Ensure your patients get the support they need with the Patient Assistance Program and $0 copay for those eligible.
Visit our sample portal for the following convenient services:
To register, simply click on the link below and provide your name, email, zip code, and HCP identifier (NPI, ME, or SLN). Your application will then be reviewed and, if approved, your account/email will then be validated and made active.Request Samples
Download the KEVZARA Experience Voucher Form below to order a 30-day sample of KEVZARA for your patients*
As little as $0 copay for eligible patients
Commercially eligible patients may pay as little as $0 per month for therapy, up to an annual maximum of $15,000, subject to additional terms and conditions.*
Patients can enroll in the program and receive membership information by:
Enrolling in the Copay Card Program at KEVZARA.com
Activating a physical copay card provided by their physician
Calling KevzaraConnect at 1-844-KEVZARA (1-844-538-9272)
The Patient Assistance Program provides KEVZARA at no cost for up to 12 months to eligible uninsured, underinsured, and certain Medicare Part D patients if additional eligibility requirements are met.
If you have patients who may meet eligibility requirements and would like to enroll in the program, they must contact KevzaraConnect (1-844-538-9272).
KEVZARA sample letters are included to help provide the type of information that may be useful when responding to a health plan. These letters provide an example of the types of information that may be provided when responding to a request from a patient's health plan to provide either a letter of appeal or a letter of medical necessity of KEVZARA. Use of the information in these letters does not guarantee that the health plan will cover KEVZARA and is not intended to be a substitute for or an influence on the independent medical judgment of the physician.