Access & Reimbursement
Amgen believes in the importance of access to treatment and may be able to help patients who have concerns about affording IMLYGIC® (talimogene laherparepvec). In this section, you’ll find information about Amgen's access and reimbursement resources, including IMLYGIC® coding and billing information, Amgen Assist 360™, the IMLYGIC FIRST STEP™ Program, and Amgen's charitable Safety Net Foundation. In addition, this section includes information about charitable independent co-pay foundations* that may help patients afford their prescribed melanoma medicine.
*Provided through independent charitable patient assistance programs; program eligibility is based on the charity's criteria. Amgen has no control over independent, third-party programs and provides referrals as a courtesy only.
IMLYGIC® Coding and Billing Information
Visit amgenassist360.com for information on reimbursement, billing and coding, and Amgen Assist 360™ Nurse Ambassadors.
Patients prescribed certain Amgen products and their caregivers can receive one-on-one phone assistance from our Nurse Ambassadors who provide guidance in such matter as co-pay and reimbursement assistance. Nurse Ambassadors also connect your eligible patients to independent, third-party organizations* for support, including:
- Help Finding Transportation and Lodging Assistance*†
- Referrals to Resources for Day-to-Day Living
*Provided through independent third-party foundations (501(c)(3), tax-exempt nonprofit organizations). Amgen Assist 360™ has no control over independent, third-party programs and provides connections as a courtesy only.
†Based on program eligibility.
IMLYGIC® Patient Brochure
Print a downloadable booklet designed to help patients understand how IMLYGIC® works and what to expect during treatment that also provides information on co-pay assistance and support organizations.
IMLYGIC FIRST STEP™ for Eligible Commercially Insured Patients
The IMLYGIC FIRST STEP™ Program can help eligible commercially insured patients meet their deductible, co-insurance, and co-payment.
- No out-of-pocket cost for the first dose.
- No income eligibility requirement.
- For subsequent doses, Amgen will pay the out-of-pocket amount in excess of $25 per dose, up to $10,000 in assistance per patient per calendar year.
Here’s what patients need to qualify‡:
- Must be prescribed IMLYGIC®.
- Must have private commercial health insurance that covers medication costs for IMLYGIC®.
- Must not be a participant in any federal-, state-, or government-funded healthcare program such as Medicare, Medicare Advantage, Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), the Department of Defense (DoD), or TRICARE.
- May not seek reimbursement for value received from the Amgen FIRST STEP™ Program from any third-party payers, including flexible spending accounts or healthcare savings accounts. If at any time patients begin receiving coverage under any federal-, state-, or government-funded healthcare program, patients will no longer be eligible to participate in the Amgen FIRST STEP™ Program and must call 1-888-65-STEP1 (1-888-657-8371) Monday through Friday, 9:00 am–8:00 pm ET, to stop participation. Restrictions may apply.
This is not health insurance. Program invalid where otherwise prohibited by law.
‡Other restrictions apply. Not valid where prohibited by law. Amgen reserves the right to revise or terminate this program, in whole or in part, without notice at any time.
- Program covers out-of-pocket medication costs for IMLYGIC® only. Program does not cover any other costs related to office visit or administration of IMLYGIC®.
- No out-of-pocket cost for first dose or cycle; $25 out-of-pocket cost for subsequent dose or cycle; maximum benefit of $10,000 per patient per calendar year. Patient is responsible for costs above these amounts.
- Ongoing activation of the Amgen FIRST STEP™ card is contingent on the submission of the required Explanation of Benefits (EOB) form by the healthcare provider’s office within 45 days of use of the Amgen FIRST STEP™ card. Patients will be responsible for reimbursing the program for all amounts paid out if the EOB for the date of service is not received within 45 days.
For additional program details please visit www.AmgenFIRSTSTEP.com or call 1-888-65-STEP1 (1-888-657-8371).
For Eligible Uninsured Patients
The Safety Net Foundation
The Safety Net Foundation is a nonprofit patient assistance program that helps qualifying uninsured patients access Amgen medicines, including IMLYGIC®, at no cost. For more information, visit www.safetynetfoundation.com, or call 1-888-SN-AMGEN (1-888-762-6436).
Independent Co-pay Foundations§
Patients who need assistance with out-of-pocket costs for melanoma medication may be eligible for assistance from an Independent Nonprofit Co-pay Foundation. For contact information or to be referred to an independent co-pay foundation, visit www.amgenassist360.com, or call 1-888-4ASSIST (1-888-427-7478).
§Provided through independent charitable patient assistance programs that set their own eligibility criteria. Amgen has no control over third party programs and provides referrals as a courtesy only.
Help for locating centers and clinics that may provide IMLYGIC® (talimogene laherparepvec) treatment to appropriate patients.
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