ILUMYA® Early Access Program Terms and Conditions
The Early Access Program provides ILUMYA® at no charge to commercially insured patients for up to 2 years or until they receive insurance coverage approval, whichever occurs earlier. Patients eligible for ILUMYA® Early Access Program must be 18 years or older and commercially insured. Eligible patients will be automatically enrolled in the Early Access Program and will remain in the program while authorization by the patient’s insurer is being determined. It is the responsibility of the patient’s healthcare provider (HCP) to submit all required authorizations in accordance to the program terms and conditions. In the event that authorization is not obtained after exhausting all options, patients may be eligible to receive ILUMYA® free of charge for up to 2 years.
ILUMYA SUPPORT® will conduct a benefit investigation to determine what authorizations are available, which may include, medical and/or pharmacy authorization(s). The program requires the initial authorization(s) be submitted as early as possible, well in advance of the patient’s third dose. Failure to do so in a timely manner will result in the patient no longer being eligible for the program. If the initial authorization(s) are denied, the Health Care Provider (HCP) will be required to appeal the decision. Appeal(s) are expected to be completed as soon as possible, as dictated by the patient’s insurance. The HCP should follow the appeal directions outlined in the authorization denial letter, including the appeal submission timeline, not to exceed the date of the patient’s 4th dose. We understand that appeals may take longer for an insurer to approve and we will support the forth dose during the appeals process, if deemed necessary. Failure to submit the appeal prior to the patient’s fourth dose, will result in the patient being no longer being able to participate in the Early Access Program. Eligibility for the Early Access Program is validated through continuous coverage checks and may change if the patient no longer meets the current program eligibility requirements.
This is not health insurance and program does not guarantee insurance coverage. The terms and conditions are subject to change. It may be terminated, rescinded, revoked, or amended by Sun Pharmaceutical Industries, Inc., at any time, without notice. Only valid for patients in the United States, Guam, Virgin Islands, or Puerto Rico residents only.
By participating in the Early Access Program, you attest that you meet the eligibility criteria and will comply with the Terms and Conditions. Your participation will require that you provide personal information that may include your name, address, phone number, email address, and information related to your prescription medication insurance and treatment. This information is necessary to permit SUN Pharma, the maker of ILUMYA®, and companies that work with SUN Pharma, including our affiliates and our service providers, to fulfill your request to enroll in the ILUMYA SUPPORT® Program. We may also use the information you give us to learn more about the people who use ILUMYA® and to improve the information we provide to people who are being treated with ILUMYA®. SUN Pharma will not share your information with anyone else except as required by law.
If you have questions regarding eligibility or benefits, or you wish to discontinue participation, call the ILUMYA SUPPORT® Program at 855-4ILUMYA (855-445-8692), Monday through Friday, 8 AM to 8 PM ET.
