LEQVIO® (inclisiran) injection 284 mg/1.5 mL

PATIENT COVERAGE AND SUPPORT

Coverage & Affordability

LEQVIO^® is broadly covered and affordable for most patients¹*

Because it is administered by an HCP, LEQVIO is covered primarily under the medical benefit, not the pharmacy benefit.

Covered & Affordable for Traditional Medicare Patients¹

80%

have supplemental plans and MAY PAY AS LITTLE AS $0

Some supplemental plans may require precertification or prior authorization

Covered for commercial and Medicare patients¹

9 out of 10

patients have confirmed coverage under the
MEDICAL BENEFIT FOR LEQVIO

Most patients pay 36% less^†for LEQVIO vs other branded nonstatin treatments^1‡

Patient monthly out-of-pocket (OOP) costs^§¶

^*Coverage information is subject to change by the relevant plan and is based on data up to July 2023. The information provided in this communication is not a guarantee of coverage or payment (partial or full). Actual coverage and reimbursement decisions are made by individual payers following the receipt of claims.¹
^†The comparison pertains only to differences in cost and should not be considered a comparison of efficacy or safety.¹
^‡Branded nonstatin treatments include Repatha^®, Nexlizet^®, Nexletol^®, and Praluent^®.
^§Patient out-of-pocket cost calculated from annualized medical and pharmacy claims. Monthly out-of-pocket per brand is based on weighted average of prescribed dose per patient. Data current as of July 2023.
^¶Includes Traditional Medicare, Medicare Advantage, and Commercial plans.

Patient annual OOP

Based on 2100+ medical and pharmacy claims, excluding low-income subsidy patients
Patient monthly OOPs represent actual yearly cost divided by 12 to reflect an average monthly cost

36% LESS

Most patients pay 36% less out-of-pocket annually vs other branded nonstatin treatments, including PCSK9 mAbs^†

For Medicaid patients, LEQVIO may be available for less than $10

Approval rates for LEQVIO are higher when claims are submitted appropriately under the medical benefit^1¶

Based on 2100+ medical and pharmacy claims, excluding low-income subsidy patients

Medical benefit 99% approval. Pharmacy benefit 34% approval.

LEQVIO Coverage and Medical Policies

See how different payers may cover LEQVIO based on medical policies, understand differences in coverage by health plan, and learn ways to appeal coverage decisions.

Commercial Co-Pay Program

$0 co-pay savings

86% of the patients who utilized the LEQVIO Co-Pay Program paid $0²

Eligible, commercially insured patients may pay as little as $0.

No financial information required. Subject to terms and conditions. Limitations apply.^#

If coverage is delayed or denied for commercial patients, reach out to the LEQVIO Service Center for more information on patient affordability support options.

Enroll your commercial patients, submit and manage co-pay claims for reimbursement

For Health Care Providers For Alternate Sites of Care For Specialty Pharmacies

Patients can directly enroll in co-pay services by signing up via Start.LEQVIO.com or by calling 833-LEQVIO2 (833-537-8462).

Looking for additional assistance?

For additional patient access support including benefits verification, enroll your patients via our LEQVIO Service Center by completing and faxing the start form or signing up via our full-service portal ↗.

^#Limitations apply. Valid only for those with commercial insurance. The Program may include the Co-pay Card, Payment Card (if applicable), and Rebate. Per treatment maximums and an annual benefit cap apply. For patients covered under the medical benefit, rebate for out-of-pocket costs will be assigned directly to provider, unless patient requests direct reimbursement. 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.
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LEQVIO Care Program

www.careprogram.leqvio.com | 1-833-LEQVIO2 (1-833-537-8462)

Patients can enroll in dedicated phone support from the LEQVIO Care Program—an optional program to help patients start and stay on track with their treatment plan. When enrolled, patients on therapy have access to: