Patient Guide to Support Services

Agios Pharmaceuticals

myAgios Patient Support Services
844-409-1141

Agios Pharmaceuticals offers the myAgios Patient Support Services, a program that provides a suite of support services for patients who have been prescribed Tibsovo (ivosidenib).

Tibsovo is indicated for the treatment of adults with relapsed or refractory acute myeloid leukemia and a susceptible IDH1 mutation, as detected by an FDA-approved test (Table).

myAgios Patient Support Services

The myAgios Patient Support Services program provides several services for patients who have been prescribed Tibsovo, including:

  • Financial assistance for patients who are commercially insured, uninsured, or underinsured
  • Support with insurance coverage and reimbursement
  • Access to Tibsovo via the Agios distribution network.

myAgios Patient Support Services includes 4 financial assistance programs, as described below.

Commercial $25 Co-Pay Program

The Commercial $25 Co-Pay Program is designed for eligible patients with commercial or private insurance, lowering their copay to no more than $25 per Tibsovo prescription, with a maximum benefit of $25,000 annually.

Patient Assistance Program

The Patient Assistance Program provides free Agios medication for eligible uninsured and underinsured patients with commercial or government insurance. Uninsured or underinsured patients may also be eligible for assistance from independent foundations (as determined by the individual foundation), a referral to which may be provided by myAgios or by network specialty pharmacies.

Quick Start Program

The Quick Start Program provides a free 14-day supply of Tibsovo to eligible patients who have commercial or government insurance and are experiencing coverage delays.

Coverage Interruption Program

The Coverage Interruption Program provides a free 30-day supply of Tibsovo for eligible, commercially insured patients who experience an interruption in coverage.

Eligibility

Commercial $25 Co-Pay Program

To enroll in the Commercial $25 Co-Pay Program, patients must:

  • Have commercial or private ­insurance
  • Not be participating in federal or state-funded healthcare insurance programs, including Medicare, Medicaid, Medigap, Tricare, Veterans Affairs
  • Not seek reimbursement for Tibsovo from a third-party payer.

This program has no income restrictions, and enrollment in the myAgios Patient Support Services program is not required; healthcare providers can apply on behalf of their patients at myAgios­copay.com.

Patient Assistance Program

To be eligible for the Patient Assistance Program, patients must:

  • Meet the program’s financial and eligibility requirements
  • Be uninsured or underinsured with commercial or government insurance
  • Reside in the United States, including Puerto Rico.

If approved, patients must reapply each calendar year and continue to meet the eligibility requirements.

Quick Start Program

Patients may be eligible to receive a free 14-day prescription of Tibsovo, allowing for 3 refills, for a total of 56 days. To qualify for the Quick Start Program, patients must:

  • Have commercial or government insurance that has been delayed by 5 or more business days after submission of a completed prior authorization request
  • Have been newly prescribed Tibsovo
  • Reside in the United States, including Puerto Rico
  • Have been diagnosed with relapsed or refractory acute myeloid leukemia and a confirmed IDH1 mutation
  • Be aged ≥18 years.

This program will end after insurance coverage approval is obtained. The Tibsovo prescription will then be filled by a network specialty pharmacy, or by an office- or hospital-­based pharmacy.

Coverage Interruption Program

Patients may be eligible to receive a free 30-day prescription of Tibsovo, allowing for 2 refills, for a total of 90 days. To be eligible for the Coverage Interruption Program, patients must:

  • Reside in the United States, including Puerto Rico
  • Be prescribed Tibsovo
  • Have had at least 1 previous prescription filled with commercial insurance coverage
  • Not be participating in federal or state health insurance programs.

This program will end after the patient’s insurance coverage is approved. The Tibsovo prescription will then be filled by a network specialty pharmacy, or by an office- or hospital-based pharmacy.

Application & Enrollment

Enrollment in the myAgios Patient Support Services program is required to obtain several services, including a benefits investigation, enrollment in free drug programs, and prescription fulfillment. To enroll in the myAgios Patient Support Services program, patients must complete the enrollment form. The form includes sections relevant to the patient and the treating physician, including confirmation of diagnosis; financial verification may be required for enrollment in the Patient Assistance Program, including a copy of recent tax returns or other proof of income.

The completed forms and supporting documents must be faxed to 844-409-1143; if sending the completed forms directly to a network specialty pharmacy, the specialty pharmacy will coordinate with myAgios to determine eligibility and provide support services.

Enrollment in the myAgios Patient Support Services program is not needed for participation in the Commercial $25 Co-Pay Program.

Table Agios Oncology Drug

Drug
Indication
Patient support programs

Drug
Tibsovo (ivosidenib)
Indication
Treatment of adults with relapsed or refractory acute myeloid leukemia and a susceptible IDH1 mutation, as detected by an FDA-approved test

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