Regeneron’s Libtayo Surround Program

Patient Support Services Guide 2019


Libtayo Surround
877-542-8296

Regeneron Pharmaceuticals (and Sanofi Genzyme), through Libtayo Surround, offer a wide range of patient support and access services to eligible patients who have been prescribed Libtayo (cemiplimab-rwlc) injection.

Libtayo, an anti–PD-1 inhibitor, is indicated for the treatment of patients with metastatic cutaneous squamous-cell carcinoma or with locally advanced cutaneous squamous-cell carcinoma who are not candidates for curative surgery or for curative radiation (Table).

Libtayo Surround

Libtayo Surround offers comprehensive patient support services that facilitate access to Libtayo and helps navigate the insurance process, including:

  • Different levels of financial assistance for eligible patients
  • Assistance with access and reimbursement, such as benefits investigations, prior authorization, appeals support, and claims assistance
  • Medication support related to ordering Libtayo from authorized distributors or from a specialty pharmacy.

Libtayo Surround offers 2 financial assistance options for patients who are prescribed Libtayo.

Libtayo Surround Commercial Copay Program

The Libtayo Surround Commercial Copay Program helps commercially insured patients with out-of-pocket prescription costs, including copay, coinsurance, and insurance deductibles. Eligible patients may pay $0 in a 12-month period, with a cap of $25,000 annually.

Libtayo Surround Patient Assistance Program

The Libtayo Surround Patient Assistance Program provides Libtayo at no cost to eligible patients.

Libtayo Surround provides information about other potential sources of financial assistance to uninsured or underinsured patients who need assistance with their out-of-pocket prescription costs.

Eligibility

Libtayo Surround Commercial Copay Program

To qualify for the Libtayo Surround Commercial Copay Program, patients must:

  • Have commercial or private insurance that requires a drug-specific copayment, coinsurance, and/or deductible amount for Libtayo
  • Have a valid prescription for an FDA-approved indication for Libtayo
  • Not be participating in federal- or state-funded insurance programs
  • Reside in the United States or its territories
  • Be aged ≥18 years
  • Not seek reimbursement from their health insurance provider or from any third party.

This program has no income requirements. Enrollment in Libtayo Surround is necessary.

Libtayo Surround Patient Assistance Program

To receive Libtayo at no cost, patients must:

  • Be uninsured or lack coverage for Libtayo, or have Medicare Part B and no supplemental insurance coverage
  • Meet income requirements; that is, have an annual gross household income that does not exceed the greater of $100,000 or 500% of the federal poverty level
  • Be a resident of the United States or its territories
  • Be enrolled in Libtayo Surround.

Application & Enrollment

Libtayo Surround

Patients can enroll in Libtayo Surround by completing the Libtayo Surround Enrollment Form and faxing it to 833-853-8362.

Libtayo Surround Commercial Copay Program

Patients enrolled in Libtayo Surround are eligible to request support from the Libtayo Surround Commercial Copay Program. Documentation reflecting charges for a Libtayo purchase, as well as reimbursement from the payer (eg, Libtayo Surround Healthcare Provider Representation Form, Centers for Medicare & Medicaid Services 1500 or 1450 claim form, and an explanation of benefits form from the patient’s health insurer) must be submitted to Libtayo Surround; all requests for reimbursement must be submitted within 120 days from the date of service.

Libtayo Surround Patient Assistance Program

Patients enrolled in Libtayo Surround are eligible to request support from the Libtayo Surround Patient Assistance Program. The patient’s proof of income must be provided.

For more information about the patient support options and assistance with enrollment, call Libtayo Surround at 877-542-8296.

Table Regeneron Oncology Drug

Drug
Indications
Patient support programs

Drug
Libtayo (cemiplimab-rwlc) injection
Indication
Treatment of patients with metastatic CSCC or with locally advanced CSCC who are not candidates for curative surgery or for curative radiation

CSCC indicates cutaneous squamous-cell carcinoma.