Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
 

Ixinity Patient Assistance Program

This program provides brand name medications at no or low cost

Provided by: Aptevo Therapeutics


TEL: 855-494-6489


Languages Spoken:

English

Program Website

 

Patient Assistance Applications

Ixinity Patient Assistance Application: Contact program

Ixinity Free Trial Request Form: Contact program

 

Brand Name Medications Covered

 
  • Ixinity
 

Generic Name

 
  • coagulation factor IX (recombinant)
 

Eligibility Requirements   

Insurance Status Must have no prescription coverage
Those with Part D Eligible? No
Income At or below 300% of FPL
Diagnosis/Medical Criteria Not disclosed
US Residency Required? Must be US citizen or legal entrant
   

Application

Obtaining Call or download from Programs website
Receiving Faxed or downloaded from website
Returning Fax
Doctor's Action Complete section, sign, attach required documents
Applicant's Action Call for information or inform doctor that he/she is in need
Decision Communicated Not specified
Decision Timeframe Not specified
   

Medication

Amount/Supply Not specified
Sent To Not specified
Delivery Time Not specified
Refill Process Not specified
Limit Not specified
Re-application Not specified
   

Additional Information


Updated August 22, 2017