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

CSL Behring Care Coordination Center

Provided by: CSL Behring

PO Box 615011020
First Avenue
King of Prussia, PA 19406-0901

TEL: 800-676-4266


Languages Spoken:

English

Program Website

 

Patient Assistance Applications

CSL Behring Care Coordination Center:Contact program

 

Brand Name Medications Covered

 
  • Afstyla
  • Idelvion
  • 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
 

Generic Name

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

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 Complete section, sign, attach a copy of proof of income
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 July 27, 2017