Your doctor prescribes SOMAVERT and, with your permission, submits your information on an SMN (Statement of Medical Necessity) and the insurance information they have in your file to the Pfizer Bridge Program®*.

Your Patient Care Consultant (PCC) contacts you to:

• Get any additional information that is needed

• Answer your insurance or reimbursement questions

You can help speed the process by having the following current information ready when your PCC calls:

• A copy of your insurance card, which you can get from your employer or insurance company

• The policy holder's name, address, and date of birth

Your PCC verifies your coverage and requests treatment authorization for SOMAVERT, if your insurance company allows. If your insurance company has approved the medicine, your PCC sends the prescription to the pharmacy, and the pharmacy contacts you to set up delivery of SOMAVERT directly to your home.

Your PCC will look for other ways to help get coverage, if your insurance benefits do not cover therapy with SOMAVERT. Your PCC may also help you appeal the decision. This means he or she asks your insurance company to extend your coverage to include SOMAVERT treatment.

Calls about insurance reimbursement are welcome during the hours of 9 AM to 7 PM Eastern Time at 1-800-645-1280.

*Certain programs and services powered by Pfizer RxPathways®.

Your PCC will look for other ways to help get coverage, if your insurance benefits do not cover therapy with SOMAVERT. Your PCC may also help you appeal the decision. This means he or she asks your insurance company to extend your coverage to include SOMAVERT treatment.

Calls about insurance reimbursement are welcome during the hours of 9 AM to 7 PM Eastern Time at 1-800-645-1280.

Financial support is available for eligible SOMAVERT patients.

Patients prescribed SOMAVERT can find help with navigating insurance coverage by calling the Pfizer Bridge Program at 1-800-645-1280. The program can help patients with Copay support for eligible commercially insured patients. Eligible patients pay as little as $5 for their monthly copay.

*Eligibility required. Annual savings up to $20,000. State and Federal Beneficiaries not eligible. Terms and conditions apply.

Learn More

Patient treatment support from the beginning.

Starting a new medicine can mean lots of questions—and, sometimes, hurdles to getting your treatment. That’s why Pfizer created the Pfizer Bridge Program®*. When you enroll in the Pfizer Bridge Program, you are assigned a Patient Care Consultant (PCC).

Learn more

Patients must be enrolled to access all IPSEN CARES support offerings.

1. Patient and HCP download the IPSEN CARES Enrollment Form and complete it at the office. The form is submitted electronically or by printing and faxing it to IPSEN CARES. The patient can also self-enroll.

2. Once a completed Enrollment Form is received, an IPSEN CARES Patient Access Specialist will conduct a benefits verification to review the patient’s out-of-pocket costs associated with the Ipsen medication. Additional support offerings for which the patient may be eligible will be discussed at that time.

Patients are required to sign the Somatuline Depot Patient Authorization form every 12 months to give the Patient Access Specialists at IPSEN CARES® permission to access the patient’s personal health information in order to help with treatment. The form can be signed and submitted online, or by downloadable PDF, which must be printed, filled out, signed, and faxed.

Patients/caregivers are required to sign the Somatuline Depot Patient Authorization form every 3 years or sooner if required by state law to give the Patient Access Specialists at IPSEN CARES® permission to access the patient’s personal health information in order to help with treatment. The form can be signed and submitted online, or by downloadable PDF, which must be printed, filled out, signed, and faxed.

Check for copay coverage. Considering that some patients need financial assistance, our copay assistance programs may help eligible* patients with the cost of their treatment.

The Somatuline Depot Copay Program for eligible, commercially insured and uninsured patients is available by enrolling in IPSEN CARES®. Here is the key information:

Patients may pay as little as $0 for their Somatuline Depot injection

For patients utilizing the Pharmacy Benefit, we will provide the virtual pharmacy copay card information on behalf of the patient directly to the specialty pharmacy being utilized

• For patients utilizing the Medical Benefit, we will send details for claims processing on behalf of the patient directly to the doctor’s office

• For patients who are eligible for government health benefits (eg, Medicare, Medicaid, TRICARE), IPSEN CARES may be able to offer the contact information for independent nonprofit foundations that may be able to offer financial assistance

Downloads:

• IPSEN CARES Copay Assistance Flashcard

• IPSEN CARES Patient Copay Flashcard