Who is this program for? Eligible patients with commercial insurance.
  • Overview
  • FAQs
  • Instructions
  • Terms and Conditions

ADYNOVATE® [Antihemophilic Factor (Recombinant), PEGylated] is an injectable medicine that is used to help treat and control bleeding in children and adults with hemophilia A (congenital Factor VIII deficiency). Your healthcare provider may give you ADYNOVATE when you have surgery. ADYNOVATE can reduce the number of bleeding episodes when used regularly (prophylaxis).

ADYNOVATE is not used to treat von Willebrand disease.

Learn More at ADYNOVATE.com

CoPay Assistance for ADYNOVATE

The CoPay Assistance Program for ADYNOVATE may help you pay for your hemophilia A product, regardless of your household income. If you qualify for the program, you can:

  • Save up to $12,000 every 12 months on ADYNOVATE*
  • Receive reimbursement for the portion you pay for your medication costs

Who Is Eligible?

You may be eligible for CoPay Assistance for ADYNOVATE if:

  • You’re starting or receiving ADYNOVATE for hemophilia A§
  • You have commercial insurance that covers medication costs for ADYNOVATE and allows for CoPay or coinsurance assistanceǂ

How to Sign Up

It’s easy to sign up for CoPay Assistance for ADYNOVATE.

CLICK HERE TO ENROLL ONLINE

You can also call us at:

1-888-229-8379
Mon – Fri | 8:30 a.m. to 8:00 p.m. ET

*Non-medication expenses, such as ancillary supplies or administration-related costs, are not eligible.
§Must have a current prescription for ADYNOVATE with an ICD9 or ICD10, as applicable, of hemophilia A.
ǂNot valid for prescriptions reimbursed, in whole or in part, by Medicaid, Medicare, Medigap, VA, DoD, TRICARE or any other federal or state healthcare programs, including state pharmaceutical assistance programs, and where prohibited by the health insurance provider or by law.

FAQs

What information do I need to have when I contact you to enroll in Shire’s CoPay Assistance Program?

When you contact us to enroll in the program, we will need your name, contact information, date of birth, diagnosis, product information and insurance information. We will also need the contact information for your prescriber and the pharmacy that ships your treatment.

What are the hours for 1-888-229-8379?

Representatives are available to help you Monday through Friday from 8:30 a.m. to 8:00 p.m. ET.

I don’t have commercial insurance. Is there an assistance program for me?

Call us at 1-888-229-8379 to learn more about programs that may be able to help you.

Do I qualify if I am insured by Medicaid, Medicare, Medigap, the Veteran’s Administration, the Department of Defense, Tricare, or another federal or state healthcare program?

Unfortunately, we are unable to provide help through our CoPay Assistance Program if you are covered by any of the programs listed above or a state pharmaceutical assistance program.

Am I allowed to request support if I need to use more than one Shire hematology product?

Yes, you are allowed to submit a claim for more than one Shire product as long as you meet all other terms and conditions and are eligible for the program. A maximum of $12,000 is available for the program over a 12-month period.

Patient Instructions

By using this program, you are certifying that:

  • You meet the eligibility criteria and have read and agree to the terms and conditions of this manufacturer CoPay program
  • You will not, at any time, submit any costs for the product dispensed pursuant to this program to any government healthcare program for reimbursement
  • You are permitting your personal information, including name, address, phone number, email address, and information related to health insurance and treatment, to be shared with Shire and companies working with Shire for the purpose of administering this program
  • You will notify your health insurance provider or other third-party payer of the use of Shire’s CoPay Assistance Program if required to do so

Have Questions?

If you have any questions about this program, give us a call at 1-888-229-8379.

Pharmacy Instructions

By submitting a claim for reimbursement pursuant to this manufacturer CoPay assistance program, the Pharmacy represents and warrants that:

  • It has dispensed ADYNOVATE® [Antihemophilic Factor (Recombinant), PEGylated] to an eligible patient and in accordance with the terms and conditions of this program and the accompanying prescription
  • Its participation in this program is consistent with all applicable laws and any obligations, including its contract with the applicable payer
  • It will report CoPay assistance received to payers
  • The entire benefit amount received will go to eligible expenses and it will not retain any portion of the benefit as payment to it for administration or ineligible expenses

Have Questions?

For questions regarding processing, claim transmission, patient eligibility or other issues, give us a call at 1-888-229-8379.

Terms and Conditions

This manufacturer’s CoPay assistance program is not valid for prescriptions reimbursed, in whole or in part, by Medicaid, Medicare, Medigap, VA, DoD, TRICARE, or any other federal or state healthcare programs, including state pharmaceutical assistance programs, and where prohibited by the health insurance provider or by law.

Shire’s CoPay Assistance Program provides a maximum benefit of $12,000 for eligible out-of-pocket costs and expires 12 months from date of activation. Eligible costs include deductible, CoPayment, and coinsurance costs for eligible Shire factor or bypass products. Non-medication expenses, such as ancillary supplies or administration-related costs, are not eligible.

To be eligible, patients must: 1. be starting or receiving treatment with (and have current prescription for) an eligible Shire factor or bypass product with an ICD9 or ICD10, as applicable, for a diagnosis of mild, moderate, or severe hemophilia A or B, or a hemophilia A or B inhibitor; and 2. have commercial insurance that covers medication costs for Shire factor or bypass product and allows for CoPay assistance.

Acceptance of this offer must be consistent with the terms of benefits provided by patient’s health insurance provider.

If your insurance situation changes it is your responsibility to notify Shire’s CoPay Assistance Program.

Offer limited to one card per person and may not be combined with any other coupon, discount, prescription savings card, rebate, free trial, patient assistance, or other offer.

This program is only valid for residents of the United States, excluding Puerto Rico and other U.S. territories.

Shire reserves the right to change or discontinue this program at any time without notice.

This is not health insurance.

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