We’re Here to Support Your Eligible Patients During Treatment
Our mission is to help your patients start and stay on therapy by assisting with access and as-needed support.
PEMAZYRE is dispensed by Biologics by McKesson specialty pharmacy.
Biologics will work with you and your patient to provide therapeutic expertise and individualized support.
For Eligible Patients, Our Team Can Provide:
- Benefits verification and as-needed prior authorization or appeal support
- Pharmacy outreach call to help patients get started on treatment
- Flexibly scheduled support calls from a pharmacy care team specialist
- Treatment history and medication monitoring
- Text message refill reminders
- Education and support resources
- Information about financial assistance options
Enroll Your Eligible Patients in IncyteCARES for PEMAZYRE
Completing the IncyteCARES for PEMAZYRE enrollment form takes about 15 minutes.
Simply complete the online enrollment form or download and fax the print enrollment form.
Biologics will conduct a benefits verification and contact your patient to coordinate delivery of the filled prescription.
Contact Us
Call IncyteCARES for PEMAZYRE at 1-855-452-5234,
Financial Assistance Options for Your Patients
For Eligible Patients With Commercial Prescription Insurance
IncyteCARES for PEMAZYRE Savings Program
IncyteCARES for PEMAZYRE Savings Program
Eligible patients can receive PEMAZYRE for as little as $0 out-of-pocket cost, subject to certain limits*
To qualify, patients must:
- Have commercial prescription drug coverage. Patients insured under federal or state government prescription drug programs—including Medicare Part D, Medicare Advantage, Medicaid, or TRICARE—are not eligible. Patients without prescription drug coverage are also not eligible
- Be a resident of the United States or a US territory
- Have a valid prescription for PEMAZYRE for an FDA-approved use
*Uninsured, cash-paying, or Alternate Funding Program (AFP) patients are not eligible. Not valid for patients insured through Medicare Part D, Medicare Advantage, Medicaid, TRICARE, or any state medical or pharmaceutical assistance program. Patient enrollment in a copay adjustment program, such as a maximizer or accumulator program, may impact the value of this offer. Annual benefit maximum applies, as may other restrictions. Valid prescription for PEMAZYRE® (pemigatinib) for an FDA-approved indication or compendia-recognized use is required. Please see the full Patient Terms and Conditions or call IncyteCARES for PEMAZYRE at 1-855-452-5234. Update effective as of January 1, 2024.
*Uninsured, cash-paying, or Alternate Funding Program (AFP) patients are not eligible. Not valid for patients insured through Medicare Part D, Medicare Advantage, Medicaid, TRICARE, or any state medical or pharmaceutical assistance program. Patient enrollment in a copay adjustment program, such as a maximizer or accumulator program, may impact the value of this offer. Annual benefit maximum applies, as may other restrictions. Valid prescription for PEMAZYRE® (pemigatinib) for an FDA-approved indication or compendia-recognized use is required. Please see the full Patient Terms and Conditions or call IncyteCARES for PEMAZYRE at 1-855-452-5234. Update effective as of January 1, 2024.
To enroll a patient, you can either:
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Contact IncyteCARES for PEMAZYRE at 1-855-452-5234, Monday through Friday, 8 AM–8 PM ET to enroll your qualifying patient.
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Complete an application at IncyteCARESsavings.PEMAZYRE.com.
Once you submit it, a patient membership number is immediately issued and accessible by Biologics, the specialty pharmacy for PEMAZYRE. Your patient can begin receiving their PEMAZYRE for as little as $0 out-of-pocket cost right away.
For Eligible Patients Who Are Uninsured or Underinsured for PEMAZYRE
IncyteCARES for PEMAZYRE Patient Assistance Program
IncyteCARES for PEMAZYRE Patient Assistance Program
Eligible patients can receive medication free of charge†
The IncyteCARES for PEMAZYRE Patient Assistance Program (PAP) helps eligible patients who do not have prescription drug insurance or who have trouble affording their out-of-pocket costs for PEMAZYRE. No purchase contingencies or other obligations apply.
