Try ALPROLIX for 3O days ‒ free

With the Free Trial Plus Program, you may be eligible to receive a 30-day supply of free factor. You may also be eligible to receive free factor for up to 1 year, if needed, until your healthcare coverage begins.

Discuss with your healthcare provider (HCP) if ALPROLIX is a good choice for you.

If you and your HCP decide to use ALPROLIX, here's how it works:
  • Download, complete, and sign the Free Trial Plus Enrollment Form and bring it to your HCP
  • Your HCP will submit the form to MyALPROLIXTM Services
  • A MyALPROLIX Coordinator will contact you within 2 business days to confirm coverage and delivery details
  • If eligible, your 30-day supply will be shipped to you within 24 hours
  • Biogen will continue to provide you with ALPROLIX for free until your insurance coverage begins, for up to one year
Initiate treatment with ALPROLIX under the supervision of a qualified healthcare provider experienced in the treatment of hemophilia B.

Find out more about other financial support available through MyALPROLIX.

This document requires Adobe® Reader®.

Don't have Adobe® Reader®?

Download it here.

  • Q

    How do I know if I'm eligible to receive a free 30-day supply of ALPROLIX?

    A

    You may be eligible for the Free Trial Plus Program if:
    • This is your first prescription of ALPROLIX
    • You are uninsured, or
    • You are insured, with the exception of government healthcare coverage, such as Medicare, Medicaid, or Tricare
    • Other restrictions may apply
  • Q

    Can I get a free 30-day supply if I'm already using ALPROLIX?

    A

    No. You are only eligible for the Free Trial Plus Program if you have not yet started treatment with ALPROLIX. There may be other programs to help with your specific situation. Call 1-855-MyALPROLIX (692-5776) Monday through Friday 8 AM to 8 PM, ET to speak with your MyALPROLIX Coordinator.

Indications
ALPROLIX [Coagulation Factor IX (Recombinant), Fc Fusion Protein] is a recombinant DNA derived, coagulation factor IX concentrate indicated in adults and children with Hemophilia B for:
  • On-demand treatment and control of bleeding episodes
  • Perioperative management of bleeding
  • Routine prophylaxis to reduce the frequency of bleeding episodes
ALPROLIX is not indicated for induction of immune tolerance in patients with Hemophilia B.
Important Safety Information

Do not use ALPROLIX if you are allergic to ALPROLIX or any of the other ingredients in ALPROLIX.

Tell your healthcare provider if you have or have had any medical problems, take any medicines, including prescription and non-prescription medicines, supplements, or herbal medicines, have any allergies and all your medical conditions, including if you are pregnant or planning to become pregnant, are breastfeeding, or have been told you have inhibitors (antibodies) to factor IX.

Allergic reactions may occur with ALPROLIX. Call your healthcare provider or get emergency treatment right away if you have any of the following symptoms: difficulty breathing, chest tightness, swelling of the face, rash, or hives.

Your body can also make antibodies called “inhibitors” against ALPROLIX, which may stop ALPROLIX from working properly.

ALPROLIX may increase the risk of formation of abnormal blood clots in your body, especially if you have risk factors for developing clots.

Common side effects of ALPROLIX include headache and abnormal sensation of the mouth. These are not all the possible side effects of ALPROLIX. Talk to your healthcare provider right away about any side effect that bothers you or does not go away, and if bleeding is not controlled using ALPROLIX.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see full Prescribing Information.