Frequently Asked Questions for
Niktimvo™ (axatilimab-csfr)
About IncyteCARES
What is the IncyteCARES program?
IncyteCARES is a support program for patients who are prescribed Niktimvo™ (axatilimab-csfr) and other Incyte medications. Our team can help you understand your insurance coverage and medication costs and find savings and financial assistance options to fit your needs. You can speak one-on-one to an IncyteCARES nurse representative who can answer questions about Niktimvo, provide education about your condition, connect you with other organizations that provide counseling and help cover transportation costs, and more. Contact IncyteCARES at 1-855-452-5234, Monday through Friday, 8 AM–8 PM ET with questions or to enroll.
How can I contact IncyteCARES?
Call us at 1-855-452-5234.
Our IncyteCARES team is available Monday through Friday, 8 AM–8 PM ET.
Who is IncyteCARES designed to help?
IncyteCARES is intended to help eligible patients who have been prescribed Niktimvo and who have trouble affording their out-of-pocket costs or who have other questions about their treatment or their prescription coverage. Contact IncyteCARES to speak one-on-one to a representative to determine if you're eligible to enroll. Our team can be reached at 1-855-452-5234, Monday through Friday, 8 AM–8 PM ET.
What kinds of support does IncyteCARES provide for patients prescribed Niktimvo?
IncyteCARES can help eligible patients understand their insurance coverage and costs for Niktimvo and explore financial assistance and savings options to help reduce out-of-pocket costs. We provide ongoing, personalized support for patients to help with questions about their condition and treatment. We can also help connect eligible patients with resources to help manage their condition day to day, including symptom trackers, counseling services, treatment education, transportation services, and more. Call IncyteCARES at 1-855-452-5234, Monday through Friday, 8 AM–8 PM ET to speak one-on-one with a nurse representative.
How do I enroll in IncyteCARES?
There are 3 ways for a patient prescribed Niktimvo to enroll in IncyteCARES.
- You can ask your Healthcare Professional to enroll you.
- You can call IncyteCARES at 1-855-452-5234, Monday through Friday, 8 AM–8 PM ET and speak to a representative to start the enrollment process.
- You can download an enrollment form, fill out your personal information yourself, and then take it to your Healthcare Professional to submit.
Do I have to be taking Niktimvo to speak to an IncyteCARES representative?
No, anyone can call IncyteCARES for general information.
Can any patient taking Niktimvo enroll in the IncyteCARES program?
Yes, any patient who has been prescribed Niktimvo can enroll in IncyteCARES but may not be eligible to receive some of the services or support we offer. Contact IncyteCARES for more details and to determine if you're eligible. Our team can be reached at 1-855-452-5234, Monday through Friday, 8 AM–8 PM ET.
Do I have to live in the United States to participate in IncyteCARES?
You must be a resident of the United States or Puerto Rico to be enrolled in the IncyteCARES Savings Program or Patient Assistance Program.
Can uninsured patients qualify for assistance with their out-of-pocket costs for Niktimvo?
Uninsured patients may qualify for the IncyteCARES Patient Assistance Program if they are enrolled in IncyteCARES and meet certain criteria. Please call IncyteCARES at 1-855-452-5234, Monday through Friday, 8 AM–8 PM ET and speak with a representative to find out if you are eligible.
Can caregivers apply on behalf of patients?
Yes, a caregiver may contact IncyteCARES on behalf of a patient who is prescribed Niktimvo to begin the enrollment process.
What information does IncyteCARES offer for patients who need social, emotional, and other types of support?
We can connect patients to nonprofit organizations that provide social and emotional support as well as information about other counseling services and support groups in their area. Please call IncyteCARES at 1-855-452-5234, Monday through Friday, 8 AM–8 PM ET and speak one-on-one with a representative to talk about the kinds of support that are available.
How long am I enrolled in IncyteCARES?
Enrollment in the IncyteCARES program lasts for one year. You can re-enroll each year (we'll remind you when it's time!) and can continue to be a part of the program for as long as you're prescribed Niktimvo.
Filling Your Prescription
Can IncyteCARES assist with the delivery of Niktimvo?
