Financial Resources

AAA PatientCONNECT™ patient assistance for
LUTATHERA­® (lutetium Lu 177 dotatate)

Go to www.aaapatientconnect.com for more information about AAA PatientCONNECT™

AAA PatientCONNECT™ provides services to facilitate your access to LUTATHERA treatment. This may include:

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Patient Financial Assistance

  • Uninsured patient assistance
  • Commercial patient copay assistance

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Other Assistance

  • Insurance benefits verification
  • Prior authorization eligibility check

Financial assistance for uninsured patients

AAA PatientCONNECT™ may provide LUTATHERA at no cost to patients who are uninsured and meet certain eligibility criteria.*

You may qualify for assistance if:

  • You are uninsured for LUTATHERA treatment
  • You meet financial criteria based on adjusted gross household income. Documentation of income is required when applying. Speak with a patient navigator to learn more about acceptable forms of documentation
  • Your LUTATHERA treatment is being provided in an outpatient setting
  • You are a permanent resident of the United States, including any of its territories, or the District of Columbia
  • Eligibility restrictions may apply. For full terms and conditions, please call AAA PatientCONNECT™ at 1-844-NETS-AAA. Patients who are enrolled in any type of government insurance or reimbursement programs are not eligible. As a condition precedent of the copayment support provided under this program, e.g. copay refunds, participating patients and pharmacies are obligated to inform insurance companies and third-party payers of any benefits they receive and the value of this program, as required by contract or otherwise. Void where prohibited by law or restricted.

For more information, contact AAA PatientCONNECT™ at 1-844-NETS-AAA (1-844-638-7222).

Financial assistance for patients with commercial insurance

AAA PatientCONNECT™ may provide copay assistance for LUTATHERA treatment to patients who have commercial insurance and meet certain eligibility criteria.*

You may qualify for assistance if:

  • You have commercial insurance
  • Your LUTATHERA treatment is being provided in an outpatient setting
  • You are a permanent resident of the United States, including any of its territories, or the District of Columbia

Copay assistance is not available through the AAA PatientCONNECT™ program for patients who have public or government insurance, such as insurance available as through Medicare, Department of Veterans Affairs, or the Department of Defense. AAA PatientCONNECT™ is not an insurance program and is not a substitute for medical insurance.

  • Eligibility restrictions may apply. For full terms and conditions, please call AAA PatientCONNECT™ at 1-844-NETS-AAA. Patients who are enrolled in any type of government insurance or reimbursement programs are not eligible. As a condition precedent of the copayment support provided under this program, e.g. copay refunds, participating patients and pharmacies are obligated to inform insurance companies and third-party payers of any benefits they receive and the value of this program, as required by contract or otherwise. Void where prohibited by law or restricted.
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Enrolling in copay assistance

To enroll in financial assistance for commercial insurance, your health care provider must submit a completed and signed copay assistance application to AAA PatientCONNECT™ on your behalf. Copay assistance applications are available online at www.aaapatientconnect.com.

By signing this application, you agree that, if approved, all copay assistance funds distributed will be used only for the cost of LUTATHERA.

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Receiving copay financial assistance

Upon approval, AAA PatientCONNECT™ will send an approval letter and outline of the copay assistance funds that are available for your treatment. Proof of treatment and claims must be submitted to AAA PatientCONNECT™ to receive a distribution of copay assistance funds. Upon receipt, copay assistance funds will be processed and distributed to you for payment of your LUTATHERA treatment copay.

For more information, contact AAA PatientCONNECT™ at 1-844-NETS-AAA (1-844-638-7222).

TERMS AND CONDITIONS

AAA PatientCONNECT™ -- LUTATHERA® PATIENT ASSISTANCE PROGRAM (PAP)

