Programs and Services

Our Kadmon ASSIST team is
available to help you Monday
through Friday, 8 AM-8 PM ET.

Phone:
1-844-KADMON1 (523-6661)
Fax:
1-833-635-1481

Insurance

A Kadmon ASSIST Case Manager will review patients' insurance coverage, discuss with patients the programs that are available to them and assist with the prior authorization (PA) or the medical exception/appeals process.

Kadmon ASSIST will help to gather relevant nonclinical information to support the completion and submission of a PA/
Nonformulary Exception (NFE)
form. If the PA/NFE form is
denied, Kadmon ASSIST will
offer assistance with appeals.
Upon PA approval, a Kadmon ASSIST Case Manager will follow up with the provider to address any outstanding questions or concerns they may have.

Institutions seeking Kadmon
ASSIST PA/appeals assistance are offered the option to have their prescription returned once approved so they can dispense product directly to patients.

Access

The Quick Start Program
delivers a free 30-day supply of
REZUROCK^® (belumosudil) tablets to eligible patients
who are experiencing a delay
in their coverage decision for their
first REZUROCK prescription.

Eligibility criteria

Patients must be enrolled in
Kadmon ASSIST and provide
consent
Patients must be new to
therapy (initial fill) with
REZUROCK
Patients must have a valid
prescription for REZUROCK
with on-label diagnosis
Patients must reside in the
United States or its territories
Patients must have prescription drug coverage
Patients must have
a coverage barrier, such as a
PA, in obtaining their
treatment that will take
longer than 5 business days

The Bridge Program delivers a
free 30-day supply of
REZUROCK to eligible patients
who are facing an interruption
in their insurance coverage.

Eligibility criteria

Patients must be enrolled in
Kadmon ASSIST and provide
consent
Patients must already be on
therapy with REZUROCK and
face an interruption in
insurance coverage
Patients must have a valid
prescription for REZUROCK
with on-label diagnosis
Patients must be
commercially or privately
insured
Patients must reside in the
United States or its territories
Patients must have a
coverage barrier, such as a
PA, change in insurance status, job change or extended foreign travel, in obtaining their treatment

The Kadmon ASSIST PAP helps eligible patients who do not have insurance coverage or who have trouble affording REZUROCK. Through the PAP, patients may be eligible to receive a free supply of REZUROCK for up to 12 months.

Eligibility criteria

Patients must be enrolled in Kadmon ASSIST and provide consent
Patients must provide proof of income and out-of-pocket expenses
Patients must have a valid prescription for REZUROCK with on-label diagnosis
Patients must reside in the United States or its territories
Patients must be uninsured or underinsured
Patients must meet additional income criteria and program requirements

Kadmon ASSIST will help identify a specialty pharmacy within the REZUROCK network and help coordinate product shipment to a preferred address.

Patients who are not eligible for any affordability programs through Kadmon ASSIST may be referred to an independent charitable foundation for assistance.

All patients are eligible for benefits investigation and verification services, as well as adherence support.

Co-Pay

Eligible patients with commercial or private insurance pay as low as $0 per month for their REZUROCK
prescription.^a

Eligibility criteria

Patients must be commercially or privately insured
Patients enrolled in a state- or federally funded insurance program are not eligible (eg, Medicare
Part D, Medicaid, TriCare)
Cash-paying patients are not eligible
Patients must have a valid prescription for REZUROCK with on-label diagnosis
Patients must be a resident of the United States or its territories
Patients must be aged ≥12 years

Enroll an eligible patient in the
Commercial Co-pay Savings
Program

^aPatient Terms and Conditions: The Kadmon ASSIST Commercial Co-pay Savings Program provides co-pay/coinsurance support for out-of-pocket costs on REZUROCK® (belumosudil) tablets prescriptions. A yearly maximum benefit applies. Limit one 30-day supply per 30 days. This program is not health insurance. This program is for commercially or privately insured patients only; uninsured or cash-paying patients are not eligible. Patients are not eligible if prescriptions are paid, in whole or in part, by any state- or federally funded programs, including, but not limited to, Medicare (including Part D, even in the coverage gap) or Medicaid, Medigap, VA, DOD, TriCare, private indemnity or HMO insurance plans that reimburse you for the entire cost of your prescription drugs, or where prohibited by law. The co-pay program may not be combined with any other rebate, coupon or offer. Kadmon Pharmaceuticals, LLC, reserves the right to rescind, revoke or amend this offer at any time without further notice. Any savings provided by the co-pay program may vary depending on patients‘ out-of-pocket costs. Card is valid through December 31 of the year of activation. On January 1 of the following year, the card automatically resets and is subject to annual limits if the prescription benefit remains the same. Upon registration, patients receive all program details.

Education

All eligible patients enrolled in Kadmon ASSIST will receive a Patient Starter Kit with their first prescription of REZUROCK, which includes disease information and treatment education. Kadmon ASSIST Case Managers will connect eligible patients with an adherence nurse who can answer their questions about REZUROCK.^b

^bKadmon does not provide medical advice, diagnosis, or treatment recommendations.

Program Enrollment Form

Find out which services patients may be eligible for by completing this form. Our Kadmon ASSIST Case Managers can determine which programs are available to patients.