Yes, an IncyteCARES team member can coordinate with your infusion center to ensure that your Niktimvo is delivered and ready when you need it.
What if my insurance changes while I’m being treated with Niktimvo?
Call IncyteCARES about any insurance changes, and we can help you understand your new coverage. We can also determine if you are now, or are still, eligible for our IncyteCARES Savings Program or eligible for other forms of support.
Financial Assistance Options
Does IncyteCARES offer copay assistance programs for Niktimvo?
IncyteCARES offers savings and financial assistance options to help patients prescribed Niktimvo with their out-of-pocket costs. With the IncyteCARES Savings Program, eligible patients with commercial prescription coverage can receive Niktimvo for as little as $15, subject to certain limits.* For patients who are uninsured or underinsured, they may be eligible to receive Niktimvo free of charge through the Patient Assistance Program.* Call IncyteCARES at 1-855-452-5234, Monday through Friday, 8 AM–8 PM ET to find out more.
*Terms and conditions apply. Terms of this program may change at any time. Read complete terms and conditions for the IncyteCARES Savings Program here.
How much can I save on Niktimvo through the IncyteCARES Savings Program?
With the IncyteCARES Savings Program, eligible patients with commercial prescription coverage can receive Niktimvo for as little as $15, subject to certain limits.* Your actual savings may differ depending upon your insurance coverage. Call IncyteCARES at 1-855-452-5234, Monday through Friday, 8 AM–8 PM ET to find out more.
*Terms and conditions apply. Terms of this program may change at any time. Read complete terms and conditions for the IncyteCARES Savings Program here.
What are the eligibility criteria for the IncyteCARES Savings Program?
To qualify for the Savings Program, patients must meet the following criteria:
- Have commercial prescription drug coverage. Patients insured under federal or state government prescription drug programs—including Medicare Part B or D, Medicare Advantage, Medicaid, or TRICARE—are not eligible. Patients without prescription drug coverage are also not eligible
- Be a resident of the United States or Puerto Rico
- Have a valid prescription for Niktimvo for an FDA-approved use
Read complete terms and conditions for the IncyteCARES Savings Program here.
For more information, call IncyteCARES at 1-855-452-5234.
How do I enroll in the IncyteCARES Savings Program to make my out-of-pocket costs for Niktimvo more affordable?
You can ask your prescribing Healthcare Professional, or contact IncyteCARES to enroll you in the program.
Read complete terms and conditions here.
For more information, call IncyteCARES at 1-855-452-5234.
How long does it take to find out if I’m approved for the IncyteCARES Savings Program to reduce my out-of-pocket costs for Niktimvo?
Once your information is submitted for the IncyteCARES Savings Program, eligibility is determined right away. If you are eligible, a program member number is typically issued immediately.
Once I’m approved for the IncyteCARES Savings Program, do I ever have to re-enroll?
No. Your enrollment in the Savings Program will automatically renew each year. You do not need to re-enroll. You should, however, contact IncyteCARES if your prescription insurance plan changes, so we can update your information.
Can I receive Niktimvo for free if I cannot afford it?
Eligible patients who do not have health insurance or have trouble affording their out-of-pocket costs for Niktimvo may be able to receive their medication free of charge through the Patient Assistance Program. The program provides free medication, but does not cover the cost to give you your infusion. Call IncyteCARES at 1-855-452-5234, Monday through Friday, 8 AM–8 PM ET to speak one-on-one with an IncyteCARES representative about the criteria for eligibility.
What are the eligibility criteria for the Patient Assistance Program through IncyteCARES for patients prescribed Niktimvo?
The IncyteCARES Patient Assistance Program (PAP) helps eligible patients who do not have health insurance or have trouble affording their out-of-pocket costs. No purchase contingencies or other obligations apply.
