VYVGART cost and coverage

Resources and information to help you navigate your VYVGART treatment journey

Insurance and coverage Cost and access Understanding your insurance

Insurance and coverage

VYVGART has coveragecoverage from both national and regional payers, with about 85% of insurance plans offering coverage for VYVGART. However, your insurance coverage for VYVGART depends on the terms and conditions listed in your insurance plan. To find out what treatment your insurance covers, visit your health insurer’s website, contact their customer service, or review your summary of benefits.

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VYVGART insurance and coverage guide

As you navigate your VYVGART treatment journey, use this guide that may help you understand the insurance process and how the team at My VYVGART Path may assist you in accessing VYVGART.

Cost and access

Your out-of-pocketout-of-pocket cost for VYVGART may vary depending on your insurance plan. Many different factors may impact your treatment cost. 

Your insurer’s co-payco-pay, co-insuranceco-insurance, deductibledeductible, and out-of-pocket maximumout-of-pocket maximum requirements for prescriptions may affect your out-of-pocket costs.

Where you receive treatment, your site of caresite of care, and whether your provider or specialty pharmacy is in networknetwork may also affect your out-of-pocket costs.

How we can help you navigate the insurance process

My VYVGART Path can help you and your doctor’s office navigate the insurance process and understand your plan’s coverage requirements for VYVGART. Once your doctor enrolls you in My VYVGART Path, the team can complete a benefits investigation to provide information about your insurance coverage, possible out-of-pocket costs, and potential financial assistance programs.

 

Co-pay Program
 

Download the VYVGART brochure

If you have commercial or private insurance, you may be eligible for assistance through the VYVGART Co-pay Program.

My VYVGART Path Patient Support Program

My VYVGART Path Patient Support Program

If you do not have health insurance, you may be eligible for financial assistance through the My VYVGART Path Patient Support Program.

Doctor Discussion Guide
 

Doctor Discussion Guide

Start the conversation and ask your doctor to sign you up for My VYVGART Path. Once you’re enrolled, you’ll be able to have access to information, resources, and personalized support.

VYVGART Insurance and coverage guide

Use this guide to help navigate the insurance process and understand potential next steps.

Understanding your insurance

Getting started on treatment and navigating insurance can feel complicated. Expand each term to learn more about the basics of health insurance.

Medicare is a federal insurance program for adults aged 65 years or older. Younger individuals with certain types of disabilities or permanent kidney failure may also qualify.

Medicare generally covers treatments for FDA-approved indications. This insurance program has four parts (A, B, C, and D) that provide a specific type of coverage.

  • Medicare Part A provides coverage for costs incurred in the hospital
  • Medicare Part B provides medical insurance
  • Medicare Part C (Medicare Advantage) provides Part A and Part B benefits
  • Medicare Part D can help pay for prescription drugs
  • Medicare Supplement Insurance (Medigap) is supplementary Medicare insurance that is sold by private companies to fill gaps in Original Medicare

Medicaid is a health insurance program that is administered by the government. Medicaid may provide coverage for families with low income, individuals who are pregnant, older adults, and people with disabilities. Each state has different eligibility rules.

Commercial insurance, also called private insurance, is provided and administered by a private insurance company. You may receive this insurance from your employer or purchase it from the Health Insurance Marketplace.

A summary of benefits is a short, plain-language summary about a health plan’s benefits and coverage. You can use it to compare the benefits and cost of different insurance plans.

Most insurance companies need to pre-approve specific healthcare services, prescriptions, or equipment before you can receive it. This process for getting approval is called a prior authorization (pre-authorization).

Each insurance company's timeline for the VYVGART prior authorization process may vary. Medicare does not require prior authorization. Reach out to your Nurse Case Manager if you have questions about the process or need an update.

To get started, ask your neurologist to enroll you in

My VYVGART Path

After you and your neurologist decide on VYVGART, your doctor's office will be able to enroll you in My VYVGART Path.

Once you are enrolled, you will receive a call from a Nurse Case Manager and get a welcome kit in the mail.

Already enrolled in My VYVGART Path?

Call 1-833-MY-PATH-1 (1-833-697-2841) to talk with a Nurse Case Manager

VYVGART (efgartigimod alfa-fcab) Injection for Intravenous Use 400 mg/20 mL vial
VYVGART (efgartigimod alfa-fcab) Injection for Intravenous Use 400 mg/20 mL vial

Picture your life in motion

What is the most important information I should know about VYVGART® (efgartigimod alfa-fcab)?

