Kevzara Experience Voucher Program (PMR)

Funded

About

The Kevzara Experience Voucher Program (PMR) offers a valuable opportunity for eligible patients to receive a one-time 30-day supply of Kevzara, a beneficial drug product, at no cost. This program is designed specifically for patients not currently using Kevzara and who have not previously received it through the KevzaraConnect Patient Assistance Program. Available across the United States and Puerto Rico, the program emphasizes accessibility and support for those prescribed Kevzara for an FDA-approved indication.

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

Enrollment Forms

Enrollment Form

Benefits

•1 maximum fills per year

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

•Patients not currently using Kevzara, and have not previously received Kevzara through the KevzaraConnect Patient Assistance Program, may be eligible to receive a onetime 30day supply of Kevzara

•The voucher is applicable only for the Kevzara 200 mg dosage prefilled pen

•HCP should fax completed voucher and written prescription to: 8882614939

•For assistance or additional information, call 8554177859

Enrollment Forms

Enrollment Form