HelloCUVITRU Free Trial Offer

Funded

About

The HelloCUVITRU Free Trial Offer provides new patients with a unique opportunity to try Cuvitru, a medication used for treating PI, free of cost. This program covers the entire expense of the first four infusions, along with necessary supplies and administration. By focusing on patient needs and physician collaboration, the HelloCUVITRU Free Trial Offer ensures that eligible patients can determine the suitability of Cuvitru for their condition.

Insurance requirements: Commercially insured, Medicare / Medicaid, Underinsured, Uninsured

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Must be 18 years of age or older

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Offer is solely intended to allow new patients to try CUVITRU and help determine, along with their HCP, if it is right for them

•Eligible new patients 2 years of age or older may receive the entire cost of their first 4 infusions of CUVITRU, along with ancillary supplies, pump, and administration are all covered

•Eligible patients must have an ICD10 code verifying diagnosis of PI and be a new patient not currently using CUVITRU and not previously enrolled in the HelloCUVITRU Program

•HCP should complete the HelloCUVITRU Free Trial Request Form and fax to 8668611752

•Free trial prescription is valid for one time only with no refills; for any future use, the patient must obtain a new prescription for CUVITRU

•For additional information contact the program at 18668611750

Enrollment Forms

Enrollment Form