What may be right for me?

Our goal is to help bring you solutions and, above all, make the process of getting information easier for you. MyALPROLIXTM is about connecting you to other resources, solutions, and answers you want.

MyALPROLIXTM Options:

Free Trial

Free Trial Plus Program*

Receive your first 30-day supply of ALPROLIX immediately with a valid prescription from your healthcare provider. You may also be able to receive free factor for up to one year, if needed.

How it works:

  • Download and complete the Free Trial Plus Form and bring it to your healthcare provider
  • Your healthcare provider will submit the form with a prescription for ALPROLIX
  • A MyALPROLIXTM Coordinator will contact you within 2 business days to confirm coverage and delivery details
  • Once approved, your 30-day supply ships within 24 hours

You may be eligible if you:

  • Have not tried ALPROLIX
  • Are being treated by a licensed doctor in the United States or Puerto Rico
  • Have commercial insurance
    • Those with federal and state government insurance, such as Medicare, Medicaid, or TRICARE® are not eligible.

Download the Free Trial Plus Form

Copay Program

Copay Program*

Offers savings up to $12,000 per year on out-of-pocket costs associated with your prescription of ALPROLIX, whether you are new to ALPROLIX or already on therapy.

Here's how it works:

  • Download, complete, and sign the MyALPROLIX Enrollment Form or call MyALPROLIX at 1-855-MyALPROLIX (692-5776)
  • Fax the completed form to 1-855-398-7634
  • A MyALPROLIX Coordinator will contact you within 24-48 hours to confirm enrollment or request additional information

The Copay Program does not cover costs associated with administration of therapy, such as office visits, infusion costs, or other professional services.

You may be eligible if you:

  • Have commercial insurance
    • Those with federal and state government insurance, such as Medicare, Medicaid, or TRICARE® are not eligible.
  • Are being treated by a licensed doctor in the United States or Puerto Rico
  • Have a United States pharmacy

Biogen reserves the right to rescind, revoke, or amend this offer without notice

Factor Access

Factor Access Program*

Helps you access ALPROLIX, even if your insurance coverage is interrupted- for example, you are between jobs or changing insurers.

There are different reasons why you may find yourself in a situation where your insurance coverage for ongoing therapy, such as ALPROLIX, may be interrupted. You may be between jobs, or changing insurers, or you might reach the lifetime insurance cap or your annual dollar limit.


Whatever the situation, a MyALPROLIXTM Coordinator can answer your questions to help you get continued access to ALPROLIX.

How it works:

  • Download, complete, and sign the MyALPROLIX Enrollment Form or call MyALPROLIX at 1-855-MyALPROLIX (692-5776)
  • Fax the completed form to 1-855-398-7634
  • A MyALPROLIX Coordinator will contact you within 24-48 hours to confirm enrollment or request additional information
  • If eligible, your ALPROLIX will be provided for free

You may be eligible if you:

  • Experienced a gap in your insurance coverage
  • Reached your maximum insurance coverage limit
  • Have no prescription coverage
Phone Vector

Questions?

Call 1-855-MyALPROLIX (692-5776)

Monday through Friday, 8 AM to 8 PM, ET

*Eligibility restrictions apply; please visit ALPROLIX.com for more information.
Phone Vector

Find what's right for you

To help us determine the MyALPROLIXTM resources that are right for you, please tell us a little more about yourself. Your responses to the few simple questions below about your insurance and treatment will allow us to recommend resources for which you may be eligible.

If you need assistance, a MyALPROLIXTM Coordinator is only a phone call away.

Are you a person with hemophilia B or a caregiver of a person with hemophilia B?

Have you tried ALPROLIX previously?

Which best describes your insurance situation?

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.