KevzaraConnect^® provides eligible patients with support getting started with and saving on KEVZARA

Help your eligible patients get the support they need with the KevzaraConnect^® Copay Program and the Patient Assistance Program

KevzaraConnect^® Copay Program

Commercially eligible patients may pay as little as $0 per month for their KEVZARA, up to an annual maximum of $15,000, subject to additional terms and conditions.*

Eligibility

KEVZARA has been prescribed for an indication approved by the FDA
Patient is a resident of the 50 United States, the District of Columbia, or Puerto Rico
Patient has commercial insurance and is not covered under any government healthcare program

Enrollment

There are flexible options for enrollment and adjudication in the Copay Card Program.
Patients can enroll in the program and receive membership information by:

Enrolling in the Copay Card Program at KEVZARA.com/PMR-COPAY

Calling KevzaraConnect® at
1-844-KEVZARA
(1-844-538-9272)

*Approval is not guaranteed. Program has an annual maximum of $15,000. THIS IS NOT INSURANCE. Not valid for prescriptions paid, in whole or in part, by Medicaid, Medicare, VA, DOD, TRICARE, or other federal or state programs including any state pharmaceutical assistance programs. This program is not valid where prohibited by law, taxed or restricted. KevzaraConnect® reserves the right to rescind, revoke, terminate, or amend this offer, eligibility, and terms of use at any time without notice. Any savings provided by the program may vary depending on patients’ out-of-pocket costs. The program is intended to help patients afford KEVZARA. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the program. In those situations, the program may change its terms. Additional terms and conditions apply.

This program only applies to patients who are residents of the 50 United States, the District of Columbia, and Puerto Rico, are prescribed KEVZARA® (sarilumab) for an FDA-approved indication, and are insured and covered by a commercial health plan. This offer is not valid for prescriptions covered by or submitted for reimbursement under Medicaid, Medicare, VA, DOD, TRICARE, or similar federal or state programs including any state pharmaceutical assistance program. It is not an insurance benefit, and does not cover or provide support for supplies, procedures, or any physician-related services associated with KEVZARA. General, non-product specific insurance deductibles above the amount set forth above are also not covered. The maximum annual patient benefit under the Program is $15,000. Copay amounts after applying copay assistance may depend on the patient’s insurance plan and may vary. The Program is intended to help patients afford KEVZARA. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the Program. In those situations, the Program may change its terms. KevzaraConnect® reserves the right to rescind, revoke, terminate, or amend this offer, eligibility, and terms and conditions at any time without notice. Patients, pharmacists, and prescribers cannot seek reimbursement from health insurance or any third party for any part of the benefit received by the patient through this offer. This offer is not conditioned on any past, present or future purchase, including refills. The copay card is non-transferable, limited to one per person, and cannot be combined with any other offer or discount. This program is not valid where prohibited by law, taxed or restricted. Offer has no cash value. Program is not valid for cash paying customers. Questions or concerns about deductible, copay, or coinsurance amounts or the ability to obtain KEVZARA? Contact KevzaraConnect® at 1-844-KEVZARA.

Patient Instructions: KEVZARA must be covered by your commercial insurance. Program is not valid for cash paying customers. If your prescription is covered by insurance, you may need to notify the insurance carrier of redemption of this copay card. This offer is not valid for prescriptions covered by or submitted for reimbursement under Medicaid, Medicare, VA, DOD, TRICARE, or similar federal or state programs including any state pharmaceutical assistance program. This program is not valid where prohibited by law. By redeeming this coupon, you are certifying that (1) you are not a beneficiary of any government funded program as noted above; (2) should you begin receiving prescription benefits from any government funded program, you will withdraw from this program; and (3) you acknowledge and understand that adherence to the terms and conditions of this offer is necessary to ensure compliance with laws pertaining to any government funded program. For questions regarding your eligibility or benefits or if you wish to discontinue your participation, please call 1-844-KEVZARA.

Pharmacist Instructions: When you use this offer, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other government programs for this prescription. Pharmacist will comply with his/her obligations when processing the prescription for payment. By using this offer, you agree to the terms and conditions of this program. Copay cards must be accompanied by a prescription for KEVZARA. If primary commercial prescription insurance exists, input offer information as secondary coverage and transmit using the COB segment of the NCPDP transaction. Submit transaction to RxC Acquisition Company d/b/a RxCrossroads by McKesson using BIN #610524. Applicable discounts will be displayed in the transaction response. Acceptance of this offer and your submission of claims are subject to the Terms and Conditions posted at www.mckesson.com/mprstnc. For questions regarding setup, claim transmission, patient eligibility or other issues, call the LoyaltyScript® for KEVZARA program at 1-844-KEVZARA.

