Insurance Coverage Information

PAH Pathways Interactive Resource Locator

PAH Pathways offers a wealth of resources including one-on-one support from PAH Pathways counselors in your area.
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accent PAH Pathways counselors help simplify the process for your patients on Tracleer by:

Verifying insurance coverage and inform you of insurance requirements like prior authorization
Clarifying potential co-payment or out-of-pocket costs before your patient's prescription is filled
Advising on financial assistance programs sponsored both by Actelion and alternative sources

Financial Assistance Programs

When your patients need help paying for Tracleer

The PAH Pathways MasterCard^® provides the first month of Tracleer at no cost to most privately insured, eligible patients^*
Caring Voice Coalition (CVC)^† offers a PAH co-pay assistance program for eligible patients
- CVC may also provide assistance with insurance policy premiums, emergency financial needs, and peer support groups
- Contact CVC toll free at 1-888-267-1440 or visit www.caringvoice.org

Medicare Part D

Tracleer is covered for reimbursement under Medicare Part D
CVC may offer assistance to those eligible patients who report a co-pay hardship
- CVC offers assistance with selecting Part D plans
- CVC may help at all levels of Medicare benefit structure

Medicaid and other government or public payers

Medicaid and other public or government payers cover Tracleer in all 50 states¹
The out-of-pocket cost for patients varies by state and program
Typical co-pays are $5 or less for patients with no spend-down or who have met their spend-down¹
- Spend-down is a process that allows people with incomes above the Medicaid limit to still receive Medicaid. The process allows patients to "spend down" their assets until they qualify for coverage

Uninsured

If a patient is currently uninsured or is rendered uninsured and has demonstrated financial hardship, PAH Pathways offers both short- and long-term assistance programs for Tracleer access to eligible patients.
- Tracleer Patient Assistance Program (TPAP) may provide therapy at no cost for up to 12 months and may be renewed
- Tracleer Bridge program offers up to 90 days of Tracleer at no cost to patients who may experience a short-term coverage gap

¹ Data on file, Actelion Pharmaceuticals, US
^*Ineligible patients: Any patients whose prescriptions are paid for by the government, Medicare, Medicaid, VA/DOD (Tricare), or Indian Health Service, patients in Massachusetts and Puerto Rico, or where prohibited by law.
^†Caring Voice Coalition is a nonprofit, independent third-party organization.
MasterCard is a registered trademark of MasterCard International.

Tracleer is indicated for the treatment of pulmonary arterial hypertension (PAH) in patients with WHO Class II-IV symptoms, to improve exercise ability and decrease the rate of clinical worsening. Patients with WHO Class II symptoms showed reduction in the rate of clinical deterioration and a trend for improvement in walk distance. Physicians should consider whether these potential benefits are sufficient to offset the risk of liver injury in WHO Class II patients, which may preclude future use as their disease progresses.

Tracleer Important Safety Information

Because of the associated risks, Tracleer may be prescribed only through the Tracleer Access Program. Potential for serious liver injury (including, after prolonged treatment, rare cases of liver failure and unexplained hepatic cirrhosis in a setting of close monitoring) – Liver monitoring of all patients is essential prior to initiation of treatment and monthly thereafter. High potential for major birth defects – Pregnancy must be excluded and prevented through the use of reliable forms of birth control; monthly pregnancy tests should be obtained.

Contraindicated for use with cyclosporine A and glyburide.

Please see full Prescribing Information, including BOXED WARNING and Medication Guide.

Ventavis

For full Prescribing Information for Ventavis, click here.