Besponsa Patient assistance program
Complete a free online enrollment application to find out if you’re eligible to pay only $49 per month for your Besponsa medication with our help.Get started today
- Secure: Your personal and medical information is safe with us
- Convenient: We manage the whole process and we’re here to assist you
- Ongoing refills: We request your medication refills on your behalf
NiceRx works with your healthcare provider to help you access affordable medications directly from U.S. pharmaceutical companies.
An introduction to NiceRx(01:52)
Next steps after qualifying(00:38)
Uploading documents and billing(00:50)
SSN & billing information(00:33)
Medication delivery time(00:41)
How it works
Get started by filling out the online enrollment application to find out if you are eligible.
NiceRx verifies your eligibility for medication assistance and notifies you if you are qualified. The pharmaceutical company provides your medication for free and you only pay our service fee.
You may be required to submit further information and documents required by the pharmaceutical company which can be securely uploaded online.
Your application is created and sent to your doctor for signature. At this stage, you will be billed $49 and will not be billed again until you receive your first medication delivery.
Your application is sent to the pharmaceutical company. You will be billed again once you receive your medication. We handle the entire ordering process including requesting ongoing refills.
Your monthly Besponsa cost savings if eligible
If you are eligible to receive your Besponsa prescription through the patient assistance program, your medication will be free. We charge a flat monthly service fee of $49 per medication to cover the cost of our services.
Am I eligible for Besponsa patient assistance?
To be eligible for the Besponsa patient assistance program, you will need to meet specific eligibility criteria set by the pharmaceutical company. At NiceRx, we review each Besponsa enrollment application individually. The main factors considered are:
- I am a permanent, legal resident of the United States or Puerto Rico
- I am uninsured or my insurance doesn’t cover my medication
- I meet certain income eligibility requirements
How do I apply for the Besponsa patient assistance program?
Applying for the Besponsa patient assistance program through NiceRx is simple. Begin by completing the enrollment application on our website. We will ask for details about your healthcare provider, your insurance plan, and your household income. This information is required by the pharmaceutical manufacturers that supply your medication. We may be able to help you access patient assistance for other medications as well as Besponsa, so please tell us about any medications that you have been prescribed.
If we determine that you may be eligible for Besponsa assistance, we will handle the full enrollment process on your behalf. We will work with your healthcare provider to prepare and submit all the documents required for you to enroll. If you are successfully enrolled in the Besponsa patient assistance program, we will also request your Besponsa medication refills on your behalf for up to 1 year. At the end of your enrollment period, we will contact you for updated details and seek to re-enroll you in the program.
Is NiceRx a Besponsa coupons provider?
NiceRx does not provide Besponsa coupons, discount cards, or copay cards. We do not offer printable Besponsa manufacturer coupons, Besponsa discounts, rebates, Besponsa savings cards, trial offers, or free samples. We are a service provider that helps eligible individuals access patient assistance programs. Our service cost is $49 a month per medication, so you will likely save more on your Besponsa medication with NiceRx.
Can NiceRx help me get Besponsa if I have insurance?
NiceRx may be able to help you access Besponsa patient assistance if:
- You have a high copay or coinsurance responsibility for Besponsa
- Your insurance company will not pay for your Besponsa prescription
- You do not have insurance
Complete your enrollment application online to find out more.
How much does Besponsa cost without insurance?
Besponsa prices without insurance will vary by retailer. As a guide, Besponsa intravenous powder for injection of 0.9 mg will typically cost around $21,350 for a supply of 1 powder for injection.
How much does Besponsa cost with insurance?
Your individual healthcare plan will determine the copay of Besponsa with insurance. To find out what you will need to pay, contact your pharmacist or insurance provider. They will be able to calculate your copay with your current insurance.
What is Besponsa?
Besponsa is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Pfizer Inc. Besponsa is a CD22-directed monoclonal antibody-drug conjugate indicated for the treatment of adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL). B-cell precursor ALL is a type of cancer in which the bone marrow makes too many B-cell lymphocytes, an immature type of white blood cell.