BY USING THIS COPAY CARD, YOU AND YOUR PHARMACIST UNDERSTAND AND AGREE TO COMPLY WITH THESE ELIGIBILITY REQUIREMENTS AND TERMS OF USE.

KevzaraConnect^® Patient Assistance Program

The Patient Assistance Program provides KEVZARA at no cost for up to 12 months to eligible uninsured, underinsured, and certain Medicare Part D patients if additional eligibility requirements are met, including household income limitations requirements

Enrollment

If you have patients who may meet eligibility requirements and would like to enroll in the program, download and complete the form below with patient signature and fax page 1 to KevzaraConnect® at 1-844-538-8960 or upload page 1 to the Patient Support Portal (www.patientsupportnow.org and enter code 8445388960).
For questions regarding the Patient Assistance Program, please call 1-844-KEVZARA.

Patient Assistance Program Application

Download application

KEVZARA Sample Program

Visit our sample portal for the following convenient services:

Order samples remotely once validated and through a few clicks—no phone calls, no emails, no texts
Choose between the KEVZARA 200-mg and 150-mg syringes
Close any outstanding Acknowledgement of Product (AOP) requirements by acknowledging receipt electronically

To register, simply click on the link below and provide your name, email, zip code, and HCP identifier (NPI, ME, or SLN). Your application will then be reviewed and, if approved, your account/email will then be validated and made active.

Request samples

KEVZARA Experience Voucher Program

To order a free, one-time, 30-day supply for your patient:

Download and complete the information on the voucher form below.

This free trial will be supplied through TheraCom. Vouchers and samples cannot be combined, and the voucher is not intended to address insurance delays and gaps in coverage. See terms and conditions on the form below.

Fax the completed voucher and a written 30-day prescription for KEVZARA to:
TheraCom Pharmacy
345 International Blvd, Ste 200
Brooks, KY 40109
Fax 888-261-4939 or call 855-417-7859

Inform the patient to expect a call from TheraCom within 2 business days to schedule delivery for a one-time, 30-day supply of KEVZARA.

QUESTIONS?
Call TheraCom at 855-417-7859.

KEVZARA Experience Voucher Form

Download form

Review national coverage

IMPORTANT SAFETY INFORMATION

WARNING: RISK OF SERIOUS INFECTIONS

Patients treated with KEVZARA are at increased risk for developing serious infections that may lead to hospitalization or death. Opportunistic infections have also been reported in patients receiving KEVZARA. Most patients who developed infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids.

Avoid use of KEVZARA in patients with an active infection.

Reported infections include:

Active tuberculosis, which may present with pulmonary or extrapulmonary disease. Patients should be tested for latent tuberculosis before KEVZARA use and during therapy. Treatment for latent infection should be initiated prior to KEVZARA use.
Invasive fungal infections, such as candidiasis, and pneumocystis. Patients with invasive fungal infections may present with disseminated, rather than localized, disease.
Bacterial, viral and other infections due to opportunistic pathogens.

Closely monitor patients for signs and symptoms of infection during treatment with KEVZARA. If a serious infection develops, interrupt KEVZARA until the infection is controlled.

Consider the risks and benefits of treatment with KEVZARA prior to initiating therapy in patients With chronic or recurrent infection.

CONTRAINDICATION

Do not use KEVZARA in patients with known hypersensitivity to sarilumab or any of the inactive ingredients.

