Your request will be referred to the appropriate Regeneron Pharmaceuticals, Inc. medical professional, such as a Libtayo pharmaceutical rep; Medical Science Liaison (MSL) or medical affairs.
Need to report a Libtayo issue?
ONLINE FORMReport adverse event
Learn More
You can report a Libtayo adverse event on MedWatch, the FDA's medical product safety reporting program for health professionals, patients and consumers.
prior authorization
Libtayo Prior authorization resources
Complete Letter of Medical Necessity
NOT PROVIDED BY BRANDCoverage Authorization Request
Coverage Authorization Appeals
Sample Letter of Medical Exception
PA Checklist
Learn More
If available, these templates are provided by the brand to help you navigate insurance, especially with newer drugs.
Benefits investigation
Libtayo Surround Enrollment Form
Libtayo Surround Enrollment Form - Spanish
Learn More
Benefits investigations are conducted to determine whether a therapy is covered under a patient's insurance, if a prior authorization is required, and which specialty pharmacies are preferred.
Reimbursement help (FRM)
Receive Assistance from an FRM Regarding Reimbursement Information
Learn More
Some brands offer a field reimbursement manager who will work with your clinical staff and preferred pharmacy to help make sure patients don't fall through the cracks.
financial assistance
Libtayo Financial assistance options
Co-pay savings program
commercial only
Libtayo Surround Enrollment Form
Libtayo Surround Enrollment Form - Spanish
Enroll in Patient Savings Program
Enroll in Patient Savings Program (HCP Office)
Learn More
Overview
Reduce patient OOP costs for drug (and occasionally for drug administration/infusion costs or drug-related test costs)
Patient benefit
A portion (or all) of patient OOP (deductible, copay), typically up to monthly and/or annual max
Patient eligibility
Patient must enroll or activate (may permit HCPs to enroll on patient’s behalf for HCP-administered drugs)
Generally, must have commercial insurance (rarely, may permit uninsured patients to use)
May never be used with government insurance
How to sign up
Cards may be downloadable digital cards or hard copies
Some pharmacos offer debit cards with pre-loaded copay benefit
Typically, available through multiple channels (e.g., rep to HCP to patient; pharmacy to patient; patient via website, Hub live agent, or copay vendor (live agent or IVR); patient and HCP via Hub enrollment form)
Some HCP-administered product programs permit HCPs to enroll on a patient’s behalf through via Hub form
Bridge program
commercial only
Learn More
Overview
Provide patient immediate access to therapy during an insurance delay (typically new starts; some may cover change in insurance)
Limited time/ fill (typically 7-30 days; some may offer additional fill for continued delay up to certain limit)
Patient benefit
100% free (outside of insurance)
Patient eligibility
HCP must enroll patient
May be limited to commercially insured patients (i.e., no government beneficiaries); some programs may allow government beneficiaries
How to sign up
Typically HCP assisted enrollment (via form)
Foundation programs
under insured
no insurance
goverment insurance
65+
Libtayo Surround Enrollment Form
Libtayo Surround Enrollment Form - Spanish
Libtayo Surround Patient Assistance Program
Learn More
Overview
Charitable 501(c)(3) organizations provide direct cost-sharing and other support (e.g., travel, counseling) through disease-state funds to indigent patients on first-come first-served basis
These organizations may receive financial contributions from drug manaufacturers for particular disease-state funds that cannot provide funds directly to patients - the foundation must be independent/unaligned
Patient benefit
Patients apply for grants that cover a portion (or all) of their out-of-pocket costs (deductibles and co-pays) until the grant is exhausted
Patient eligibility
Patients must apply and meet eligibility criteria including income level (typically a multiple of federal poverty line), specific diagnosis, insurance status, etc.
How to sign up
Patients submit proof of out-of-pocket drug costs to charities for reimbursement
patient education
Libtayo Patient education
Getting started on Libtayo
NOT PROVIDED BY BRANDInstructions For Use: Non-Small Cell Lung Cancer
NOT PROVIDED BY BRANDInstructions For Use: Basal Cell Carcinoma
Patient toolkit
About Libtayo: Non-Small Cell Lung Cancer
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
How Libtayo Works: Non-Small Cell Lung Cancer
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Receiving Libtayo: Non-Small Cell Lung Cancer
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Side Effects: Non-Small Cell Lung Cancer
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Patient Resources: Non-Small Cell Lung Cancer
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Caregiver Resources: Non-Small Cell Lung Cancer
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Patient Stories: Non-Small Cell Lung Cancer
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Patient Navigators Flashcard
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Patient Brochure: Non-Small Cell Lung Cancer
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Biomarker Testing: Non-Small Cell Lung Cancer
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Patient Brochure: Non-Small Cell Lung Cancer - English
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Patient Brochure: Non-Small Cell Lung Cancer - Korean
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Patient Brochure: Non-Small Cell Lung Cancer - Vietnamese
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Patient Brochure: Non-Small Cell Lung Cancer - Spanish
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Patient Brochure: Non-Small Cell Lung Cancer - Chinese
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Patient Wallet Card - English
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Libtayo Surround Copay Program Brochure
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Libtayo Surround Overview Brochure
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
About Libtayo: Basal Cell Carcinoma
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
How Libtayo Works: Basal Cell Carcinoma
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Receiving Libtayo: Basal Cell Carcinoma
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Side Effects: Basal Cell Carcinoma
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link