Limitations apply. The Advanced Accelerator Applications (AAA) PatientCONNECT™ Lutathera® Patient Assistance Program is valid only for patients with no insurance coverage. The patient is obligated to notify AAA PatientCONNECT™ at 844-638-7222 promptly if the patient obtains insurance coverage or otherwise becomes ineligible for coverage under the Program. Patient must be age 18 or older. Patient must be a permanent resident of the United States, Commonwealth of Puerto Rico or the United States Virgin Islands. Patient must be prescribed Lutathera (lutetium Lu 177 dotatate) for an FDA approved indication. Treatment with Lutathera must be provided in an appropriate outpatient setting. The Program provides Lutathera free of charge to patients who meet the financial and all other eligibility requirements of the Program. The Program only provides Lutathera free of charge to eligible patients. The Program does not cover any costs or expenses, even if such expenses are associated with the administration of Lutathera (e.g., charges for a visit to the health care provider’s office or medication administration charges). The patient is subject to eligibility verification, including income verification, prior to approval for the Program. The patient’s eligibility for the Program expires on the anniversary of the first year following the patient’s initial enrollment in the Program. Thereafter, the patient may re-enroll in the Program on a yearly basis. For each re-enrollment period, the patient is subject to eligibility verification, including income verification. The benefit conferred by the Program is exclusively for the patient. The Program is not valid where prohibited by law. Patient and the patient’s health care provider must not seek reimbursement for the benefit conferred by the Program from any other party, including without limitation, any health insurance program or plan, flexible spending account or healthcare savings account. The Program is not health insurance. The Program may not be combined with any third-party rebate, coupon, or offer. Data related to the patient’s receipt of benefits under the Program may be collected, analyzed and shared with AAA, in an aggregated and patient de-identified form, for purposes that include assessing the Patient Assistance Program and potentially making adjustments to such Program. Advanced Accelerator Applications, a Novartis company, reserves the right to rescind, revoke or amend the Program and/or discontinue assistance at any time without notice. No other purchase is necessary. Program is limited to 1 per person during this offering period and is not transferable.

AAA PatientCONNECT™ -- LUTATHERA® COPAY ASSISTANCE PROGRAM

Limitations apply. The Advanced Accelerator Applications (AAA) PatientCONNECT™ Lutathera® Copay Assistance Program (the “Program”) is valid only for patients with commercial insurance coverage who are otherwise eligible for the Program. The Program is not valid under Medicare, Medicaid, or any other federal or state program, for cash-paying patients, where the product is not covered by the patient’s commercial insurance, or where the patient’s insurer reimburses the patient for the entire cost of Lutathera (lutetium Lu 177 dotatate). The patient is obligated to notify AAA PatientCONNECT™ at 844-638-7222 promptly if the patient’s insurance coverage changes or otherwise becomes ineligible for coverage under the Program. Patient must be age 18 or older. Patient must be a permanent resident of the United States, Commonwealth of Puerto Rico or the United States Virgin Islands. Patient must be prescribed Lutathera for an FDA approved indication. Treatment with Lutathera must be provided in an appropriate outpatient setting. The Program provides that an eligible patient will be responsible for the first $25.00 per infusion and then may receive up to a maximum of $15,000.00 over the course of the treatment (i.e., four Lutathera infusions) to cover eligible out-of-pocket costs for Lutathera. After the maximum coverage is reached, the patient will be responsible for any costs incurred. Patient must have an out-of-pocket cost for Lutathera and be administered Lutathera prior to the expiration date of the Program. The benefit available under the Program is valid for the patient’s out-of-pocket cost for Lutathera only. It is not valid for any other out-of-pocket costs (e.g., office visit charges or medication administration charges) even if such costs are associated with the administration of Lutathera. If a patient’s insurance benefit year expires during the course of approved Program eligibility, confirmation of ongoing treatments and updated insurance information must be received from the treatment facility or physician’s office for eligibility under the Program to be continued into the new benefit period. The patient is subject to eligibility verification prior to enrollment in the Program. The patient’s eligibility for the Program expires on the anniversary of the first year following the patient’s initial approval for the Program. Thereafter, the patient may re-enroll in the Program on a yearly basis. For each re-enrollment period, the patient is subject to eligibility verification. Reimbursement under the Program is processed after services are rendered and the appropriate documentation is submitted to the Program. Such documentation must be submitted within 365 days after the date of service and must specify a line item specifically for Lutathera. The benefit conferred by the Program is exclusively for the patient. The Program is not valid where prohibited by law. Patient and the patient’s health care provider must not seek reimbursement for the benefit conferred by the Program from any other party, including without limitation, any health insurance program or plan, flexible spending account or healthcare savings account. The Program is not health insurance. The Program may not be combined with any third-party rebate, coupon, or offer. Data related to the patient’s receipt of benefits under the Program may be collected, analyzed and shared with AAA, in an aggregated and patient de-identified form, for purposes that include assessing the Program and potentially making adjustments to such Program. Advanced Accelerator Applications, a Novartis company, reserves the right to rescind, revoke or amend the Program and/or discontinue assistance at any time without notice. No other purchase is necessary. Program is limited to 1 per person during this offering period and is not transferable.

What is LUTATHERA?

LUTATHERA® (lutetium Lu 177 dotatate) is a prescription medicine used to treat adults with a type of cancer known as gastroenteropancreatic neuroendocrine tumors (GEP-NETs) that are positive for the hormone receptor somatostatin, including GEP-NETs in the foregut, midgut, and hindgut.

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