VYVGART may cause serious side effects, including:

  • Infection. VYVGART may increase the risk of infection. In a clinical study, the most common infections were urinary tract and respiratory tract infections. More patients on VYVGART vs placebo had below normal levels for white blood cell counts, lymphocyte counts, and neutrophil counts. The majority of infections and blood side effects were mild to moderate in severity. Your health care provider should check you for infections before starting treatment, during treatment, and after treatment with VYVGART. Tell your health care provider if you have any history of infections. Tell your health care provider right away if you have signs or symptoms of an infection during treatment with VYVGART such as fever, chills, frequent and/or painful urination, cough, pain and blockage of nasal passages/sinus, wheezing, shortness of breath, fatigue, sore throat, excess phlegm, nasal discharge, back pain, and/or chest pain.
  • Undesirable immune reactions (hypersensitivity reactions). VYVGART can cause the immune system to have undesirable reactions such as rashes, swelling under the skin, and shortness of breath. In clinical studies, the reactions were mild or moderate and occurred within 1 hour to 3 weeks of administration, and the reactions did not lead to VYVGART discontinuation. Your health care provider should monitor you during and after treatment and discontinue VYVGART if needed. Tell your health care provider immediately about any undesirable reactions.

Before taking VYVGART, tell your health care provider about all of your medical conditions, including if you:

  • Have a history of infection or you think you have an infection
  • Have received or are scheduled to receive a vaccine (immunization). Discuss with your health care provider whether you need to receive age-appropriate immunizations before initiation of a new treatment cycle with VYVGART. The use of vaccines during VYVGART treatment has not been studied, and the safety with live or live-attenuated vaccines is unknown. Administration of live or live-attenuated vaccines is not recommended during treatment with VYVGART.
  • Are pregnant or plan to become pregnant and are breastfeeding or plan to breastfeed.

Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

What are the common side effects of VYVGART?

The most common side effects of VYVGART are respiratory tract infection, headache, and urinary tract infection.

These are not all the possible side effects of VYVGART. Call your doctor for medical advice about side effects. You may report side effects to the US Food and Drug Administration at 1-800-FDA-1088.

What is VYVGART?

VYVGART is a prescription medicine used to treat a condition called generalized myasthenia gravis, which causes muscles to tire and weaken easily throughout the body, in adults who are positive for antibodies directed toward a protein called acetylcholine receptor (anti-AChR antibody positive).

Please see the full Prescribing Information for VYVGART and talk to your doctor.

What is the most important information I should know about VYVGART® (efgartigimod alfa-fcab)?

VYVGART may cause serious side effects, including:

  • Infection. VYVGART may increase the risk of infection. In a clinical study, the most common infections were urinary tract and respiratory tract infections. More patients on VYVGART vs placebo had below normal levels for white blood cell counts, lymphocyte counts, and neutrophil counts. The majority of infections and blood side effects were mild to moderate in severity. Your health care provider should check you for infections before starting treatment, during treatment, and after treatment with VYVGART. Tell your health care provider if you have any history of infections. Tell your health care provider right away if you have signs or symptoms of an infection during treatment with VYVGART such as fever, chills, frequent and/or painful urination, cough, pain and blockage of nasal passages/sinus, wheezing, shortness of breath, fatigue, sore throat, excess phlegm, nasal discharge, back pain, and/or chest pain.
  • Undesirable immune reactions (hypersensitivity reactions). VYVGART can cause the immune system to have undesirable reactions such as rashes, swelling under the skin, and shortness of breath. In clinical studies, the reactions were mild or moderate and occurred within 1 hour to 3 weeks of administration, and the reactions did not lead to VYVGART discontinuation. Your health care provider should monitor you during and after treatment and discontinue VYVGART if needed. Tell your health care provider immediately about any undesirable reactions.

Before taking VYVGART, tell your health care provider about all of your medical conditions, including if you:

  • Have a history of infection or you think you have an infection
  • Have received or are scheduled to receive a vaccine (immunization). Discuss with your health care provider whether you need to receive age-appropriate immunizations before initiation of a new treatment cycle with VYVGART. The use of vaccines during VYVGART treatment has not been studied, and the safety with live or live-attenuated vaccines is unknown. Administration of live or live-attenuated vaccines is not recommended during treatment with VYVGART.
  • Are pregnant or plan to become pregnant and are breastfeeding or plan to breastfeed.

Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

What are the common side effects of VYVGART?

The most common side effects of VYVGART are respiratory tract infection, headache, and urinary tract infection.

These are not all the possible side effects of VYVGART. Call your doctor for medical advice about side effects. You may report side effects to the US Food and Drug Administration at 1-800-FDA-1088.

What is VYVGART?

VYVGART is a prescription medicine used to treat a condition called generalized myasthenia gravis, which causes muscles to tire and weaken easily throughout the body, in adults who are positive for antibodies directed toward a protein called acetylcholine receptor (anti-AChR antibody positive).

Please see the full Prescribing Information for VYVGART and talk to your doctor.