Help navigating the insurance process, including benefits verification and support with the prior authorization and appeals processes.
Benefits Verification Once you’ve enrolled your patients in Novartis Patient Support, our team will conduct a benefits verification to help you better understand your patient’s coverage, including:
Inform your practice about additional requirements, such as prior authorization
Identify savings options available to your patients
Prior Authorizations (PAs) and Appeals Novartis Patient Support can help with PA requests or letters of appeal by working directly with you or your office, including:
Provide best practices and timely updates via phone
Patients can call Novartis Patient Support to sign up at 866-433-8000
Providers, with their patients, can complete the SCEMBLIX Start Form and send to Novartis Patient Support
*Limitations apply. Valid only for those with private insurance. The Program includes the Co-Pay Plus offer, Plus Card (if applicable), and Rebate, with a combined annual limit up to $15,000. Patient is responsible for any costs once limit is reached in a calendar year. Program not valid (i) under Medicare, Medicaid, TRICARE, VA, DoD, or any other federal or state health care program, (ii) where patient is not using insurance coverage at all, (iii) where the patient’s insurance plan reimburses for the entire cost of the drug, or (iv) where product is not covered by patient’s insurance. The value of this program is exclusively for the benefit of patients and is intended to be credited towards patient out-of-pocket obligations and maximums, including applicable co-payments, coinsurance, and deductibles. Program is not valid where prohibited by law. Patient may not seek reimbursement for the value received from this program from other parties, including any health insurance program or plan, flexible spending account, or health care savings account. Patient is responsible for complying with any applicable limitations and requirements of their health plan related to the use of the Program. Valid only in the United States and Puerto Rico. This Program is not health insurance. Program may not be combined with any third-party rebate, coupon, or offer. Proof of purchase may be required. Novartis reserves the right to rescind, revoke, or amend the Program and discontinue support at any time without notice.
Other Affordability Assistance
30-day Free Trial Offer
Available to all patients who have a valid prescription† for SCEMBLIX, regardless of insurance.
With our 30-day Free Trial Offer,† patients can start on SCEMBLIX today and see if it might be right for them.
†No purchase required. This free trial is not health insurance. Void where prohibited by law. Product dispensed pursuant to terms and conditions of offer. Valid only in the US and Puerto Rico. Claims shall not be submitted to any public or private third-party payer or any federal or state health care program for reimbursement. Offer not valid if reproduced or submitted to any other payer. It is illegal for any person to sell, purchase or trade, or offer to sell, purchase or trade, or to counterfeit, this offer. Prescriber ID# is required on prescription. This is the property of Novartis Pharmaceuticals Corporation and must be returned upon request. Novartis Pharmaceuticals Corporation reserves the right to rescind, revoke, or amend this offer without notice.
The Novartis Patient Assistance Foundation, Inc. (NPAF)
If uninsured or underinsured patients express financial hardship, Novartis Patient Support can help connect them with Novartis Patient Assistance Foundation (NPAF). NPAF is an independent 501(c)(3) non-profit, non-commercial entity. Patients who cannot afford the cost of their Novartis medication may be eligible to receive them from NPAF at no cost.
NPAF is committed to providing access to Novartis medications for those most in need. To be eligible, a patient must:
Reside in the United States or a U.S. Territory
Have limited or no prescription insurance coverage
Meet income guidelines for the medication for which the patient is seeking assistance
Have a valid prescription for the Novartis medication
Be treated by a licensed U.S. healthcare provider on an outpatient basis
Questions?
For more information on NPAF call 1-800-277-2254, then select option 2 for a dedicated prescriber line Monday-Friday from 8:00 AM-8:00 PM ET, or visit www.PAP.Novartis.com for more information.
Ongoing Support
Novartis Patient Support provides patients with ongoing help to stay on track with their SCEMBLIX treatment plan, including:
A dedicated Novartis Patient Support Team member to answer questions at every step
Information on financial support options
Help navigating health care changes
Tips for setting up a routine that can help patients stay on track with their medication dosing
Educational resources about SCEMBLIX and living with Ph+ CML-CP and Ph+ CML in CP with the T315I mutation
A guide to help them start treatment with SCEMBLIX
A brochure that can help them find answers to many of their questions
For more information on available resources, call Novartis Patient Support at 866-433-8000 Monday-Friday, 8:00 AM-8:00 PM ET, excluding holidays.
See details about the SCEMBLIX Specialty Pharmacy Network and Specialty Distribution. Additional resources can be accessed through the links provided below.
Specialty Pharmacy Network
The specialty pharmacies (SPs) listed below are authorized to dispense SCEMBLIX in the United States and in US territories. These SPs can service most commercial and Medicare Part D plans.
These network pharmacies can help providers manage the prior authorization process and provide eligible patients with information about co-pay support options, patient support programs, and additional resources.
Provided for informational purposes only and is subject to change. Novartis does not endorse the use of any specific listed distributors.
EHR Considerations Checklist
Ensure drug routing and administration records are correct
For Example:
NDC: 0078-1091-20, 0078-1098-20, 0078-1196-20
Dosage
Route of Administration: Oral
Order Class: Specialty pharmacies
When configuring SCEMBLIX in your electronic health record (EHR), ensure the routing is correctly configured
Configure SCEMBLIX to be distributed via specialty pharmacies (Biologics and Onco360)
Configure the medication record on the specific drug itself to restrict available pharmacies to Biologics or Onco360, in-office dispensing pharmacy, and select health system pharmacies that are able to dispense the medication
IMPORTANT SAFETY INFORMATION
Myelosuppression
Thrombocytopenia, neutropenia, and anemia, including grade 3/4 reactions, have occurred in patients receiving SCEMBLIX
Perform complete blood counts every 2 weeks for the first 3 months of treatment and monthly thereafter or as clinically indicated. Monitor patients for signs and symptoms of myelosuppression...
INDICATIONS
SCEMBLIX is indicated for the treatment of adult patients with:
Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML) in chronic phase (CP), previously treated with 2 or more tyrosine kinase inhibitors (TKIs)