Our Commitment to Improving Lives Through Access

Paying for treatment shouldn’t get in the way of your patient’s health. That’s why the Horizon By Your Side team is diligent in exploring all options to help your patient.

  • Does your patient have commercial insurance, like a preferred provider organization (PPO) or health maintenance organization (HMO)? If so, they may qualify for a lower co-pay*
  • Does your patient have government insurance, such as Medicare, Medicare Part D, Medicaid, Medigap, VA, CHAMPUS, Department of Defense, TRICARE, or any state, patient foundation, or other pharmaceutical program? If so, there may be additional support for them
  • Once your treatment plan is set in place, the Patient Access Liaison can help talk with your patient about the insurance approval process and what the potential out-of-pocket treatment costs may be

Through our team’s knowledge of how insurance companies work and our understanding of your specific benefits, our Patient Access Liaisons can help your patient understand the insurance process by walking them through coverage and possible financial assistance options.

Shared Responsibility

As an industry partner, we have limitations that we must respect. We cannot guarantee access or reimbursement for our medicines; however, we can educate you and your staff about gaining access to the medicine and various patient financial support programs. Similarly, we cannot provide medical advice to your patient about the medicines you prescribe or act as an extension of—or substitution for—your staff.

Access Journey for New Medicines

With any medicine, the time from prescribing the medicine to infusion may take longer than initially expected, as payers learn about the medicine and develop their policies. We are committed to working with payers to enhance access and learning more about payer policies so we can educate you about these nuances.

Together, we can advocate for your patient to gain access to the medicines you believe will improve their lives.

Independent Organizations That Can Provide Foundational Assistance for Your Patient

Patient Advocate Foundation logo Patient Advocate Foundation logo Patient Advocate Foundation logo

Patient Advocate Foundation

The Patient Advocate Foundation provides support and assistance to patients with chronic, debilitating diseases to help access care and treatment recommended by their doctor. Case managers will help patients understand roadblocks to access to care and affordability to Americans with chronic, life-threatening, and debilitating illnesses.

https://www.patientadvocate.org/

Logo for The Assistance Fund Logo for The Assistance Fund Logo for The Assistance Fund

The Assistance Fund

The Assistance Fund is an independent charitable patient assistance organization that provides support for adults and children with rare and chronic diseases. The organization may help provide families with finacial and travel assistance.

https://TAFcares.org/

National Organization for Rare Disorders (NORD) logo National Organization for Rare Disorders (NORD) logo National Organization for Rare Disorders (NORD) logo

National Organization for Rare Disorders (NORD)

NORD is a patient advocacy organization dedicated to people with rare diseases and the groups that help them. NORD provides patients and families with advocacy information, assistance programs, and connections to patient organizations.

NORD also has an Emergency Relief Program. This fund provides financial assistance that can be used to pay for unexpected or emergency non-medical expenses such as utility expenses, cellular or internet service, emergency repairs to car, home or major appliance, and rent or mortgage payment assistance.

https://rarediseases.org

*The Horizon Commercial Co-Pay Program may be available to patients who meet the following minimum criteria:

  • Patient’s prescription cannot be paid in part or in full by any government-funded program including but not limited to: Medicare, Medicare Part D, Medicaid, Medigap, VA, CHAMPUS, Department of Defense (DOD), TRICARE, or any state, patient foundation, or other pharmaceutical program
  • Patient is prescribed a covered Horizon rare disease medication for an indication approved by the Food and Drug Administration; the indication for each product is shown in its prescribing information
  • Patient is a resident of the United States
  • Patient must be commercially insured and have financial responsibility for a portion of the drug and/or infusion cost if applicable

The assistance offered under this co-pay program is subject to additional terms and conditions, including but not limited to the following:

Terms and Conditions: Offer cannot be combined with any other rebate or coupon, free trial, or similar offer for the specified prescription. Not valid for prescriptions reimbursed in whole or in part by any government-funded program including but not limited to Medicare, Medicare Part D, Medicaid, Medigap, VA, CHAMPUS, DOD, TRICARE, or any state, patient foundation, or other pharmaceutical program. Offer good only in the United States at participating specialty pharmacies or sites of care. Offer not valid where otherwise prohibited by law, for example by applicable state law prohibiting co-pay cards. Horizon reserves the right to rescind, revoke, or amend offer without notice. The selling, purchasing, trading, or counterfeiting of any co-pay card or benefits is prohibited by law. This co-pay program is not insurance and is not intended to substitute for insurance. Age for eligibility is dependent on product indication.

