Access & Support
Coverage and Affordability
PLUVICTO is accessible for most insured patients*
The other 20% 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-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 PLUVICTO by state, payer, and plan type†
View insurance coverage for PLUVICTO
Download prior authorization forms and coverage summaries for PLUVICTO
Obtain payer contact information
†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 can help your patients start and stay on treatment
We can help you and your patients with:
Insurance Support
Get help navigating the insurance process.
Benefits Verification
Once you’ve enrolled your patients in Novartis Patient Support, our team can conduct a benefits verification to better understand your patients’ coverage.
Prior Authorization
We can help support the prior authorization and appeals process as you navigate your patients’ access to treatment.
Financial Support
Co-Pay Plus may help make PLUVICTO affordable for eligible patients.
Patient Education
After you prescribe PLUVICTO, Novartis Patient Support can help your patients navigate some of the most common questions about treatment, including:
How to prepare for treatment
What to expect after treatment
What are the potential costs and financial support options?
What are the most common side effects with treatment?
Coding & Billing
Get helpful information about how to file claims.
To find a full list of codes that may be relevant to PLUVICTO, download our Coding & Billing Guide.
Product Ordering
Ready to order PLUVICTO for your patient? Our team is available to assist you every step of the way.
Helpful Resources
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Novartis Patient Support Overview for HCPs
PLUVICTO Co-Pay Reimbursement Form for Patients
Start Form
PLUVICTO at a Glance
LOCAMETZ at a Glance
PLUVICTO Sample Letter of Appeal
PLUVICTO Co-Pay Reimbursement Form for HCPs
PLUVICTO Reimbursement Guide