WARNINGS AND PRECAUTIONS

Infections. Serious and sometimes fatal infections due to bacterial, mycobacterial, invasive fungal, viral, or other opportunistic pathogens have been reported in patients receiving immunosuppressive agents including KEVZARA. The most frequently observed serious infections with KEVZARA included pneumonia and cellulitis. Among opportunistic infections, TB, candidiasis, and pneumocystis were reported with KEVZARA.
- Hold treatment with KEVZARA if a patient develops a serious infection or an opportunistic infection.
- Patients with latent TB should be treated with standard antimycobacterial therapy before initiating KEVZARA. Consider anti-TB therapy prior to initiation of KEVZARA in patients with a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent TB but having risk factors for TB infection.
- Consider the risks and benefits of treatment prior to initiating KEVZARA in patients who have: chronic or recurrent infection, a history of serious or opportunistic infections, underlying conditions that may predispose them to infection, been exposed to TB, or lived in or traveled to areas of endemic TB or endemic mycoses.
- Viral reactivation has been reported with immunosuppressive biologic therapies. Cases of herpes zoster were observed in clinical studies with KEVZARA.
Laboratory Abnormalities. Treatment with KEVZARA was associated with decreases in absolute neutrophil counts (including neutropenia), and platelet counts; and increases in transaminase levels and lipid parameters (LDL, HDL cholesterol, and/or triglycerides). Increased frequency and magnitude of these elevations were observed when potentially hepatotoxic drugs (e.g., MTX) were used in combination with KEVZARA. Assess neutrophil count, platelet count, and ALT/AST levels prior to initiation with KEVZARA. Monitor these parameters 4 to 8 weeks after start of therapy and every 3 months thereafter. Assess lipid parameters 4 to 8 weeks after start of therapy, then at 6 month intervals.
Gastrointestinal Perforation. GI perforation risk may be increased with concurrent diverticulitis or concomitant use of NSAIDs or corticosteroids. Gastrointestinal perforations have been reported in clinical studies, primarily as complications of diverticulitis. Promptly evaluate patients presenting with new onset abdominal symptoms.
Immunosuppression. Treatment with immunosuppressants may result in an increased risk of malignancies. The impact of treatment with KEVZARA on the development of malignancies is not known but malignancies have been reported in clinical studies.
Hypersensitivity Reactions. Hypersensitivity reactions have been reported in association with KEVZARA. Hypersensitivity reactions that required treatment discontinuation were reported in 0.3% of patients in controlled RA trials. Injection site rash, rash, and urticaria were the most frequent hypersensitivity reactions. Advise patients to seek immediate medical attention if they experience any symptoms of a hypersensitivity reaction. If anaphylaxis or other hypersensitivity reaction occurs, stop administration of KEVZARA immediately. Do not administer KEVZARA to patients with known hypersensitivity to sarilumab.
Active Hepatic Disease and Hepatic Impairment. Treatment with KEVZARA is not recommended in patients with active hepatic disease or hepatic impairment, as treatment with KEVZARA was associated with transaminase elevations.
Live Vaccines. Avoid concurrent use of live vaccines during treatment with KEVZARA due to potentially increased risk of infections. No data are available on the secondary transmission of infection from persons receiving live vaccines to patients receiving KEVZARA.

ADVERSE REACTIONS

For Rheumatoid Arthritis: The most common serious adverse reactions were infections. The most frequently observed serious infections included pneumonia and cellulitis. The most common adverse reactions (occurred in at least 3% of patients treated with KEVZARA + DMARDs) are neutropenia, increased ALT, injection site erythema, upper respiratory infections, and urinary tract infections.
For Polymyalgia Rheumatica: Serious adverse reactions of neutropenia occurred in 2 patients (3.4%) in the KEVZARA group compared to none in the placebo group. The proportion of patients with serious infections was similar in the KEVZARA group (5.1%) compared to the placebo group (5.2%). The common adverse reactions occurring in ≥5% of patients treated with KEVZARA were neutropenia, leukopenia, constipation, rash pruritic, myalgia, fatigue, and injection site pruritus.

DRUG INTERACTIONS

Exercise caution when KEVZARA is co-administered with CYP substrates with a narrow therapeutic index (e.g. warfarin or theophylline), or with CYP3A4 substrates (e.g. oral contraceptives or statins) as there may be a reduction in exposure which may reduce the activity of the CYP3A4 substrate.
Elevated interleukin-6 (IL-6) concentration may down-regulate CYP activity such as in patients with RA and hence increase drug levels compared to subjects without RA. Blockade of IL-6 signaling by IL-6Rα antagonists such as KEVZARA might reverse the inhibitory effect of IL-6 and restore CYP activity, leading to altered drug concentrations.

USE IN SPECIFIC POPULATIONS

KEVZARA should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. Because monoclonal antibodies could be excreted in small amounts in human milk, the benefits of breastfeeding and the potential adverse effects on the breastfed child should be considered along with the mother's clinical need for KEVZARA.
Use caution when treating the elderly.

Advise patients to read the FDA-approved patient labeling (Medication Guide and Instructions for Use).

Please click here to see full Prescribing Information, including Boxed WARNING.

INDICATIONS

KEVZARA® (sarilumab) is indicated for treatment of adult patients with:

polymyalgia rheumatica (PMR) who have had an inadequate response to corticosteroids or who cannot tolerate corticosteroid taper.
moderately to severely active rheumatoid arthritis (RA) who have had an inadequate response or intolerance to one or more disease-modifying antirheumatic drugs (DMARDs).