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ALYGLO SUPPORT FOR HEALTHCARE PROVIDERS


Co-Pay Assistance

If you need co-pay assistance for your patient please visit ALYGLO Co-Pay Assistance Portal For Providers by clicking the button below. Eligible patients can receive up to $15,000 to cover the deductible, co-pay, and/or coinsurance for ALYGLO.

    ELIGIBILITY CRITERIA FOR CO-PAY ASSISTANCE

    • Patient must be a US resident
    • Patient must express financial need
    • Assistance is available to commercially insured patients only

    RESTRICTIONS

    • Assistance covers only out-of-pocket expenses for the drug portion; administration supplies and nursing copay costs are not covered through the program
    • Patients are ineligible for copay assistance if they participate in Medicare, Medicaid, Medigap, Veterans Affairs, Department of Defense, Tricare, or any other federal or state-funded programs.



Additional Reimbursement Support

For any inquiries or assistance with reimbursement, please don't hesitate to contact our dedicated Support Team at (888) 501-8040. We are fully committed to guiding you through any questions or concerns you may encounter.

Please reach out to our Reimbursement Support Team at (888) 501-8040 if your patient:

  • Requires benefit verification
  • Requires prior authorization

We're here to support you every step of the way and eagerly anticipate the opportunity to assist you.



This program is subject to change or discontinuation by GC Biopharma at any time, for any reason, and with or without prior notice.


INDICATION

ALYGLO™ is indicated for the treatment of primary humoral immunodeficiency (PI) in adults aged 17 years and older. This includes, but is not limited to, congenital agammaglobulinemia, common variable immunodeficiency (CVID), Wiskott-Aldrich syndrome, and severe combined immunodeficiencies.

IMPORTANT SAFETY INFORMATION

WARNING: THROMBOSIS, RENAL DYSFUNCTION and ACUTE RENAL FAILURE

  • Thrombosis may occur with immune globulin intravenous (IGIV) products, including ALYGLO. Risk factors may include: advanced age, prolonged immobilization, hypercoagulable conditions, history of venous or arterial thrombosis, use of estrogens, indwelling vascular catheters, hyperviscosity, and cardiovascular risk factors.
  • Renal dysfunction, acute renal failure, osmotic nephropathy, and death may occur with the administration of IGIV products in predisposed patients.
  • Renal dysfunction and acute renal failure occur more commonly in patients receiving IGIV products containing sucrose. ALYGLO does not contain sucrose.
  • For patients at risk of thrombosis, renal dysfunction or renal failure, administer ALYGLO at the minimum dose and infusion rate practicable. Ensure adequate hydration in patients before administration. Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk for hyperviscosity.

  • For more information about ALYGLO, please see full Prescribing Information

    You are encouraged to report negative side effects of prescription drugs to GC BioPharma USA. Email medicalinfo@gcbiopharmausa.com or call 1-833-426-6426