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 line.

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

7 out of 10

patients’ medical insurance plans
DO NOT REQUIRE A STEP THROUGH ANOTHER INJECTABLE

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.

Co-pay Offers

$0 co-pay savings

86% of commercial patients who utilized the LEQVIO^® Co-pay Program paid $0

LEQVIO is covered primarily under the medical benefit, not the pharmacy benefit.

Eligible privately insured patients may pay as little as $0 for LEQVIO with the co-pay savings offer. Subject to terms and conditions. Limitations apply.^#

Eligible privately insured new patients may be able to receive up to two (2) free doses if coverage is delayed or denied. Limitations apply.^**

Valid only for those with commercial insurance. The Program may include the Co-pay Card, Payment Card (if applicable), and Rebate, with a per treatment benefit maximum of $3000 and an annual benefit limit of $3600. Per treatment maximums and an annual benefit cap apply.

Enroll your patients electronically via LEQVIO-CoPayPortal.com for co-pay-only support.

Visit Co-pay Portal

^#Eligible patients must have commercial insurance, a valid prescription for LEQVIO, and a prior authorization that has been denied or pending for greater than 3 calendar days. Program provides up to two (2) doses of free medication. Program is not available to patients who are uninsured or whose medications are reimbursed in whole or in part by Medicare, Medicaid, TRICARE, or any other federal or state program, or where prohibited by law. No purchase necessary. Program is not health insurance, nor is participation a guarantee of insurance coverage. Other limitations may apply. Novartis reserves the right to rescind, revoke, or amend the Program and discontinue support at any time without notice.
**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.
All trademarks are the property of their respective owners.