Access & Financial Assistance
SYNAGIS CONNECT® offers support to help appropriate
patients get access to SYNAGIS.
Help your highest-risk RSV patients get SYNAGIS
Describes the pathways to get patients started on SYNAGIS
Framework that may be useful to document medical necessity when requesting approval for eligible patients
Explains the general process for completing prior authorization for eligible patients
Explains information that may be useful in the event a prior authorization request is denied by a health plan, and provides general guidance on the appeal process
List of useful codes for billing and reimbursement of SYNAGIS for eligible patients
SYNAGIS CONNECT® is a support program that provides options for patient healthcare coverage and financial assistance information that may be available to help appropriate patients get access to SYNAGIS.*
Authorization to enroll a patient in SYNAGIS CONNECT®
View form en español
How can SYNAGIS CONNECT® help provide support
Provides the required information to prescribe SYNAGIS through a specialty pharmacy and/or enroll a patient in SYNAGIS CONNECT®
*SYNAGIS CONNECT® is not a CoverMyMeds LLC program or solution. SYNAGIS CONNECT® is owned and operated solely by Sobi, Inc.
Eligibility requirements apply: Patient must be a resident of the US or Puerto Rico. Patient must be commercially insured. There are no income requirements to participate in the program. Patient must not be insured by any government, state, or federally funded prescription program, including Medicare, Medicaid, Medigap, VA, DOD, or TRICARE.
SYNAGIS Copay Assistance Program
The SYNAGIS Copay Assistance Program helps eligible patients with commercial insurance manage out-of-pocket costs. Patients may save up to a maximum of $6,000 per calendar year. See terms and conditions.
DISCLAIMER: The SYNAGIS Copay Assistance Program covers only the cost of the medication, not the cost of administration.
How to Order SYNAGIS
SYNAGIS is only available for order through approved Specialty Distributors
McKesson Plasma and Biologics
Cardinal Health Specialty Distribution
Acute, retail, and specialty pharmacies: orderexpress.cardinalhealth.com
McKesson Specialty Care Distribution
SYNAGIS is only available through a Limited Distribution Specialty Pharmacy Network
Order SYNAGIS® (palivizumab) by calling or faxing prescriptions to these specialty pharmacies.
CVS Specialty Pharmacy
(Including US Bioservices)
Phone: 1-800-753-2777 (ext. 1307886)
In Puerto Rico
NICU=neonatal intensive care unit; RSV=respiratory syncytial virus.
All imagery is for illustrative purposes only.