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Kepivance Patient assistance program

Is your Kepivance medication too expensive? Start receiving your medication for only $49 per month.*

Complete a free online enrollment application to find out if you’re eligible to pay only $49 per month for your Kepivance medication with our help.

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  • NiceRx Benefit
    Secure: Your personal and medical information is safe with us
  • NiceRx Benefit
    Convenient: Your medication is delivered straight to your door
  • NiceRx Benefit
    Ongoing refills: Your medication is refilled automatically
  • NiceRx Benefit
    Secure: Your personal and medical information is safe with us
  • NiceRx Benefit
    Convenient: We manage the whole process and we’re here to assist you
  • NiceRx Benefit
    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

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  • An introduction to NiceRx
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  • Next steps after qualifying
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  • Uploading documents and billing
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  • SSN & billing information
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  • Medication delivery time
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How it works

  • Apply Online

    Get started by filling out the online enrollment application to find out if you are eligible.

  • Qualification

    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.

  • Upload Documents

    You may be required to submit further information and documents required by the pharmaceutical company which can be securely uploaded online.

  • Application Created

    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.

  • Receive Medication

    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.

Medically reviewed by  Jamie Winn, PharmD

Your monthly Kepivance cost savings if eligible

If you are eligible for the Kepivance patient assistance program, the cost of your medication will be free. We only charge $49 per month for each medication, to cover our service fees. You could receive your Kepivance prescription for just $49 a month, regardless of the retail price of your medication.

Am I eligible for the Kepivance patient assistance program?

We will review your application to determine whether you are eligible for the Kepivance patient assistance program. Each program has its own eligibility criteria which is set by the pharmaceutical companies, however, the 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 the Kepivance patient assistance program?

We make it as easy as possible to apply for the Kepivance patient assistance program. The first step is to complete our enrollment application. Tell us about any medications you are taking, including Kepivance. We will also ask for details about your healthcare provider, insurance, and your household income. This information is required by the pharmaceutical manufacturers who ship your medication.

If we determine that you may be eligible for Kepivance assistance, we will handle the application process for you. We will work directly with your healthcare provider to prepare your application documents. Once we have received the signed application and supporting documents, we will submit them to the patient assistance program on your behalf. Our service continues once you are enrolled in the Kepivance patient assistance program, and we will automatically request your Kepivance medication refills for up to 1 year.

Is NiceRx a Kepivance coupon provider?

We are a service provider that helps eligible individuals access the Kepivance patient assistance program. That means that we do not offer printable Kepivance manufacturer coupons, Kepivance discounts, or free Kepivance samples. We are not a Kepivance coupon provider or Kepivance discount card. Our service extends to assisting eligible individuals to access the medications they need through patient assistance programs.

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

We may be able to help you to access Kepivance patient assistance in a variety of circumstances. This includes when your insurance company will not pay for your Kepivance medication or if you have a high copay or coinsurance responsibility. We may also be able to help you if you do not have insurance. Please apply online to find out more.

How much does Kepivance cost without insurance?

Kepivance cost without insurance will vary depending on where you buy it. As a guide, Kepivance intravenous powder for injection 6.25 mg usually costs $9,400 for 3 powders for injection. With NiceRx you will pay a flat monthly fee of $49, regardless of the retail price of your medication.

How much does Kepivance cost with insurance?

The copay for Kepivance with insurance depends on the terms of your healthcare plan. To find out how much this is, your healthcare provider or pharmacist will be able to calculate your copay with your current insurance.

What is Kepivance?

Kepivance is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Swedish Orphan Biovitrum AB (publ) SE-112 76 Stockholm, Sweden.

It is a recombinant human keratinocyte growth factor that works at the cellular level to help protect patients with hematologic malignancies undergoing certain cancer treatments such as high-dose chemotherapy and/or radiation therapy followed by bone marrow stem cell transplant from severe oral mucositis (mouth ulcers).

Kepivance reduces the incidence and duration of severe oral mucositis in these patients receiving myelotoxic therapy requiring hematopoietic stem cell support. Kepivance is indicated as supportive care for preparative regimens predicted to result in ≥ WHO Grade 3 mucositis in the majority of patients.

Kepivance protects the epithelial cells that line the mouth and throat from the damage caused by chemotherapy and radiation by stimulating the growth and development of new epithelial cells to build up the mucosal barrier.

Kepivance is used in people receiving chemotherapy to treat blood cancers (Hodgkin’s disease, multiple myeloma, leukemia). This medicine is not a treatment for cancer itself.

Limitations of Use

  • The safety and efficacy of Kepivance have not been established in patients with non-hematologic malignancies
  • Kepivance is not recommended for use with melphalan 200 mg/m2 as a conditioning regimen
  • Kepivance was not effective in decreasing the incidence of severe mucositis in patients with hematologic malignancies receiving myelotoxic therapy in the setting of allogeneic hematopoietic stem cell support

What doses of Kepivance are available?

Kepivance is available in lyophilized powder form, in the following doses: 6.25 mg in single-use vials

Administer Kepivance as an intravenous bolus injection at a dose of 60 mcg/kg/day for 3 consecutive days before and 3 consecutive days after myelotoxic therapy for a total of 6 doses. Administer the first 3 doses prior to myelotoxic therapy with the third dose 24 to 48 hours before myelotoxic therapy. Administer the last 3 doses after myelotoxic therapy is complete with the first of these doses on the day of hematopoietic stem cell infusion after the infusion is completed, and more than 4 days after the most recent administration of Kepivance.

Always speak with a healthcare professional about any changes to your dose so they can monitor and evaluate your condition.

Kepivance active ingredients

Kepivance contains palifermin as the active ingredient.

Kepivance side effects

The most common side effects of Kepivance in clinical trials (incidence ≥20% and 5%≥placebo) include:

  • Rash
  • Fever
  • Elevated serum amylase
  • Pruritus
  • Erythema
  • Edema
  • Gastrointestinal events
  • Respiratory events
  • Dysesthesia
  • Mouth/tongue thickness/discoloration

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

  • Stimulation of keratinocyte growth factor (KGF) receptor-expressing, non-hematopoietic tumors

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

Kepivance drug interactions

Kepivance can interact with other medications. These include:

  • Heparin
  • Myelotoxic chemotherapy

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

Kepivance contraindications

You should not use Kepivance if you:

  • Are allergic to the active ingredient palifermin
  • Are allergic to any of the other ingredients in Kepivance
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed – you should not breastfeed while receiving this medication or for 2 weeks after your last dose

Talk to your doctor before using Kepivance if you:

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

Kepivance generic

Kepivance is the trademark brand name for palifermin manufactured by Swedish Orphan Biovitrum AB. A generic version of palifermin is not available. Generic drugs are generally cheaper than brand-name drugs, but you can still find Kepivance 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 the different programs and filling out all the required paperwork for each program. Subject to medication availability.

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.