Vyjuvek Patient Assistance Program

Funded

About

The Vyjuvek Patient Assistance Program offers a remarkable opportunity for patients prescribed Vyjuvek to access the medication at no cost. Designed for U.S. residents with limited or no insurance and meeting specific income conditions, Vyjuvek Patient Assistance Program ensures that qualifying individuals can receive Vyjuvek for up to 12 months without financial burden. The program extensively supports functionally uninsured patients, requiring an annual reapplication to continue these benefits.

Insurance requirements: Medicare / Medicaid, Underinsured, Uninsured

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: Yes

•Activation Required: No

Program Details

•The VYJUVEK Patient Assistance Program (PAP) is designed to provide VYJUVEK at no cost to eligible patients who have been prescribed VYJUVEK by their doctor

•The program is intended for people that live in the United States, have limited or no health insurance coverage and demonstrate qualifying financial need

•Qualifying patients may receive free medication for up to 12 months

•The program will review insurance changes prior to each monthly refill

•Patients will be required to reapply annually

•For functionally uninsured patients who are covered by a federal healthcare program, the coverage period will cover the entire coverage year, or the remainder of the coverage year in which the patient applied for PAP assistance, regardless of whether the patient’s insurance plan begins coverage of the product during that time

Enrollment Forms

Enrollment Form