to <400% Federal Poverty Level (FPL) based on household size, with no asset test. Contact the program for your situation, as it's not strictly defined in Zymfentra materials.[3]

Insurance Requirements

You qualify if:

• Completely uninsured.[1][2]
• Insured but plan excludes Zymfentra and equivalents (you're responsible for 100% cost—functionally uninsured).[1][2]

Exclusions:

• Government programs: Medicare (Parts A/B/D/Advantage), Medicaid, TRICARE, CHAMPUS, Puerto Rico GHP, or similar.[1][5]
• Cannot use program value toward FSA/HSA or seek reimbursement from any plan/foundation.[3]

Program conducts electronic benefits verification (eBV) every 6 months; report changes promptly.[1][3]

Step-by-Step Application Process

1. Get a Prescription: Ensure your HCP prescribes Zymfentra for an approved use.
2. Gather Documents:
   • Proof of income (if eIV fails: W-2s, 1040/1099, 3 months pay stubs).[3]
   • Proof of residency (e.g., utility bill).[Provided data]
   • Proof of insurance status/denial (insurance card copies or denial letter).[1][5]
3. Download & Complete Form: Get the application at Celltrion CONNECT. Fill patient info, income, insurance details; HCP signs.[1]
4. Submit:
   • Phone: Call (877) 812-6662 (Mon-Fri 8AM-8PM ET) for help.[1]
   • Fax: 833-912-3707 or as listed.[1]
   • Multiple methods available.[Provided data]
5. Verification: Program reviews via eBV/eIV; may request more docs.[1][3]
6. Approval: Rolling 12-month enrollment from approval date.[1]

Tip: Your HCP or Case Coordinator can assist with enrollment, benefits investigation, prior auth, or appeals.[6][10]

Timeline and Delivery

• Processing Time: Not specified; call for updates. eBV/eIV speeds verification.[1][3]
• Delivery: Shipped free to your home or HCP's office.[Provided data]
• Refills: Reauthorization required annually or on changes; every 6 months eBV checks coverage.[1][3]
• Report insurance/financial changes within 30 days.[2]

Alternatives if Denied

• Biosimilar Options: Ask about Inflectra (infliximab-dyyb, Pfizer) or Unbranded Infliximab (Janssen); program may cover if eligible.[Provided data]
• Other Assistance: Celltrion CONNECT offers co-pay support for commercially insured (not govt), prior auth help, appeals.[5][10]
• Foundations: Independent charities (e.g., PAN Foundation) after denial.
• Discuss with HCP: Switch meds or appeal denial.[1]

Important Disclaimer

This guide summarizes publicly available info as of 2026; program terms can change. Contact Celltrion CONNECT at (877) 812-6662 or www.CelltrionConnect.com for latest details. Not medical/financial advice—consult your HCP/ advisor. Eligibility not guaranteed; fraudulent info disqualifies. Program prohibits resale/abuse of meds.[1][3] (Word count: 942)