Coverage and Affordability

LUTATHERA is accessible for most insured patients*

• 76% of insured patients have favorable coverage for LUTATHERA as of January 2025¹

The other 24% are on plans that do not have published policies and/or cases may be decided on an individual basis. Follow up with the patient’s plan to determine coverage.¹

A review of claims data between Q1 2023 to Q2 2024 indicated that approximately 85% of patients paid $0 for the product. For remaining patients, the out-of-pocket cost for the product varies and may be as high as the total cost of the product. Additional out-of-pocket costs may be incurred related to treatment, including but not limited to administration fees.²

Patient Access Lookup Tool

A resource to help you understand patient coverage for LUTATHERA by state, payer, and plan type^†

*The information provided in this communication is not a guarantee of coverage and patient out-of-pocket costs may vary. Actual coverage and reimbursement decisions are made by individual payers following the receipt of claims and will vary.

^†This website provides general information and is not intended to provide reimbursement or legal advice. Furthermore, it is not intended to increase or maximize payment by any payer. Because laws, regulations, and coverage policies are complex and updated frequently, you should check with your local Medicare carrier and payers often or go to www.cms.gov ↗.

Nothing in the information provided shall be construed as a guarantee of Novartis regarding levels of reimbursement, payment, or charge that reimbursement will be received. The ultimate responsibility for obtaining reimbursement lies with the physician, provider, or patient. Please consult with your counsel or reimbursement specialist for any practice-specific reimbursement or billing questions.

Novartis Patient Support

A dedicated team for you and your patients

Novartis Patient Support is a comprehensive program that is designed to help your patients start, stay, and save on LUTATHERA

Your practice and patients will have access to a Novartis Patient Support team committed to supporting your patients, including:

• Dedicated assistance with access and reimbursement

• Personalized support for your patients receiving therapy

• Single points of contact for you and your patients

Insurance Support

Help navigating the insurance process, including benefits verification and support with the prior authorization and appeals processes

Benefits Verification
Once you’ve enrolled your patients in Novartis Patient Support, our team will conduct a benefits verification to better understand your patient’s coverage, including:

• Informing your practice about additional requirements, such as prior authorization

• Identifying savings options available to your patients

Prior Authorizations and Appeals
Novartis Patient Support can help with prior authorization requests or letters of appeal by working directly with you or your office, including:

• Providing helpful information and timely updates via phone

• Sample Letters of Appeal

Financial Support

Assist with connecting patients to relevant savings options. 

At Novartis Patient Support, we understand that affordability is important. That’s why we offer a range of savings options and resources to help your patients access treatment regardless of their ability to pay.

Co-Pay Plus

To sign up for the $0 Co-Pay Plus offer:

Providers, with their patients, can complete the LUTATHERA Start Form and send to Novartis Patient Support.

*Limitations apply. Valid only for those patients with commercial insurance. Not valid under Medicare or any other federal or state program. Offer subject to a maximum benefit per course of treatment. See complete Terms and Conditions in the Start Form for details.

Other Affordability Assistance

Novartis Patient Assistance Foundation, Inc. (NPAF)

Novartis Patient Assistance Foundation, Inc., an independent 501(c)(3) nonprofit organization, provides Novartis medications free of cost to eligible patients who have limited or no prescription insurance coverage and cannot afford the cost of their medication.

To be eligible, your patients must:

• Reside in the United States or a US Territory

• Be treated by a licensed US health care provider on an outpatient basis

• Meet income and insurance guidelines

Visit www.PAP.Novartis.com ↗ or call NPAF at 1-800-277-2254 to learn more about eligibility and how to apply.

Ongoing Support

Novartis Patient Support provides patients with ongoing help to stay on track with their LUTATHERA treatment plan, including:

• A dedicated Novartis Patient Support Team member to answer their questions at every step

• Information on financial support options

• How to prepare for treatment

• What to expect after treatment

• What the most common side effects with treatment are

• Their choice of calls and emails

Novartis Patient Support does not provide clinical advice or care and is not a substitute for patient consultation with a health care provider.

Getting Patients Started with Novartis Patient Support

Coding & Billing Support

Novartis Patient Support is dedicated to helping you get treatment for your patients.

Product Ordering

LUTATHERA can be delivered within 5 days of order placement,* so your patients can begin treatment as soon as possible

With unconstrained supply, we've increased production for faster, on-time delivery of LUTATHERA to meet current and future demand

• 99% on-time delivery for all LUTATHERA orders³

• ~63K doses shipped from launch to date ^4,†

Ready to order LUTATHERA for your patient? Our team is available to assist you every step of the way

*Exceptions may apply for select geographic locations.
^†US commercial orders only.

Resources

Novartis Patient Support has helpful resources for you and your practice to help support your patients throughout their treatment journey.