To qualify, you must:*
- Be confirmed as eligible for and enrolled in IncyteCARES
- Be a resident of the United States or Puerto Rico
- Have a valid prescription for Niktimvo for an FDA-approved use
- Meet one of these 3 criteria:
Uninsured
- Have no prescription drug coverage and meet household income criteria
Underinsured†
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- Have Medicare Part B, Medicare Part D, or Medicare Advantage and meet household income criteria
- Have any other type of health insurance (commercial, Medicaid, etc) but have exhausted or been denied coverage for Niktimvo and meet household income criteria
For more information, call IncyteCARES at 1-855-452-5234.
*Terms and conditions apply. Terms of this program may change at any time.
†Patients who are enrolled in an Alternate Funding Program (AFP) are not eligible to receive free drug.
How long does it take to find out if a patient has been approved for the Patient Assistance Program?
Conditional approval for the Patient Assistance Program (PAP) is provided in 3 business days after we receive a patient's completed enrollment form. Eligible patients are fully approved for the PAP after proof of current household income is received and income eligibility criteria have been confirmed.
What are acceptable documents to prove my income eligibility for the Patient Assistance Program?
You must document your current household income by submitting one of the following: your most recent federal income tax return, your most recent W-2 earnings statement from your employer, or one month of recent pay stubs.
How does conditional approval work for the Patient Assistance Program?
Once we receive your completed Patient Assistance Program (PAP) enrollment form, you will be given "conditional approval" for the program. Eligible patients are fully approved for the PAP after proof of current household income is received and income eligibility criteria have been confirmed.
If I am approved for the Patient Assistance Program, do I need to reapply each year?
Yes, if you are enrolled in the Patient Assistance Program (PAP), you need to reenroll in IncyteCARES and reapply for PAP every year.
Understanding Insurance Coverage
Will IncyteCARES help me understand my insurance coverage for Niktimvo?
Yes, once we have your prescription and insurance information and you are enrolled in IncyteCARES, an IncyteCARES nurse representative will call you to go over your coverage and costs for your medication. Call IncyteCARES at 1-855-452-5234, Monday through Friday, 8 AM–8 PM ET if you have questions.
How long does it take to find out about my insurance coverage for Niktimvo?
Once we receive your insurance information, we can research your coverage for Niktimvo right away. In most cases, we’ll call you with this information within 3 business days. If there is a delay, we’ll notify you and/or your Healthcare Professional within that time frame.
Can IncyteCARES help with prior authorization requests?
Once you are enrolled in IncyteCARES, a team member will contact your insurance company to determine your coverage for Niktimvo and whether prior authorization is required. If prior authorization is needed, we will notify your doctor and ensure that the required information is sent to your insurance company.
How can I find out how much Niktimvo will cost?
A team member will contact you after you are enrolled in IncyteCARES. They will review your insurance coverage for Niktimvo with you and will also explain any savings or financial assistance programs for which you may be eligible. You can also call IncyteCARES at 1-855-452-5234, Monday through Friday, 8 AM–8 PM ET to speak one-on-one to an IncyteCARES representative if you have questions.
Are patients who have Medicare or Medicaid eligible for savings on Niktimvo?
Patients who have Medicare Part B or Medicaid may be eligible to receive Niktimvo free of charge through the IncyteCARES Patient Assistance Program as long as they meet household income requirements and other criteria.* This program helps eligible patients who do not have health insurance or have trouble affording their out-of-pocket costs for their medication. Call IncyteCARES at 1-855-452-5234, Monday through Friday, 8 AM–8 PM ET to find out more.
*Terms and conditions apply. Terms of this program may change at any time.
Why might there be a delay in my coverage for Niktimvo?
Many insurance plans require prior authorization before they will approve coverage for Niktimvo. This means they require your Healthcare Professional to send them additional information about your condition and why Niktimvo is being prescribed. Based on the additional details, they will determine coverage. In most cases, this extra step delays their coverage approval by just a few days.
What if I lose my insurance or my insurance changes?
Please contact IncyteCARES if your insurance coverage changes or is lost or if you have a life-changing event such as a job loss or other change in household income. We can determine any changes in your coverage for Niktimvo or your out-of-pocket costs. We can also find out if your specialty pharmacy is still within network for your insurer and can communicate any changes to them. If you need to change specialty pharmacies, we can help with that as well.