Participating Pharmacies or Healthcare Providers: By using this co-pay program, you acknowledge and confirm that the prescription will not be reimbursed in whole or in part by any government-funded program (such as, without limitation, Medicare, Medicaid, VA, DOD, TRICARE) and the patient and prescription meet the eligibility criteria set forth in the terms and conditions. You are responsible for reporting the receipt of the co-pay program benefits as required by an insurer, payer, or applicable law or regulation.

Patients: By enrolling in this co-pay program, you acknowledge and confirm that you and the prescription meet the eligibility requirements set forth in the terms and conditions, including that the prescription will not be reimbursed in whole or in part by any government-funded program (such as, without limitation, Medicare, Medicaid, VA, DOD, TRICARE). You may not seek any claims to government payers or other payers or insurers for this prescription. You may not seek reimbursement from any health savings, flexible savings, or other healthcare reimbursement account for any amounts received from the co-pay program. You are responsible for reporting the receipt of the co-pay program benefits as required by an insurer, payer, or applicable law or regulation.


INDICATION AND IMPORTANT SAFETY INFORMATION

IMPORTANT SAFETY INFORMATION

Warnings and Precautions

Infusion Reactions: TEPEZZA may cause infusion reactions. Infusion reactions have been reported in approximately 4% of patients treated with TEPEZZA. Reported infusion reactions have usually been mild or moderate in severity. Signs and symptoms may include transient increases in blood pressure, feeling hot, tachycardia, dyspnea, headache, and muscular pain. Infusion reactions may occur during an infusion or within 1.5 hours after an infusion. In patients who experience an infusion reaction, consideration should be given to premedicating with an antihistamine, antipyretic, or corticosteroid and/or administering all subsequent infusions at a slower infusion rate.

Preexisting Inflammatory Bowel Disease: TEPEZZA may cause an exacerbation of preexisting inflammatory bowel disease (IBD). Monitor patients with IBD for flare of disease. If IBD exacerbation is suspected, consider discontinuation of TEPEZZA.

Hyperglycemia: Increased blood glucose or hyperglycemia may occur in patients treated with TEPEZZA. In clinical trials, 10% of patients (two-thirds of whom had preexisting diabetes or impaired glucose tolerance) experienced hyperglycemia. Hyperglycemic events should be managed with medications for glycemic control, if necessary. Monitor patients for elevated blood glucose and symptoms of hyperglycemia while on treatment with TEPEZZA. Patients with preexisting diabetes should be under appropriate glycemic control before receiving TEPEZZA.

Adverse Reactions

The most common adverse reactions (incidence ≥5% and greater than placebo) are muscle spasm, nausea, alopecia, diarrhea, fatigue, hyperglycemia, hearing impairment, dysgeusia, headache, and dry skin.

INDICATION

TEPEZZA is indicated for the treatment of Thyroid Eye Disease.

Please see Full Prescribing Information for more information.

INDICATION AND IMPORTANT SAFETY INFORMATION

IMPORTANT SAFETY INFORMATION

Warnings and Precautions

Infusion Reactions: TEPEZZA may cause infusion reactions. Infusion reactions have been reported in approximately 4% of patients treated with TEPEZZA. Reported infusion reactions have usually been mild or moderate in severity. Signs and symptoms may include transient increases in blood pressure, feeling hot, tachycardia, dyspnea, headache, and muscular pain. Infusion reactions may occur during an infusion or within 1.5 hours after an infusion. In patients who experience an infusion reaction, consideration should be given to premedicating with an antihistamine, antipyretic, or corticosteroid and/or administering all subsequent infusions at a slower infusion rate.

Preexisting Inflammatory Bowel Disease: TEPEZZA may cause an exacerbation of preexisting inflammatory bowel disease (IBD). Monitor patients with IBD for flare of disease. If IBD exacerbation is suspected, consider discontinuation of TEPEZZA.

Hyperglycemia: Increased blood glucose or hyperglycemia may occur in patients treated with TEPEZZA. In clinical trials, 10% of patients (two-thirds of whom had preexisting diabetes or impaired glucose tolerance) experienced hyperglycemia. Hyperglycemic events should be managed with medications for glycemic control, if necessary. Monitor patients for elevated blood glucose and symptoms of hyperglycemia while on treatment with TEPEZZA. Patients with preexisting diabetes should be under appropriate glycemic control before receiving TEPEZZA.

Adverse Reactions

The most common adverse reactions (incidence ≥5% and greater than placebo) are muscle spasm, nausea, alopecia, diarrhea, fatigue, hyperglycemia, hearing impairment, dysgeusia, headache, and dry skin.

INDICATION

TEPEZZA is indicated for the treatment of Thyroid Eye Disease.

Please see Full Prescribing Information for more information.