Financial Assistance for Uninsured Patients
AAA PatientCONNECT™ may provide LUTATHERA® (lutetium Lu 177 dotatate) at no cost to patients who are uninsured and meet certain eligibility criteria.
AAA PatientCONNECT™ — LUTATHERA® PATIENT ASSISTANCE PROGRAM (PAP)
TERMS AND CONDITIONS
- Limitations apply.
- The Advanced Accelerator Applications (AAA) PatientCONNECT™ Lutathera® Patient Assistance Program is valid only for patients with no insurance coverage.
- The patient is obligated to notify AAA PatientCONNECT™ at 844-638-7222 promptly if the patient obtains insurance coverage or otherwise becomes ineligible for coverage under the Program.
- Patient must be age 18 or older.
- Patient must be a permanent resident of the United States, Commonwealth of Puerto Rico or the United States Virgin Islands.
- Patient must be prescribed Lutathera (lutetium Lu 177 dotatate) for an FDA approved indication.
- Treatment with Lutathera must be provided in an appropriate outpatient setting.
- The Program provides Lutathera free of charge to patients who meet the financial and all other eligibility requirements of the Program.
- The Program only provides Lutathera free of charge to eligible patients. The Program does not cover any costs or expenses, even if such expenses are associated with the administration of Lutathera (e.g., charges for a visit to the health care provider’s office or medication administration charges).
- The patient is subject to eligibility verification, including income verification, prior to approval for the Program.
- The patient’s eligibility for the Program expires on the anniversary of the first year following the patient’s initial enrollment in the Program. Thereafter, the patient may re-enroll in the Program on a yearly basis. For each re-enrollment period, the patient is subject to eligibility verification, including income verification.
- The benefit conferred by the Program is exclusively for the patient.
- The Program is not valid where prohibited by law.
- Patient and the patient’s health care provider must not seek reimbursement for the benefit conferred by the Program from any other party, including without limitation, any health insurance program or plan, flexible spending account or healthcare savings account.
- The Program is not health insurance.
- The Program may not be combined with any third-party rebate, coupon, or offer.
- Data related to the patient’s receipt of benefits under the Program may be collected, analyzed and shared with AAA, in an aggregated and patient de-identified form, for purposes that include assessing the Patient Assistance Program and potentially making adjustments to such Program.
- Advanced Accelerator Applications, a Novartis company, reserves the right to rescind, revoke or amend the Program and/or discontinue assistance at any time without notice.
- No other purchase is necessary.
- Program is limited to 1 per person during this offering period and is not transferable.
For more information on enrolling your patient in, call AAA PatientCONNECT™ 1-844-638-7222 Monday-Friday from 8AM-8PM