- Hepatotoxicity, including hepatic veno-occlusive disease (VOD)(Also known as sinusoidal obstruction syndrome and increased risk of post hematopoietic stem cell transplant (HSCT) non-relapse mortality. See the full prescribing information for the complete boxed warning
- Hepatotoxicity, including fatal and life-threatening VOD, occurred in patients who received Besponsa
- A higher post-HSCT non-relapse mortality rate occurred in patients receiving Besponsa
- Other risk factors for VOD in patients treated with Besponsa included ongoing or prior liver disease, prior HSCT, increased age, later salvage lines, and a greater number of treatment cycles with Besponsa
What doses of Besponsa are available?
Besponsa is available in injection form, in the following doses: 0.9 mg lyophilized powder in a single-dose vial for reconstitution and further dilution.
Pre-medicate with a corticosteroid, antipyretic, and antihistamine before all infusions. Dosing regimens for subsequent cycles will depend on the response to treatment.
Always speak with your healthcare provider about any changes to your dose so they can monitor and evaluate your condition.
Besponsa active ingredients
Besponsa contains the active ingredient inotuzumab ozogamicin.
Besponsa side effects
The most common adverse reactions of Besponsa in clinical trials include:
- Thrombocytopenia (low platelets)
- Neutropenia, febrile neutropenia, infection
- Anemia, leukopenia
- Increased transaminases, increased gamma-glutamyltransferase
- Fatigue, hemorrhage
- Nausea, headache
- Abdominal pain
In rare instances, Besponsa can cause more serious adverse events. These can include:
- Myelosuppression – monitor complete blood counts
- Infusion-related reactions
- QT interval prolongation
Your doctor will assess the benefits of using Besponsa against your risk of side effects. Patients are encouraged to report negative side effects or adverse reactions of Besponsa to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Besponsa drug interactions
Besponsa can interact with other medications:
- Concomitant use with drugs known to prolong the QT interval or cause Torsades de Pointes may increase the risk of a clinically significant QTc interval prolongation. Discontinue or use alternative concomitant drugs that do not prolong QT/QTc interval
This list is not exhaustive and other prescription drugs may interact with Besponsa.
You should not use Besponsa if you:
- Are allergic to the active ingredient inotuzumab ozogamicin
- Are allergic to any of the other ingredients in Besponsa
- Are pregnant or are planning to become pregnant – based on its mechanism of action and findings from animal studies, Besponsa can cause Embryo-fetal toxicity. Females of reproductive potential are advised to use effective contraception
- Are breastfeeding or are planning to breastfeed – do not breastfeed while receiving treatment and for 2 months after the last dose
Talk to your doctor before using Besponsa if you:
- Are taking any of the medications that could interact with Besponsa
Besponsa is the trademark brand name for inotuzumab ozogamicin manufactured by Pfizer Inc. A generic version of inotuzumab ozogamicin is available. Generic drugs are generally cheaper than brand-name drugs, but you can still find Besponsa savings through NiceRx.
*Qualifying persons may obtain medications directly from patient assistance programs without any out-of-pocket cost (or for less than $49 per medication). However, our monthly flat rate of just $49 per medication spares you the hassle of tracking down the different programs and filling out all the required paperwork for each program.
Enrollees enjoy a full-service solution, as NiceRx assists them and their physicians with the entire process. We prepare all required documents for the physician to sign, help enrollees manage all prescription refills, monitor eligibility criteria, and maintain enrollment.
**If you do not receive medications because you were determined to be ineligible for the prescription assistance by the applicable pharmaceutical companies and you have a letter of denial, we will refund any fees you paid toward medications for which you did not qualify to receive prescription assistance (“Refund”).
To receive a refund, you must send the letter of denial to us by fax to 888-517-7444, or by e-mail to [email protected] within 30 days of your receipt of such letter. The Refund is your sole and exclusive remedy for any fees you may wish to dispute.
The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.