To qualify, patients must:
- Be confirmed as eligible and enrolled in IncyteCARES for PEMAZYRE
- Be a resident of the United States or a US territory
- Have a valid prescription for PEMAZYRE for an FDA-approved use
Meet one of these 3 criteria: Uninsured
- Have no prescription drug coverage and meet household income criteria
Underinsured‡
- Have Medicare Part D and meet household income criteria
- Have Medicare Part D and meet household income criteria
- Have any other type of prescription drug insurance (commercial, Medicaid, etc) but have exhausted or been denied coverage for PEMAZYRE and meet household income criteria
How to enroll your patients:
Enroll online or download, complete, and submit the IncyteCARES for PEMAZYRE form.
If you’re not able to provide the patient’s required income information and/or authorization on the form, a program representative will contact the patient by phone to gather this information.
Within 2 business days of receiving the IncyteCARES for PEMAZYRE form, patients are notified of "conditional approval" for the program. This allows them to receive free medication for 90 days. Full approval is only granted once your patient’s proof of income is submitted and confirmed.†
†Terms and conditions apply. Terms of this program may change at any time.
‡Patients who are enrolled in an Alternate Funding Program (AFP) are not eligible to receive free drug.
For Patients Whose Insurance Coverage Is Delayed
IncyteCARES for PEMAZYRE Temporary Access Program
IncyteCARES for PEMAZYRE Temporary Access Program
Eligible patients receive a free short-term supply of medication§
If a patient’s prescription drug insurer requires more than a 5-day wait for determining coverage approval, we may be able to provide a free short-term supply of PEMAZYRE in the meantime. To be eligible, the patient must submit a proof of insurance claim verifying the delay. Free product is offered to eligible patients without any purchase contingency or other obligation.
To qualify, the patient must:
- Have commercial prescription drug coverage or a healthcare exchange plan. Patients insured under federal or state government prescription drug programs—including Medicare Part D, Medicare Advantage, Medicaid, or TRICARE—are not eligible. Patients without prescription drug coverage are also not eligible
- Be a resident of the United States or a US territory
- Have a valid prescription for PEMAZYRE for an FDA-approved use
- Provide proof of the coverage delay. This may be a notice you or your patient receive from the insurance company
§Terms and conditions apply. Terms of this program may change at any time.
How to enroll your patients:
Enroll online or download, complete, and submit the IncyteCARES for PEMAZYRE form.
Indications and Usage
PEMAZYRE is indicated for the treatment of adults with previously treated, unresectable locally advanced or metastatic cholangiocarcinoma with a fibroblast growth factor receptor 2 (FGFR2) fusion or other rearrangement as detected by an FDA-approved test.
This indication is approved under accelerated approval based on overall response rate and duration of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial(s).
PEMAZYRE is indicated for the treatment of adults with relapsed or refractory myeloid/lymphoid neoplasms (MLNs) with FGFR1 rearrangement.
Practice Resources: ICD-10 Codes for PEMAZYRE
The following codes are from the International Classification of Diseases, 10th Revision (ICD-10), which have been in effect since October 1, 2015.
Disease State
PEMAZYRE
Intrahepatic Bile Duct Carcinoma
C22.1
Malignant Neoplasm of Extrahepatic Bile Duct
C24.0
Myeloid/Lymphoid Neoplasms With Eosinophilia and Tyrosine Kinase Fusion
C94.80, C94.81, C94.82, C95.10, C95.11, C95.12, C96.Z, C96.9
Incyte has provided these codes as background information. They are some of the available ICD-10-CM codes that relate to these disease states. They are not intended to encourage or address the use of any specific ICD-10-CM codes for individual patients. Using the codes provided does not guarantee or support payment, coverage, or reimbursement decisions.
For more information about ICD-10 codes, visit CMS.gov.
Forms
IncyteCARES for PEMAZYRE Form (PDF)
Complete this form to:
- Enroll your patients in either the IncyteCARES for PEMAZYRE Patient Assistance Program or Temporary Access Program
- Write a prescription for PEMAZYRE to submit by fax
Letter of Medical Necessity (PDF)
Some payers require documentation of medical necessity for certain medications before approving coverage. This sample letter, with fillable fields, can be used for this requirement.
Letter of Appeal (PDF)
This sample letter, with fillable fields, can be used to appeal an insurer’s denial of coverage for an Incyte medication.