Check eligibility for a BioMarin Co-Pay Assistance Program

1) The BioMarin Co-Pay Assistance Program (“Program”) is valid only for those patients with commercial prescription insurance coverage who have a valid prescription for an FDA-approved indication for BRINEURA® (cerliponase alfa), KUVAN® (sapropterin dihydrochloride), PALYNZIQ® (pegvaliase-pqpz), ROCTAVIAN® (valoctocogene roxaparvovec­-rvox), or VOXZOGO® (vosoritide), and who meet eligibility criteria. Offer not valid for prescriptions reimbursed, in whole or in part, by any federal, state, or government-funded insurance programs (for example, Medicare, Medicare Advantage, Medigap, Medicaid, VA, DoD, or TRICARE), for cash-paying patients, where product is not covered by patient’s commercial insurance, where patient’s commercial insurance plan reimburses them for entire cost of their prescription drug, or where prohibited by law or by the patient’s health insurance provider. If at any time a patient begins receiving prescription drug coverage under any such federal, state, or government-funded healthcare program, patient will no longer be able to use the Program and patient must notify BioMarin RareConnections at 1-866-906-6100 to stop participation. Patients may not seek reimbursement for the value of the out-of-pocket expense amount covered by the Program from any third-party payer, whether public or private. Valid only in the United States and Puerto Rico.

This Program is not health insurance. Offer may not be combined with any other rebate, coupon, or offer. Co-payment assistance under the Program is not transferable. BioMarin Pharmaceutical Inc. reserves the right to rescind, revoke, or amend the program without notice. Patient/caregiver certifies responsibility for complying with applicable limitations, if any, of any commercial insurance and reporting receipt of program rewards, if necessary, to any commercial insurer. This program is subject to termination or modification at any time. By enrolling in the Program, you agree that this program is intended solely for the benefit of you, the patient. The funds made available through the Program may only be used to reduce the out-of-pocket costs for the patient enrolled in the Program. Some health plans have established programs referred to as “accumulator adjustment” or “co-pay maximizer” programs. An accumulator adjustment program is one in which payments made by you that are subsidized by manufacturer assistance do not count toward your deductibles and other out-of-pocket cost sharing limitations. Co-pay maximizers are programs which exhaust the available support offered by a manufacturer assistance program. The Program is not intended for the benefit of third parties, including without limitation third party payers, pharmacy benefit managers, or their agents. If BioMarin determines that a third party has implemented a program that adjusts patient cost-sharing obligations based on the availability of support under the Program and/or excludes the assistance provided under the Program from counting towards the patient’s deductible or out-of-pocket cost limitations, BioMarin may impose a per fill cap on the cost-sharing assistance available under the Program. You also agree that you are personally responsible for paying any amount of co-pay required after the savings card is applied. Any out-of-pocket costs remaining after the application of the co-pay assistance program could not be paid by your health plan, pharmacy benefit programs, or any other program. If you learn your insurance company or health plan has implemented either an accumulator adjustment program or a co-pay maximizer program, you agree to inform BioMarin of this fact by emailing support@biomarin-rareconnections.com or calling 1-866-906-6100 to discuss alternative options that may be available to support you. BioMarin will monitor program utilization data and, except where prohibited by applicable state law, reserves the right to rescind, revoke, or amend the co-pay assistance program at any time including if BioMarin determines that you are subject to an accumulator adjustment or co-pay maximizer program.

2) The following additional terms and conditions apply for the following therapies:

BRINEURA: Residents of MA and RI are eligible for assistance with cost share associated with BRINEURA (drug) only and not costs associated with the administration/procedure.

ROCTAVIAN: Program terms and conditions as stated apply to all ROCTAVIAN patient support programs. Some restrictions apply. Offer not valid for prescriptions, administration, or related labs reimbursed, in whole or in part, by any federal, state, or government-funded insurance programs (for example, Medicare, Medicare Advantage, Medigap, Medicaid, VA, DoD, or TRICARE), for cash-paying patients, where product, administration, or related lab are not covered by patient’s commercial insurance, where patient’s commercial insurance plan reimburses them for the entire cost of their prescription drug, administration, and/or related labs, or where prohibited by law or by the patient’s health insurance provider. Patients who are residents of certain states (MA or RI) are not eligible for drug administration co-pay support. Patients who are residents of certain states (MI, MN, or RI) are not eligible for laboratory services co-pay support or travel-related expenses. If at any time a patient begins receiving prescription drug, administration, or related lab coverage under any such federal, state, or government-funded healthcare program, patient will no longer be able to use the Program and patient must notify BioMarin RareConnections at 1-866-906-6100 to stop participation.

For more information on BioMarin financial assistance options, contact BioMarin RareConnections by emailing support@biomarin-rareconnections.com or call 1-866-906-6100.