What is the appeal process if my insurance denies coverage for Niktimvo?
If your coverage for Niktimvo is denied, IncyteCARES can help you and your doctor file an appeal. If your appeal is unsuccessful, we can assess your eligibility for free medication through the Patient Assistance Program.
What is a copay adjustment program?
Copay adjustment programs are used by health insurance companies—mostly for specialty medications that have drug manufacturer copay savings programs. Health plans use adjustment programs to offset what they pay for a medication rather than allow the manufacturers’ savings program to be applied to the patient's out-of-pocket costs and deductibles as it was intended to be.
As drug manufacturers attempt to create programs to subsidize out-of-pocket costs for patients, the payers reduce the value of these programs by exhausting such funds while also requiring the patient to pay their deductibles and coinsurance up to their out-of-pocket maximums to obtain their medications.
Copay adjustment programs may vary in name, but traditionally they are called copay accumulators or maximizers. Patients may often have difficulty knowing if their health insurance program includes accumulators and maximizers. In some cases, patients are offered reduced costs if they enroll in a particular program.
What are the types of copay adjustment programs?
The most common types of copay adjustment programs are accumulators and maximizers. These programs are designed to exclude the use of manufacturer copay savings programs from counting toward patients’ annual deductibles and out-of-pocket costs, such as copays.
- An accumulator adjustment program is used by the plan/pharmacy benefit managers (PBMs) to prevent manufacturers’ copay savings from being applied to deductibles and maximum out-of-pocket cost. That means that the value of the copay savings program goes directly to the plan rather than being subtracted from the patient’s annual deductible or out-of-pocket expenses. Once the full value of the copay savings is used, the patient is still responsible for their full or remaining deductible and out-of-pocket cost
- A maximizer adjustment program is used to adjust the patient’s copay responsibility to match the maximum value of the manufacturer’s savings program. Generally, the value is divided over the year, a shorter specified period of time determined by the plan, or the number of months a patient is on the product within a calendar year to extract the full value of the copay savings program. For plans to use maximizers, the insurance company deems the specialty drug nonessential so that they are not limited to the Affordable Care Act (ACA) maximums
How do I know if my insurance plan includes copay adjustment programs?
First, take a look at your plan details. The explanation of benefits (EOB) report is a good place to start.
Your health insurance company can provide your EOB upon request. The document should describe how to meet your deductible and out-of-pocket maximum. You can also ask your employer if your plan includes these programs.
Next, review your insurance plan’s Pharmacy Limitations and Exclusions or Schedule of Benefits statement.
Be on the lookout for terms like “manufacturer,” “copay card,” “coupon,” and “discount.” These keywords can help you find the restrictions or limitations for financial assistance you may receive from drug manufacturers.
What questions should I ask my health insurance provider about copay adjustment programs?
You can contact a customer service agent from your insurance company who may help you find out if the plan you are enrolled in (or are considering) has a copay adjustment program that could change your out-of-pocket costs.
Straightforward questions to ask include:
- Does this health plan have an accumulator or maximizer program?
- How does it impact me?
- What are my options for handling gaps in coverage that may occur?
- Am I required to enroll, or may I opt out?
- If I can opt out, can I do so at any time of the year or only during open enrollment?
What is an alternate funding program?
Alternate funding programs (AFPs) are not medical insurance, but they can be used by health plans to deny or delay patients’ access to specialty medications. AFPs operate in agreement on behalf of the health plan to exclude certain specialty products from the patient’s prescription drug benefit. AFPs then coordinate with the patient’s enrollment into the drug manufacturer’s foundation or Patient Assistance Program (PAP). AFPs may create challenges and delays for starting or staying on therapy due to the PAP’s enrollment processes and timelines. AFPs may prevent a patient from moving through their insurance out-of-pocket requirements in the way the patient would have if the medication had been included in the insurer’s prescription drug benefit.
Need Help?
Our IncyteCARES team is available Monday through Friday, 8 AM–8 PM ET
Our IncyteCARES team is available
Monday through Friday,
8 AM–8 PM ET
Call us at 1-855-452-5234
