PRALUENT is covered by a majority of health plans and covered by most Medicare Part D insurance plans*
- Most Medicare patients can expect to pay between $25 and $150 per month†
- Eligible commercially insured patients may pay as little as a $25 copay for PRALUENT each month up to a maximum annual amount of $3500 (restrictions apply)‡
*Formulary data are provided by Managed Markets Insights & Technology, LLC (MMIT) and are current as of August 2020. Because formularies do change and many health plans offer more than one formulary, please check directly with the health plan to confirm coverage.
†Subject to plan adoption and tier placement determination.
‡Eligible patients with commercial insurance not funded through a government healthcare program such as Medicare, Medicaid, or TRICARE are subject to program terms and restrictions.
PRALUENT is empowering more:
Accessibility
Simplified prior authorization process for some plans1
Affordability

Financial assistance for eligible patients
Flexibility
2 powerful dosing options in adults with established CV disease§
§Based on patient’s efficacy needs.
DOSING INFORMATION IN ADULTS WITH ESTABLISHED CARDIOVASCULAR DISEASE
The recommended starting dose of PRALUENT is 75 mg once every 2 weeks or 300 mg once every 4 weeks (monthly) administered subcataneously. If the LDL-C response is inadequate, the dosage may be adjusted to 150 mg administered every 2 weeks.
Programs to help patients pay for PRALUENT
Commercially insured patients

Commercially insured patients
As little as a $25 copay for PRALUENT each month||¶
The MyPRALUENT® Copay Card Program may help eligible, commercially insured patients with out-of-pocket costs for their PRALUENT treatments, including deductibles, copays, and coinsurance.¶
- The MyPRALUENT® Copay Card can be used yearly
- Patients can submit for reimbursement if they paid their copay in full within 90 days
||Eligible patients with commercial insurance not funded through a government healthcare
program such as Medicare, Medicaid, or TRICARE are subject to program terms and restrictions.
¶Subject to a maximum annual copay assistance amount from MyPRALUENT® of $3,500.

Uninsured and Medicare patients who meet income restrictions
Are your patients eligible? Click below to register and submit the MyPRALUENT® Patient Assistance Program (PAP) form electronically. For questions, contact 1-844-PRALUENT (1-844-772-5836). If your patient is eligible and approved, your patient's prescription will be forwarded to the PAP pharmacy for processing.
Low-income Medicare patients

Low-income Medicare patients
If your patients are faced with limited income and resources, there's a US government-funded program that may help pay some of their Medicare prescription drug costs. It's called the Extra Help Program and it offers:
- Reduced Medicare Part D premiums
- No cost share in the coverage gap or "donut hole"
- Lower drug copays
Clinical documentation and prior authorization (PA) tips
Many health plans require a PA for PRALUENT. Here are some helpful tips to keep in mind when gathering your patient’s clinical information and preparing a PA submission.
Items to include when submitting a PA
Clinical documentation
Important patient information to collect:
Specific ICD-10 codes and details to support your patient’s diagnosis
Complete history of lipid-lowering therapy, including doses, frequency, and dates of use
- Be sure to include proof of maximally tolerated high-intensity statin(s) if required
- Also note if your patient tried and failed on ezetimibe
Contraindications or any intolerance/adverse reactions to lipid-lowering therapies
Lab work within the last 30 days showing lipid profile test results
Documentation of family history and any comorbid conditions
Proof of lifestyle modification (eg, diet, exercise, smoking cessation counseling)
Completed and signed plan-specific PA form
Before submitting any documentation to the health plan, be sure that it’s accurate and up to date to avoid unnecessary denials.
Getting patients started

iAssist is an electronic platform that simplifies access to help get PRALUENT to appropriate patients. This free, all-in-one tool:
Sends prescriptions and completed prior authorization forms directly to the pharmacy and payer
May help reduce incomplete prior authorization submission