Folotyn Patient assistance program

Your monthly Folotyn cost savings if eligible

If you are eligible for the Folotyn patient assistance program you can receive your medication for free. Our monthly service fee of $49 per medication covers the cost of our services in applying for the program and requesting your ongoing refills on your behalf. If you obtain your Folotyn through NiceRx, you will only pay $49 a month regardless of the retail price of your medication.

Am I eligible for the Folotyn patient assistance program?

You could receive your Folotyn without paying the full retail price if you meet the eligibility criteria for assistance. The eligibility requirements are set by the pharmaceutical companies that are providing assistance programs. At NiceRx, we review each application individually, although the main factors considered by most programs 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 Folotyn patient assistance?

We do everything that we can to take the hassle and stress out of applying for patient assistance programs. Simply start by filling in our enrollment application. We will ask for details about your healthcare provider, your insurance, and your household income. This information is required by the pharmaceutical companies you are applying to for assistance. We may also be able to help you access patient assistance for other medications that you have been prescribed, so be sure to tell us about any medications you are taking as well as Folotyn.

NiceRx will review the information you have provided, and if we determine that you may be eligible for assistance, we will seek to enroll you in the Folotyn patient assistance program. We will handle the enrollment process for you by working with your healthcare provider and preparing all the required paperwork for your doctor to sign. We will also request your Folotyn medication refills on your behalf for up to 1 year once you are enrolled in the program.

Is NiceRx a Folotyn coupon provider?

At NiceRx, we help eligible individuals access the Folotyn patient assistance program. This means that we are not a Folotyn coupon, a Folotyn discount card, or a Folotyn copay card provider. We do not offer any medication trial offers, or free Folotyn samples.

Can NiceRx help me get Folotyn cheaper if I have insurance?

We may be able to help you if you have insurance, including if your insurance company will not pay for your Folotyn medication, or you have a high copay or coinsurance responsibility. We may even be able to assist if you do not have insurance. Please fill in our enrollment application to find out more.

How much does Folotyn cost without insurance?

Folotyn costs without insurance will vary depending on how much you buy and the retailer you buy it from. As a guide, Folotyn intravenous solution (20 mg/mL) will typically cost around $6,700 for 1 milliliter. If you obtain your medication through NiceRx, you will pay a flat monthly rate of $49 per medication regardless of its retail price.

How much does Folotyn cost with insurance?

The copay of Folotyn will vary in line with the specific terms of your healthcare plan. For further details about what you may need to pay, your insurance provider or pharmacist will be able to calculate the copay costs with your current insurance.

What is Folotyn?

Folotyn (pralatrexate injection) is an FDA (U.S. Food and Drug Administration) approved medication manufactured for Allos Therapeutics, Inc. Folotyn is a folate analog metabolic inhibitor indicated for the treatment of patients with relapsed or refractory peripheral T-cell lymphoma (PTCL). This indication is based on overall response rate.

What doses of Folotyn are available?

Folotyn is available in injection form, in the following doses: 20 mg/mL.

Patients are instructed to take folic acid 1 to 1.25 mg orally once daily beginning 10 days before the first dose of Folotyn. Continue folic acid during the full course of therapy and for 30 days after the last dose. Also, vitamin supplementation with vitamin B12 is recommended.

The recommended dose of Folotyn is 30 mg/m2 administered as an intravenous push over 3 to 5 minutes once weekly for 6 weeks in 7-week cycles until disease progression or unacceptable toxicity.

Please see the full prescribing information for the full patient information and always speak with your healthcare provider for medical advice about any changes to your dose so they can monitor and evaluate your condition.

Folotyn active ingredients

Pralatrexate inhibits the enzyme dihydrofolate reductase, folate transport, and possibly folate polyglutamation, to cause folate reduction and diminish the production of biological compounds.

Its mechanism is almost identical to that of the anticancer drugs methotrexate and pemetrexed. The depletion of folate results in decreased concentrations of thymidylate and certain purines which leads to errors in DNA replication, which brings about necrosis or apoptosis in rapidly dividing cells, such as some cancer cells and normal cells of the gastric mucosa and bone marrow.

Pralatrexate inhibited the growth of a wide variety of human cancer cell types at relatively low concentrations after 48 hours exposure in the standard National Cancer Institute (NCI) in vitro assay.

Folotyn side effects

The most common possible side effects of Folotyn in clinical trials include:

• Mucositis – redness or painful sores in your mouth or throat, or trouble speaking, eating, or drinking
• Nausea, and fatigue
• Pyrexia
• Sepsis
• Dehydration
• Dyspnea

In rare instances, Folotyn can cause more serious side effects. These can include:

• Thrombocytopenia (reduced platelet count)
• Neutropenia and anemia
• Fetal harm – women should avoid becoming pregnant while being treated and pregnant women should be informed of the potential harm to the fetus
• Low blood cell counts – tell your healthcare provider if you develop any signs of infection, fever, bleeding or tiredness during treatment
• Low potassium levels – leg cramps, constipation, irregular heartbeats, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling
• Severe skin reactions – dermatologic reactions, peeling and loss of skin, sores, blisters
• Tumor lysis syndrome – is caused by the fast breakdown of certain types of cancer cells
• Hepatic toxicity and liver function test abnormalities
• Increased risk of serious reactions in people with kidney problems

Your doctor will assess the benefits of using Folotyn against your risk of side effects. Patients are encouraged to report negative side effects or adverse reactions of Folotyn to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Folotyn drug interactions

Folotyn can interact with other medications. These include:

• Probenecid
• NSAIDs
• Trimethoprim/sulfamethoxazole

This list is not exhaustive and other prescription drugs may interact with Folotyn.

Folotyn contraindications

You should not use Folotyn if you:

• Are allergic to the active ingredient pralatrexate
• Are allergic to any of the other ingredients in Folotyn
• Are pregnant or are planning to become pregnant – Folotyn can harm your unborn baby
• Are breastfeeding or are planning to breastfeed

Talk to your doctor before using Folotyn if you:

• Are taking any of the medications that could interact with Folotyn

Folotyn generic

Folotyn is the trademark brand name for pralatrexate manufactured for Allos Therapeutics, Inc. A generic version of pralatrexate is not available. Generic drugs are generally cheaper than brand name drugs, but you can still find Folotyn savings through NiceRx.