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Financial assistance

Financial assistance

AVEO ACE Co-pay Assistance Program*

Patients who have commercial or private insurance may be eligible to enroll in the AVEO ACE Co-pay Assistance Program. If approved, your patient could pay as little as $0 for their FOTIVDA. Annual limits of $25,000 apply.

Eligibility requirements

A patient must:

  • Be a resident of the US or US Territory
  • Have a commercial (private) insurance plan
  • Not be enrolled in any government-funded insurance programs (Medicare, Medicaid, etc)

AVEO ACE Patient Assistance Program

Patients who are uninsured or underinsured may access FOTIVDA free of charge through the AVEO ACE Patient Assistance Program.

Eligibility requirements

The FOTIVDA® (tivozanib) Co-pay Card program provides eligible, commercially insured patients up to $25,000 per calendar year toward a patient’s FOTIVDA prescription costs. The FOTIVDA Co-pay Card program is not valid for uninsured patients. Annual and transaction limits apply. No other purchase is necessary.  

Eligible patients must be prescribed FOTIVDA for an FDA-approved indication.

Eligible patients with a FOTIVDA prescription may pay as little as $0 toward their out-of-pocket costs. Patients must be 18 years or older to enroll and activate a co-pay card. The program can only be used by eligible residents of the United States, Puerto Rico, and Guam, and at participating pharmacies.

The offer does not constitute prescription drug coverage and is not intended to substitute for health insurance. The offer is not available to patients receiving any form of prescription coverage under any federal, state, or government-funded insurance program or where prohibited by law. Such programs include Medicare (including Medicare Part D and Medicare Advantage), Medicaid, TRICARE, Department of Defense, and Veterans Affairs programs. If at any time a patient begins receiving prescription drug coverage under any federal, state, or government-funded healthcare program, the patient will no longer be able to use the FOTIVDA Co-pay Card and the patient must call AVEO ACE patient support at 1-833-368-4832 to terminate participation.

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How to Apply

To determine if your patient may be eligible for the AVEO ACE Patient Assistance Program, you and your patient must:

Enroll online

OR

Download and print

the AVEO ACE enrollment form

and fax the completed form
to 1-888-920-2830.

AVEO ACE will evaluate the patient for eligibility and communicate the results to you and your patient within 24 hours.

DISCLAIMER:

AVEO ACE makes no representation or guarantee concerning reimbursement or coverage for any service or item. Information provided through the AVEO ACE program does not constitute medical or legal advice and is not intended to be a substitute for a consultation with a licensed healthcare professional, legal counsel, or applicable third-party payer(s). AVEO ACE reserves the right to modify the program at any time without notice.

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