Amgen By Your Side Copay Assistance Program: Uplizna

Funded

About

The Amgen By Your Side Copay Assistance Program: Uplizna helps patients access Uplizna with ease. The program is designed to minimize the cost of the drug product Uplizna for eligible individuals, ensuring affordability with potential benefits like a $0 co-pay for those with commercial insurance. By enrolling in the Amgen By Your Side Copay Assistance Program: Uplizna, patients can navigate their treatment journey with more financial confidence.

Insurance requirements: Commercially insured

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

•Patients with commercial insurance may be eligible for a $0 copay

•HCP should fax completed enrollment form to 8333298477 or emailed to UPLIZNAABYS@amgen.com

•Enrollment form may also be submitted online

•For assistance or additional information, call 8338428477

Enrollment Forms

Enrollment Form