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

Provided by: CSL Behring


TEL: 800-676-4266


Languages Spoken:

English

Program Website

 

Patient Assistance Applications

CSL Behring Care Coordination Center: Contact program

 

Brand Name Medications Covered

 
  • Afstyla
  • Kcentra
  • Berinert vial; single-use
  • Monoclate-P vial; single-use
  • Carimune NF injection
  • Mononine vial; single-use
  • Corifact injection
  • Privigen vial; single-use
  • Helixate FS vial
  • RiaSTAP injection
  • Hizentra vial; single-use 20%
  • Stimate spray; nasal
  • Humate-P vial
  • Zemaira vial
  • Idelvion
 

Generic Name

 
  • alpha1-proteinase inhibitor (human) vial
  • factor IX vial; single-use
  • antihemophilic factor (human) vial; single-use
  • factor xiii concentrate (human) injection
  • antihemophilic factor (recombinant)
  • fibrinogen concentrate (human) injection
  • antihemophilic factor (recombinant) vial
  • immune globulin; intravenous (human) injection
  • antihemophilic factor/von willebrand factor complex (human) vial
  • immune globulin; intravenous (human) vial; single-use
  • C1 esterase inhibitor vial; single-use
  • immune globulin; subcutaneous vial; single-use 20%
  • coagulation factor IX (recombinant), albumin fusion protein
  • prothrombin complex concentrate (human)
  • desmopressin acetate spray; nasal
 

Eligibility Requirements   

Insurance Status Determined case by case
Those with Part D Eligible? No
Income Not disclosed
Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
US Residency Required? Must be citizen or legal resident
   

Application

Obtaining Call. *See Additional Information section below
Receiving Faxed or mailed
Returning Fax
Doctor's Action Will be discussed with patient and Doctor after request is received
Applicant's Action Call for information or inform doctor that he/she is in need
Decision Communicated Decision made during phone screening
Decision Timeframe Not specified
   

Medication

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

Additional Information

Since drug availability changes based on inventory, call to make sure requested drug is available.

This program lists medications that may be covered under a different CSL Behring savings program: Contact Program for more details
*877-355-4447: Carimune, Hizentra & Privigen
*866-936-2472: Zemaira

The Berinert Copay BEnefit covers up to $12,000 in eligible out-of-pocket expenses per year.
Patient must be diagnosed with HAE (Hereditary Angleodema)

Assurance Program: Once enrolled in the Program, Patient will begin earning an Award Certificate for every 3 consecutive months of therapy use. Each Certificate is worth a 1-month supply of therapy (up to the maximum amount redeemable) and can be redeemed in the event of a lapse in insurance.


Updated March 16, 2018